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Biomedical subjects

Y Satoh

Publications and source records attributed to Y Satoh.

At least 667 records · Page 37Linked to original sources

Vascular and metabolic reserve in Alzheimer's disease.

Vascular and metabolic reserve were analyzed in probable Alzheimer's disease (AD) and vascular dementia (VaD). Cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rate of oxygen (CMRO(2)), and oxygen extraction fraction (OEF) were measured quantitatively with positron emission tomography (PET). Vascular reactivity (VR) was also calculated by comparing the CBF during 5% CO(2) inhalation with the CBF during normal breathing. Vascular transit time (VTT) that was calculated as a ratio of CBV/CBF and VR reflect vasodilating capacity of the small resistance vessels, whereas OEF designates metabolic (oxygen-extraction) reserve in threatening brain ischemia. Significant increase in OEF was seen in the parieto-temporal cortex and both VTT and VR were preserved in AD patients. By constrast, there was no significant increase in OEF whereas VTT was prolonged and VR was markedly depressed in VaD patients. The increase of OEF and preserved VTT and VR seen in AD patients indicate the possible participation of vascular factors in the pathogenesis of AD perhaps at the capillary level.

Aged↗

MR imaging of bilateral adrenal hemorrhage.

Serial magnetic resonance (MR) findings (2 weeks and 7 weeks after onset of symptoms) in a case of bilateral adrenal hemorrhage, complicating severe infection are reported. Spin echo 600/20 images initially showed triangular enlarged adrenal glands with intermediate intensity centers and concentric high intensity outer rings. Spin echo 2,000/60 images showed inhomogeneous intensity. Follow-up MR examination 5 weeks later demonstrated that the hematomas decreased in size, and the signal intensity changes showed resolving hematomas (i.e., increased signal intensity centrally, decreased peripherally).

Adrenal Gland Diseases↗

Evaluation of high-resolution CT after tympanoplasty.

The temporal bones of 28 patients who underwent tympanoplasty were evaluated with high-resolution CT (HRCT). Seventeen patients had undergone tympanoplasty with a columella, used to form an ossicular reconstruction. The incus body was used as the columella in 4 patients and a prosthesis was used in 13 patients. No columella was used in the other 11 patients. After tympanoplasty, CT demonstrated normal appearance in 8 patients. Of the other 20 patients, 16 were diagnosed with chronic otitis media, and 4 were diagnosed with recurrent cholesteatoma on the basis of follow-up CT examinations. Seven underwent reoperation. In all 4 patients with recurrent cholesteatoma, the diagnosis was pathologically confirmed at reoperation. In 1 patient diagnosed with chronic otitis media, the pathological diagnosis was recurrent cholesteatoma. The columellae in 8 of the 17 patients could not be identified on CT because of surrounding soft tissue mass, but in the other 9 patients the condition of the ossicular reconstruction was well demonstrated. Prosthesis dislocation was apparent in 2 patients. We recommend HRCT examination in the follow-up of tympanoplasty patients.

Cholesteatoma↗

Liver metastases from colon cancer with intra-bile duct tumor growth: radiologic features.

PURPOSE: Our goal was to characterize the radiologic features of liver metastases from colon cancer with intrahepatic bile duct (IHBD) dilatation. METHOD: Radiologic findings of liver metastases from colon cancer with IHBD dilatation of four patients were compared with pathologic findings. RESULTS: The cause of bile duct dilatation in all cases was due to papillary tumor growth in the bile duct. In two patients, intra-bile duct tumor growth (IBDTG) was observed on imaging. In the other two patients, IBDTG was not observed, but a nontapered abrupt obstruction of a dilated bile duct was seen, corresponding to the microscopically proven papillary tumor growth in the ductal lumen. In three patients who underwent an extensive hepatic resection, there has been no recurrence. In one patient who had a nonanatomic limited resection, a recurrence was seen 1 year after surgery. CONCLUSION: When liver tumor with IBDTG is suspected on imaging, liver metastases should be considered in the differential diagnosis besides hepatocellular carcinoma or cholangiocellular carcinoma. Careful preoperative assessment for IBDTG by imaging is essential to determine the extent of surgical resection.

Aged↗

Lack of plasma leptin response to feeding in newborn infants.

OBJECTIVE: Previous reports of the postprandial regulation of leptin are controversial, and there have been few studies on the effects of breast-feeding on postprandial regulation in newborn infants. We examined the response of plasma leptin to breast- and formula-feeding in newborn infants. METHODS: We measured the plasma leptin levels using an enzyme-linked immunosorbent assay kit before and after feeding in 12 breast-fed and 11 formula-fed mature infants. RESULTS: There was no significant difference in plasma leptin levels in breast-fed infants before and after feeding or in artificially fed infants before and after feeding. CONCLUSION: Our results suggest that feeding does not play a role in the acute response of circulating leptin levels in either breast- or formula-fed infants.

Breast Feeding↗

Analysis of the prognosis and the recovery process of profound facial nerve paralysis secondary to acoustic neuroma resection.

The prognosis and the recovery process of facial nerve paralysis were reviewed in 74 patients who, despite preservation of nerve continuity, showed no facial movement after acoustic neuroma resection. In 50 or 67.6% of patients, facial movement recovered sufficiently so as not to require any reanimation procedures. However, no apparent sign of remission was observed for 7-49 months in the other 24 patients (32.4%), and hypoglossal-facial nerve anastomosis was performed in 20 of these patients. When remission was seen, the first sign of muscle movement appeared most frequently after 3-4 months but, in a small number of patients, it was also seen within 1.5 months or after 5-10 months. Based upon these results, the timing of reanimation procedures for facial nerve paralysis following acoustic neuroma resection is discussed.

Adult↗

Hypoglossal-facial nerve anastomosis after acoustic neuroma resection: influence of the time anastomosis on recovery of facial movement.

Facial movement following hypoglossal-facial nerve anastomosis was investigated in 29 acoustic neuroma patients. The amount of facial movement was assessed using both the grading system of House and Brackmann and the revised grading scale of Yanagihara. The data were analyzed to determine the influence of the time elapsed between tumor resection and anastomosis upon recovery of facial movement. A slightly larger number of patients with delayed anastomosis (7-23 months) showed minimally poorer results than those with early anastomosis (within 3 months). However, these differences were not statistically significant. Moreover, there was no apparent relationship between the duration of facial nerve paralysis and the recovery of facial movement within either of these two groups. These results showed that hypoglossal-facial nerve anastomosis can be delayed up to 2 years following tumor resection with only minimal effect on the recovery of facial movement.

Adult↗

Electromyographic analysis of profound facial nerve paralysis following acoustic neuroma resection.

The aim of our retrospective study was to determine whether electromyographic findings (motor unit action potentials, MUAPs) can be used in long-term prognosis for profound facial nerve paralysis in patients whose nerve continuity is preserved during surgery for acoustic neuroma. The orbicularis oris, frontal, and orbicularis oculi muscles were examined for the occurrence of MUAPs in 48 such patients. In 30 patients who recovered from complete paralysis within 10 months after surgery, MUAPs in the first two muscles tended to precede the first sign of facial movement. MUAPs appeared in the orbicularis muscle in 80% of these patients at 1 month and in all at 5 months. In the frontal and orbicularis oculi muscles, MUAPs occurred in only 0-20% of these patients in the first month; within 3-5 months the number increased rapidly, and MUAPs were present in 95% of these patients at 10 months. In the remaining 18 patients with long-term complete paralysis (at least 1 year), MUAPs appeared solely in the orbicularis oris muscle: in 20% of these patients in the first month after surgery. While this number slowly rose, there was no period of rapid increase later. We conclude that the occurrence of MUAPs in the orbicularis oris and frontal muscles within 3 months of surgery indicates a good prognosis for reversal of facial nerve paralysis.

Anastomosis, Surgical↗

High cellular atypia in a pulmonary tumorlet. Report of a case with cytologic findings.

BACKGROUND: Pulmonary tumorlets are localized lesions of neuroendocrine cell proliferation, usually found in association with chronic pulmonary inflammation. Since they are mostly incidental histologic or radiologic discoveries, they have received little attention, and there have been no reports on their detailed cytology. We describe for the first time the cytologic features of a pulmonary tumorlet and discuss its differential diagnosis. CASE: An abnormal nodule in the right lung field was discovered on a regular checkup by chest roentgenogram in a 70-year-old, nonsmoking female. Intraoperative aspiration cytology demonstrated cohesive, spindle-shaped cells arranged in fascicles or singly. Since these cells showed nuclear atypia, such as hyperchromasia, a coarsely granular chromatin pattern and nuclear grooving, a nonepithelial malignant lesion was suspected and upper lobectomy performed. The final diagnosis was a pulmonary tumorlet on the basis of histologic examination of the resected material. CONCLUSION: This is the first cytologic report of a pulmonary tumorlet. In this case, differential diagnosis was made of a tumor consisting predominantly of spindle-shaped cells. Although cytologic findings included nuclear atypia, the lesion was not malignant.

Aged↗

Cytology of primary pulmonary meningioma. Report of the first multiple case.

BACKGROUND: Ectopic meningiomas arising in the lung are rare. We report here the first multiple primary case diagnosed by intraoperative imprint cytology. CASE: Asymptomatic pulmonary nodules, two in the left and three in the right lung, were found in a 61-year-old woman, and video-assisted thoracoscopic surgery was undertaken. Because the largest tumor was diagnosed as a meningioma by intraoperative imprint cytology using an excised biopsy specimen, further resection was not performed immediately. Histopathologically the tumor was characterized by whorled nests of cells accompanied by psammoma bodies intermingled with a fibrous pattern. The diagnosis was a transitional meningioma, positive for vimentin and epithelial membrane antigen and negative for keratin immunohistochemically. All the nodules were subsequently surgically resected and showed a similar cytohistologic appearance. Ultrastructurally the tumor cells demonstrated interdigitation of adjacent plasma membranes with numerous desmosomes and hemidesmosomes, typical of meningiomas. We failed to detect another primary tumor in the nervous system, and at this writing the patient was healthy three years after the operation. CONCLUSION: Because of the characteristic cytomorphologic features of primary pulmonary meningioma, the cytologic approach provides useful information for therapy.

Adult↗

A case of hepatocellular carcinoma with the sign of Leser-Trelat: a possible role of a cutaneous marker for internal malignancy.

A rare case of hepatocellular carcinoma who developed the complication of the sign of Leser-Trelat is reported. The patient, a 57-year-old male, visited our hospital with complaints of generalized malaise and anorexia. A diagnosis of hepatocellular carcinoma was made based on elevated alpha-fetoprotein measurement, ultrasonography, and hepatic arteriography findings. Chest x-ray film suggested pulmonary metastases of hepatocellular carcinoma. Thereafter, complications of the seborrheic keratosis developed in the trunk and the skin lesion was diagnosed as the sign of Leser-Trelat associated with hepatocellular carcinoma. The patient died of pneumonia 9 months after development of the sign of Leser-Trelat.

Biomarkers, Tumor↗

Immunohistochemical heterogeneity of type 1 blood group antigen expressions in testicular germ cell tumors.

The immunohistochemical expression of type 1 blood group antigens (type 1 BGAs) was analyzed for 30 cases of testicular germ cell tumors (TGCTs), using monoclonal antibodies against DU-PAN-2, CA19-9, Lewis(a) (Le(a)), and Lewis(b) (Le(b)). DU-PAN-2 was expressed very frequently in all of the embryonal carcinomas (ECs). CA19-9 expression was demonstrated in 53% of ECs, but the number of positive cells was generally smaller than that for DU-PAN-2. CA19-9-negative ECs tended to show a higher number of DU-PAN-2-positive cells compared to CA19-9-positive ECs, and ECs in which DU-PAN-2 was more strongly expressed showed a relatively frequent expression of CA19-9. In 36% of seminomas and 56% of yolk sac tumors (YSTs), DU-PAN-2 was weakly expressed, and the positive cells were few in number. Little or no expression of CA19-9 was demonstrated in seminomas and YSTs. Regarding Le(a) and Le(b), the expressions were found to be limited to teratomas at a frequency of 57% and 86%, respectively, with the exception of one EC positive for Lea and one YST positive for Leb. Eighty-six percent of teratomas showed expressions of DU-PAN-2 and CA19-9. DU-PAN-2 was also seen in some intratubular malignant germ cells. The antibodies used were all negative for choriocarcinomas, syncytiotrophoblastic giant cells, and normal testicular tissues. The antigen expressions were predominantly observed on the surface of tumor cells developing luminal structures. In conclusion, although CA19-9 was relatively specific for ECs, it should be emphasized that ECs were rather characteristic of extensive DU-PAN-2 expression. Particularly in CA19-9-negative ECs, a combined analysis of DU-PAN-2 and CA19-9 would be helpful in confirming the histopathologic diagnosis of TGCTs. The clinical significance of DU-PAN-2 in ECs as a tumor marker remains to be clarified. Le(a) and Le(b) expressions were thought to be related to the differentiation or maturation rather than to the malignant transformation in TGCTs.

Adolescent↗

Gonadal vein graft for hepatic artery reconstruction.

BACKGROUND/AIMS: Resection of hepatic arteries is often obligatory on resecting pancreatic, gastric and hepatobiliary malignancies. Hepatic artery reconstruction is required to preserve liver function and blood flow to the bile duct. We applied the gonadal vein to hepatic artery reconstruction. METHODOLOGY: Hepatic artery reconstruction using a gonadal vein graft was performed in two patients: one with gallbladder cancer and the other with recurrent gastric cancer. RESULTS: The right ovarian vein, 2 mm in diameter and 4 cm in length, was grafted for reconstruction between the proper hepatic and the posterior hepatic artery in one patient who underwent modified central hepatic bisegmetectomy and common bile duct resection. The left spermatic vein, 3 mm in diameter and 6 cm in length, was grafted for reconstruction between the celiac artery and the right hepatic artery in the other, who underwent upper abdominal exenteration. The former graft was occluded due to tumor invasion at 4 months after surgery, the latter one was patent at 8 weeks after surgery. CONCLUSIONS: The gonadal vein had an ideal diameter and sufficient length to accomplish hepatic arterial reconstruction. The gonadal vein graft will be a new and preferable addition to the selection of an optimal graft for hepatic arterial reconstruction.

Aged↗

Endoscopic pericardial fenestration for a patient with sustained lupus pericarditis.

A 57-year-old woman was diagnosed in January 1982 with SLE based on ANA 1:640, positive LE cell preparation, proteinuria (3+), and pericarditis. In 1984, 1994, and 1997, the pericardial effusion was noted to have increased without signs of disease exacerbation or cardiac tamponade, and pericardial drainage was repeated to control the effusion. A massive pericardial effusion developed in August 1997. After tuberculosis, hypothyroidism, neoplasm, and progression of SLE were ruled out, we decided to perform pericardial fenestration. A safe and minimally invasive pericardial fenestration was successfully completed endoscopically. Pathologic study of the specimen revealed chronic pericarditis. We consider endoscopic pericardial fenestration to be useful for at risk patients with pericarditis to control the effusion and establish a differential diagnosis.

Endoscopy↗

Effects of nilvadipine on regional cerebral blood flow and skin blood flow in anesthetized cats.

The effects of an intravenous injection of the novel calcium channel blocker, nilvadipine, on the relative regional cerebral blood flow and relative regional skin blood flow were studied in anesthetized cats using the laser-Doppler method. The effects of nilvadipine were compared with those of nicardipine hydrochloride (nicardipine). Nilvadipine and nicardipine both increased the relative regional cerebral blood flow dose-dependently, in spite of their hypotensive effect. At a dose of 32 micrograms/kg, nilvadipine and nicardipine increased the relative regional cerebral blood flow by 61 +/- 8% and 25 +/- 10% of the predrug value, respectively, 15 min after administration. At this time, both drugs induced a comparable degree of hypotension: -18 +/- 3% of the predrug value for nilvadipine and -25 +/- 2% for nicardipine. After nilvadipine, the relative regional cerebral blood flow enhanced by 45 +/- 10% 180 min after drug administration, whereas after nicardipine, it returned to the predrug value within 60 min. In contrast, the increase in relative regional skin blood flow produced by nilvadipine (32 micrograms/kg) and nicardipine (32 micrograms/kg) was 23 +/- 15% and 32 +/- 8% of the predrug value, respectively, 5 min after drug administration. The effect of nicardipine on the relative regional skin blood flow, compared with that of control, was significantly higher. These results indicate that nilvadipine exhibits a pronounced and longer-lasting effect on the relative regional cerebral blood flow, compared with the relative regional skin blood flow, and that its action on the relative regional cerebral blood flow is more potent than that of nicardipine.

Anesthesia↗

Effects of veno-arterial counterpulsation (VACP) on ischemic-injured myocardium. A hemodynamic, ultrastructural and cytochemical study.

An experimental study was performed in order to evaluate the effects of veno-arterial counterpulsation (VACP) on ischemic-injured myocardium. Following ischemic episodes in 9 dogs, reperfusion by VACP was performed under normal temperature for 45 min, while reperfusion by partial cardiopulmonary bypass (PCPB) was performed in another 9 dogs in order to observe cardiac function, myocardial ultrastructure and cytochemical changes. The results thus obtained can be summarized as follows: Cardiac output recovered to 100% of the pre-ischemic value 60 min after weaning from cardiopulmonary bypass in the VACP group; however, only 70% at most could be recovered in the PCPB group. Glycogen granules were favorably maintained during cardiopulmonary bypass or even after the weaning in the VACP group as compared to the PCPB group. Sarcomere length after removal of cardiopulmonary bypass was almost similar to the control value in the VACP group, although this was longer than the control value. Succinate dehydrogenase activity in mitochondria was better maintained in the VACP group than in the PCPB group. From the evidence mentioned above, it was suggested that VACP is useful for the recovery of aerobic metabolism and myocardial contractility in ischemic-injured myocardium.

Acid Phosphatase↗

Spontaneous retrograde dissection of the right common iliac artery: a case report.

Spontaneous retrograde dissection of the right common iliac artery incidentally imaged by intra-arterial digital subtraction angiography (IADSA) and confirmed by contrast infusion computed tomography (CT) is reported. This is the first case report of this extremely rare condition, but histologic verification could not be obtained. The usefulness of IADSA in mapping during catheterization complicated by marked resistance is underscored.

Adult↗

Femoral arterial thrombosis in nephrotic syndrome. Steroid and long term heparin therapy.

Thrombosis due to increased coagulability of the blood is a common complication in patients with nephrotic syndrome. Thrombosis has a tendency to recur in these patients. We recommend steroid and long term heparin therapy after thrombectomy for the prevention of the recurrence of thrombosis in nephrotic patients and for the control of nephrotic syndrome. This report deals with two cases of femoral arterial thrombosis complicated by nephrotic syndrome. In one case the result was not satisfactory despite usual postoperative treatment, while the other case was successfully treated by long term heparin infusion in combination with oral administration of steroid.

Adult↗