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Biomedical subjects

Y Suto

Publications and source records attributed to Y Suto.

At least 19 recordsLinked to original sources

Gene arrangement of the killer cell inhibitory receptor family on human chromosome 19q13.4 detected by fiber-FISH.

Human chromosome 19q13.4 has recently been revealed to be a remarkable region harboring multiple receptor genes of the immunoglobulin (Ig) superfamily differentially expressed on hematopoietic cell lineages. Over the past few years, more than 50 cDNAs have been cloned for the natural killer cell inhibitory receptor (KIR) gene family, which possess two or three Ig-like domains in the extracellular region. In this study, using two genomic DNA probes containing intron sequences of genes corresponding to the two- and three-domain types, we applied two-color-fluorescence in situ hybridization on stretched DNA fiber preparations (fiber-FISH). As a result, 11 positions homologous to KIR genes were found as a cluster within a range of approximately 120 kilobases on a chromatin fiber from human chromosome 19.

Chromosome Mapping

Establishment and characterization of a megakaryoblast cell line with amplification of MLL.

A new cell line with megakaryoblastic features, designated UoC-M1, was established from the malignant cells of a 68-year-old patient with acute myeloid leukemia. The patient's leukemic cells reacted with alpha-naphthyl acetate esterase and acid phosphatase and expressed CD7, CD24, CD34, CD38, CD45, HLA-DR and CD61. Cytogenetic analysis of the patient's malignant cells (and of the UoC-M1 cells) showed a human, male hypodiploid karyotype with many chromosome rearrangements and marker chromosomes. Spectral karyotyping (SKY) analysis complemented the G-banded karyotyping and clarified several chromosomal translocations and identified the marker chromosomes. Fluorescence in situ hybridization (FISH) and SKY analysis demonstrated that one marker chromosome contained three segments of chromosome 9 interspersed with three segments of chromosome 11, as well as a portion of chromosome 19. FISH analysis with a probe for MLL revealed that the UoC-M1 cells contained four copies of the MLL gene. Southern blot analysis determined that the MLL gene had a germline profile while Northern and Western analyses showed that the MLL mRNAs and protein were of the appropriate sizes. This is the first report of amplification of the MLL gene which may be an additional mechanism of leukemogenesis or disease progression.

Aged

End-tidal sevoflurane concentration for tracheal extubation and skin incision in children.

UNLABELLED: We sought to determine minimum alveolar anesthetic concentrations for skin incision (MAC) and for tracheal extubation (MAC(Ex)) for sevoflurane and its associated awakening time and respiratory complications during emergence from sevoflurane anesthesia in children. We studied 40 (20 in each group) unpremedicated pediatric patients ranging in age from 2 to 8 yr. For MAC(Ex) determination, anesthetic induction, tracheal intubation, and maintenance of anesthesia were performed with sevoflurane and N2O in oxygen. However, N2O administration was discontinued at the end of surgery. The ratio of the predetermined end-tidal to inspiratory concentration was maintained at 0.95-1.00 for at least 15 min. The trachea was gently extubated, and smooth tracheal extubation was defined by the absence of gross purposeful muscular movements. In addition, the respiratory complications and awakening time were investigated during emergence from anesthesia for each patient. For MAC determination, anesthesia induction and tracheal intubation were performed with 5% sevoflurane in oxygen. After the predetermined end-tidal sevoflurane concentration had been established and maintained for at least 15 min, skin incision was attempted. Patients' responses to skin incision were described as "no movement" or "movements." The MAC or MAC(Ex) for sevoflurane was 2.22% +/- 0.13% (mean+/-SD) or 1.70%+/-0.12%, and the 95% effective dose (ED95) for smooth extubation was 1.87% (95% confidence limits 1.75%-2.62%), respectively, in children. During emergence from anesthesia, none of patients held their breath or experienced laryngospasm in the current study. One patient in a subgroup at 1.5% coughed before tracheal extubation. All 10 patients with smooth tracheal extubation had hemoglobin oxygen saturation levels of > or =98% in this study. Awakening time was 9.7+/-3.7 min in the subgroup that received 1.75% sevoflurane. In conclusion, the MAC(Ex) and ED95 values of sevoflurane were 1.64% and 1.87%, respectively, in children. The MAC(Ex) to MAC ratio for sevoflurane was 0.8 in children within the same age range and mean age. IMPLICATIONS: Because tracheal extubation of anesthetized patients may be advantageous in certain clinical situations, we performed this study. The ratio minimum alveolar anesthetic concentrations for skin incision and for tracheal extubation for sevoflurane was 0.8 in children within the same age range and mean age. No patient in the current study had laryngospasm.

Anesthesia, General

Mechanism of action and therapeutic indication of prosthetic mandibular advancement in obstructive sleep apnea syndrome.

Prosthetic mandibular advancement (PMA) was applied to nine patients with obstructive sleep apnea syndrome (OSAS) and its therapeutic usefulness, mechanism of action, and clinical indication were discussed based on polysomnographic findings and serial examination of upper airway before and during PMA treatment. Apnea hypopnea index significantly decreased during PMA treatment compared with the value before treatment (P < 0.01) and the rate of the treatment responder counted 78.1%. Cephalometric variables indicated forward and inferior advancement of mandible in our subjects. Magnetic resonance imaging of the upper airway during sleep revealed a marked improvement of velophanryngeal obstruction in most subjects. In addition, intraesophageal negative pressure during sleep decreased significantly. Our results confirmed the high therapeutic efficacy of PMA for OSAS and indicated forward advancement of the mandible and decrease of negative pressure loading on upper airway with PMA might suppress velopharyngeal collapse. Thus, PMA was regarded as one of the treatments of choice for OSAS occurring based on with velopharyngeal narrowing.

Adult

Application of the reversed elephant trunk technique during total thoracoabdominal replacement in patients with Marfan's syndrome.

The reversed elephant trunk operation has been applied in patients with extensive aortic involvement as a scheduled staged operation. We report application of the same technique in two patients with Marfan's syndrome. The two patients underwent total replacement of the thoracoabdominal aorta for a DeBakey IIIb aortic dissection. The proximal end of the prosthetic graft was invaginated to facilitate future proximal operation. No complication related to the trunk had been observed during the follow-up period.

Adult

Usefulness of MR angiography in detection of persistent trigeminal arteries.

OBJECTIVES: To examine the usefulness of magnetic resonance angiography (MRA) in detection of persistent trigeminal arteries (PTA). MATERIAL AND METHODS: 3D-time-of-flight (TOF)-MRA images obtained from 1100 patients (798 males and 302 females aged 6-75 years with a mean of 55 years) at our and related institutions were examined retrospectively for PTA. The course of the PTA was classified into the posteromedial type and posterolateral type. Charts of the patients were also examined retrospectively for clinical symptoms related to PTA. RESULTS: PTA was observed in 5 (0.45%) of the 1100 patients, and no aneurysm or arteriovenous malformation was noted in any of these 5 patients. PTA was the posteromedial type in 2 and posterolateral type in 3. PTA was possibly related with clinical symptoms in only 1 patient with oculomotor paresis. CONCLUSION: MRA is useful for non-invasive screening for PTA.

Adolescent

Heterogeneity in the breakpoints in balanced rearrangements involving band 12p13 in hematologic malignancies identified by fluorescence in situ hybridization: TEL (ETV6 ) is involved in only one half.

Using fluorescence in situ hybridization (FISH) and probes located on 12p12.1 to 13.3, we studied the breakpoints of 23 patients who had various hematologic malignant diseases and who had 12p13-balanced translocations (21 patients), inversion (1 patient), or insertion (1 patient). Among them, 14 patients had breakpoints within YAC964c10, which contains the TEL (ETV6 ) gene and in 12 of these with balanced translocations or insertion, the FISH results suggested that TEL was involved. Two of the 14 patients, patients no. 13 and 14, had breakpoints in YAC 964C10 that were centromeric to TEL but telomeric to KIP1. In the other 9 patients whose breakpoints did not fall within the YAC, the breakpoints were found telomeric to the YAC in at least three different locations on distal 12p. These results indicated that TEL was involved in only half (12 of 23) of the patients with balanced 12p13 rearrangements and that there probably were several other breakpoint cluster regions on 12p13, suggesting that genes other than TEL were involved in these rearrangements.

Adult

Acute myocardial infarction caused by thrombotic occlusion of a coronary aneurysm.

We encountered an unusual case of acute myocardial infarction due to obstruction of a coronary aneurysm in a 38-year-old Japanese man. Although thrombolysis and rescue percutaneous transluminal coronary angioplasty, performed in the acute phase, did not result in recanalization, serial angiography and intravascular ultrasonography showed spontaneous recanalization and partial thrombosis within the aneurysmal segment during 3 months.

Adult

A t(6;12)(q23;p13) results in the fusion of ETV6 to a novel gene, STL, in a B-cell ALL cell line.

ETV6 (TEL) is rearranged in various types of hematologic malignancies. The B-cell precursor acute lymphoblastic leukemia (ALL) cell line SUP-B2 has a t(6;12)(q23;p13) involving ETV6 at 12p13 and a submicroscopic deletion of the other ETV6 allele. The reciprocal translocation results in the fusion of ETV6 to a previously unknown gene at 6q23, which we named STL (six-twelve leukemia gene). Both reciprocal fusion transcripts can be detected: On the der(6) chromosome, the ETV6/STL mRNA shows an apparently out of frame fusion of ETV6 at nucleotide 187 to STL, which would result in the addition of 14 amino acids to the first 54 amino acids of ETV6. On the der(12) chromosome three different variants of the STL/ETV6 fusion mRNA could be detected; variable size segments were inserted at the breakpoint between STL and ETV6 exon 3. One of these variants could give rise to a protein in which the first 54 amino acids of ETV6 are replaced by 12 amino acids from one of the STL short open reading frames. Sequence analysis of a 1.4 kb STL cDNA clone from a skeletal muscle library revealed no long open reading frames. This cell line will be very useful in studying the different mechanisms by which alterations of ETV6 contribute to leukemogenesis and in testing the hypothesis that ETV6 might act as a tumor suppressor gene.

Amino Acid Sequence

Identification of pericentric inversion 12, inv(12)(p13.1q11), by fluorescence in situ hybridization in a patient with acute myeloid leukemia (AML-M6).

Using probes located between 12p12.1 and 12p13.3, we performed fluorescence in situ hybridization (FISH) analysis and identified an inv(12)(p13.1q11) in a patient with acute myeloid leukemia (AML-M6). Standard cytogenetic analysis had identified the rearranged chromosomes 12 as del(12) (p11p13). Although deletions and translocations involving band 12p13 are fairly common chromosomal abnormalities observed in a broad spectrum of hematologic malignancies, inv(12) is a rather rare abnormality. We compare the clinical and cytogenetic findings with those of the previous cases reported in the literature.

Chromosome Banding

Effects of stimulated free latissimus dorsi muscle graft on LVEDV and LVSW: a new dynamic cardiomyoplasty technique.

The effectiveness of dynamic cardiomyoplasty (DCMP) remains controversial. We hypothesized that effectiveness of DCMP using the latissimus dorsi muscle graft (LDMG) depends on the wrapping method. We analyzed pressure-volume relations (PVR), the left ventricular stroke work (LVSW), and the left ventricular end diastolic volume (LVEDV) changes during nonstimulation and stimulation of the LDMG to evaluate the effect of a new wrapping method of DCMP on the LVSW and the LVEDV changes. The new wrapping technique was evaluated in an acute animal experimental model. In 12 mongrel dogs, we performed continuous measurement of the dimensional and pressure dates of the left ventricle (LV) after the DCMP. The measurement was performed 15 min after wrapping during 5 periods. The duration of one measurement period was 15 s. The animals were divided into 2 groups according to the wrapping method. The heart was wrapped with the LDMG using 2 different methods. For Method 1, Carpentier's method, the heart was wrapped primarily with the distal part of the LDMG, the lateral segment. The vasculoneural pedicle of the latissimus dorsi muscle (LDM) was preserved. For Method 2, the LDM was separated, and the vasculoneural pedicle was cut. The medical sternotomy was performed. The thoracodorsal artery of LDMG was anastomosed to the right internal mammary artery, and the thoracodorsal vein was anastomosed to the right atrial appendage. The heart was wrapped primarily with the proximal part of the "free LDMG," the transverse segment. Based on the PVR loops, the changes of the LVSW and the LVEDV in both experimental groups were analyzed. The paired t-test was used for statistical analysis. Using Method 1, the LVSW and the LVEDV showed no significant changes during stimulation (stim) of the LDMG, compared with nonstimulation (nonstim) (LVSW: nonstim, 970 +/- 168 erg x 10(3); stim, 1,181 +/- 203 erg x 10(3); p = 0.126 and LVEDV: nonstim, 36.6 +/- 6.7 ml; stim, 37.2 +/- 6.8 ml; p = 0.36). Using Method 2, the LVSW was increased, and the LVEDV was decreased during stimulation of the free LDMG, compared with nonstimulation (LVSW: nonstim, 694 +/- 117 erg x 10(3); stim, 846 +/- 104 erg x 10(3); p < 0.001 and LVEDV: nonstim, 47.7 +/- 2.8 ml; stim, 46.8 +/- 2.7 ml; p < 0.001). The stimulated free LDMG wrapping of the heart seems to be a more effective wrapping method for DCMP, and it results in an increase of the LVSW and a decrease of the LVEDV, compared with the original Carpentier's method.

Animals

Cerebral metabolism in sleep apnea. Evaluation by magnetic resonance spectroscopy.

Repeated apneic episodes during sleep may lead to cerebral damage in patients with obstructive sleep apnea (OSA). We performed proton magnetic resonance (MR) spectroscopic studies to examine cerebral metabolism in patients with OSA. We studied 15 healthy subjects and 23 patients with OSA who displayed no anatomical abnormalities on MR imaging. The patients were classified into two groups based on the results of polysomnography: mild OSA (11 patients) or moderate to severe OSA (12 patients). All the subjects were examined with two-dimensional chemical shift imaging. The N-acetylaspartate (NAA)/choline (Cho), NAA/creatine (Cre), and Cho/Cre ratios for cerebral cortex and white matter were calculated separately. A statistically significant intergroup difference was found for the NAA/Cho ratio in cerebral white matter (p < 0.005). This ratio was significantly lower in patients with moderate to severe OSA than in patients with mild OSA (p < 0.01) and healthy subjects (p < 0.01). Our findings indicate that cerebral metabolic changes occur in normal-appearing brain tissue in patients with moderate to severe OSA. The findings of a decreased NAA/Cho ratio suggests the presence of cerebral damage, probably caused by repeated apneic episodes. Proton MR spectroscopy may be useful for evaluating cerebral damage in patients with OSA.

Adult

A case of rest angina due to microvascular spasm.

A 66-year-old woman underwent elective cardiac catheterization for investigation of periodic attacks of chest pain at rest. During the examination, a chest pain attack occurred unexpectedly, resulting in ST elevation in the precordial leads on electrocardiography. Immediate coronary arteriography demonstrated no organic stenosis but markedly delayed contrast medium perfusion in the mild to distal portion of the left anterior descending artery. These phenomena spontaneously disappeared about 3 min later, and the patient was diagnosed as having angina pectoris due to microvascular spasm. The demonstration of angina pectoris due to microvascular spasm by coronary arteriography during a spontaneous attack is very rare.

Aged

Optimum conditions for iron colloid enhanced fast spin echo imaging in hepatocellular carcinoma.

The optimum conditions for iron colloid enhanced fast spin echo (FSE) in the detection of hepatocellular carcinoma have not been clearly established as yet. MRI was performed on 14 patients with hepatocellular carcinoma (45 nodules) before and after administration of chondroitin sulphate iron colloid (CSIC). One type of conventional spin echo (CSE) (TR/TE = 1800/80) was then quantitatively and qualitatively compared with three types of FSE (FSE 1800 (TR/effective TE/echo factor = 1800/90/7); FSE 7 (3500/90/7); and FSE 11 (3500/99/11)). The liver signal-to-noise ratio (SNR) was significantly decreased after CSIC administration in all sequences, while the tumour-to-liver contrast-to-noise ratio (CNR) was significantly increased. Although the decreased ratio of the liver SNR was smaller on the three FSE sequences compared with CSE, the increased ratio of the tumour-to-liver CNR was higher on the FSE sequences. The highest increase of the tumour-to-liver CNR was on the FSE 7 sequence. The number of detectable tumours, both before and after the administration of CSIC, was largest on FSE 7. In conclusion, FSE with longer TR and TE, and decreased echo factor, was especially useful for CSIC enhanced liver MRI.

Adult