Re: Left renal cell carcinoma communicating with inferior mesenteric vein.
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Carcinoma, Renal Cell↗
Biomedical subjects
Y Tsushima
Publications and source records attributed to Y Tsushima.
[Optimal dosage of contrast material in screening upper abdominal enhanced CT].
PURPOSE: To examine the possibility of decreasing the amount of intravenous contrast materia for screening upper abdominal CT scanning. MATERIALS AND METHODS: Eighty-seven patients(53 men and 34 women; 56.0 +/- 15.7 y.o.; range 20-88 y.o.; body weight 57.6 +/- 11.1 kg, range 29-85 kg) were randomly divided into two groups according to the amount of i.v. contrast material: 100 ml independent of patient weight(group 1) and 2 ml/kg (group 2). In both groups, contrast material(Iopamiron 300 mgI/ml) was intravenously administrated at an infusion speed of 1.5 ml/sec. Spiral scanning was started 90 sec after the start of contrast material injection. CT numbers of the portal vein, hepatic parenchyma of the right lobe, and background were measured on pre- and postenhanced images, and the contrast-to-noise ratio(CNR) and increases in CT the number of the right hepatic lobe(CNIliver) and portal vein(CNIportal) were calculated. RESULTS: In group 1, patient's weight showed negative linear correlations with CNR(r = 0.442, p = 0.0027), CNIliver(r = 0.422, p = 0.0043), and CNIportal(r = 0.509, p = 0.00042). In group 2, such correlations were not observed. CONCLUSION: Contrast enhancement in screening upper abdominal CT was negatively correlated with patients' weight in the group of contrast material injected with 100 ml.
Adult↗
[Combined valvular and coronary artery surgery].
Between 1990 and 1999, 78 patients underwent combined valvular coronary artery operation. Aortic valve disease was present in 49 patients, mitral valve disease in 23 patients, aortic and mitral valve disease in 6 patients. The average age was 67 years. Twelve patients had had a previous myocardial infarction. The average number of grafts inserted was 1.82 per patients, and the average number of artery grafts inserted was 0.96 per patients. The most number of grafts were placed prior to valve replacement or plasty. And periods of myocardial ischemia were kept at a minimum by coronary perfusion through free grafts. Preoperative mortality was 1.3%. And event fee ratio after operation was 95% (mean follow up 42 month). Therefore the operative risk of combined surgery is, in general, low and the long term results are favorable.
Aged↗
[A case report of aneurysm of the ductus arteriosus combined with mitral regurgitation].
A case with the giant aneurysm of the ductus arteriosus combined with severe mitral regurgitation is reported. 58-year-old male underwent MVR and patch closure of the ductal orifice for staged operation. The first operation was MVR and patch closure of the PDA orifice of the pulmonary artery end using retrograde cerebral perfusion (RCP) with deep hypothermic circulatory arrest (DHC). The second operation was performed on 3 months after the first operation using left thoracotomy approach, and patch closure of the ductal orifice via the aorta using RCP with DHC was performed. Upon following-up examination, the patient is now doing well 20 months after the initial surgery.
Cerebrovascular Circulation↗
The three-dimensional structure of human RNase 4, unliganded and complexed with d(Up), reveals the basis for its uridine selectivity.
The RNase 4 family is unique among RNase enzymes, displaying the highest level of sequence similarity and encompassing the shortest polypeptide chain. It is the only one showing high specificity. The human representative is an intracellular and plasma enzyme, first isolated from colon adenocarcinoma cell line HT-29. The crystal structures of human recombinant RNase 4, unliganded and in complex with d(Up), have been determined, revealing in the unique active site an explanation for the uridine specificity. Arg101, at a position not involved in catalysis in the other RNase enzymes, penetrates the enzyme moiety shaping the recognition pocket, a flip that is mediated by the interaction with the (shorter chain) C-terminal carboxylate group, providing an anchoring point for the O4 atom of the substrate uridine. The bulky Phe42 side-chain forces Asp80 to be in the chi1=-72.49 degrees rotamer, accepting a hydrogen bond from Thr44, further converting the latter into a hydrogen bond acceptor. This favours an interaction with the -NH-donor group of uridine at position 3 over that with the =N-acceptor of cytidine. The two chemical groups that distinguish uracyl from cytosine are used by the enzyme to discriminate between these two bases.
Amino Acid Sequence↗
Gene arrangement and RNA transcription of the BamHI fragments K and M2 within the non-oncogenic Marek's disease virus serotype 2 unique long genome region.
We determined the nucleotide sequence of a 6593 bp fragment of the Marek's disease virus serotype 2 (MDV2) unique long region located in the right part of genomic BamHI-M2 and the adjacent part of BamHI-K fragments. Within this region five complete open reading frames (ORFs) were identified whose deduced amino acid sequences exhibited homology to the UL53 (glycoprotein K), UL54 (immediate early regulatory protein ICP27), and UL55 gene products of herpes simplex virus type 1 (HSV-1). Homologue to the HSV-1 UL56 was not detected. However, we identified a gene between the MDV2 UL54 and UL55 genes with homology to the first ORF (ORF-1) of equine herpesvirus type 1 and corresponding gene identified in pseudorabies virus. Two adjacent ORFs contained in the BamHI-K fragment, ORF 873s and ORF 873, were found by computer analysis to have the properties of an intron encoding a glycoprotein: ORF 873s encodes a 84 amino acid polypeptide with a stretch of a hydrophobic signal sequence in the C-terminus, and ORF 873 encodes a 873 amino acid polypeptide with a transmembrane domain and putative three N-linked glycosylation sites. All the identified genes were confirmed to be transcribed with 3'-coterminal transcripts and/or a unique transcript in the virus-infected cells. Especially, 3.5 kb mRNA of ORF 873s and ORF 873 are transcribed from a potential promoter region of ORF 873s, and splice donor and acceptor sites are used to splice the mRNA after cleavage of a 113 bp-nucleotide sequence.
Amino Acid Sequence↗
Use of contrast-enhanced computed tomography to measure clearance per unit renal volume: a novel measurement of renal function and fractional vascular volume.
The iodinated contrast agents used for computed tomography (CT) have pharmacokinetics similar to inulin and can measure physiological indices, such as clearance per unit renal volume (alpha/V) and fractional vascular volume (fvv). Clinical experience with these techniques is, however, scanty, and the present study explored their potential in subjects with and without renal dysfunction. In a series of subjects, a single slice of kidney was scanned sequentially after the bolus injection of contrast material. Time-attenuation curves were constructed, and alpha/V and fvv were calculated using a Patlak graphic analysis. In the first part of the study, 50 normal kidneys in 35 subjects (aged 21 to 75 years) were studied. In the second stage, alpha/V was compared with glomerular filtration rate (GFR) measurements in 24 patients with diabetes (aged 28 to 84 years) with or without renal dysfunction. In normal kidneys, alpha/V averaged 0.49 +/- 0.11 mL/min/mL and fvv averaged 35% +/- 12%. These values agree with literature data obtained using other techniques. A negative correlation was seen between age and alpha/V (r = 0.66; P < 0.0001), but not fvv. In patients with diabetes, a strong correlation was observed between renal clearance values, calculated from CT and corrected for renal volume, and GFR (r = 0.87; P < 0.0001). Dynamic CT can provide quantitative renal physiological information on a regional basis noninvasively.
Adult↗
Functional CT of the kidney.
The iodinated contrast agents used for computed tomography (CT) are filtered at the glomerulus and not reabsorbed by the tubules and have pharmacokinetics comparable to inulin. They can thus measure physiological indices such as contrast clearance per unit volume, which is closely related to glomerular filtration rate per unit renal volume of kidney, after due allowance for the difference between blood and plasma clearance. In this review, we show how dynamic CT can be used to measure both regional and global blood clearance of contrast material. A single slice of kidney is scanned sequentially after bolus intravenous (i.v.) injection of contrast material. Next, time-attenuation curves are constructed and contrast clearance per unit volume is calculated using a Patlak graphical analysis. CT determination of renal volume is made and global contrast clearance can be then also calculated. In normal kidneys, clearance/volume averaged 0.49+/-0.11 ml min(-1) ml(-1) (mean +/- S.D.), and these values agreed with literature data obtained using other techniques. A negative correlation between patient's age and clearance/volume was seen. A strong correlation was observed between creatinine whole blood clearance and the global contrast clearance (the product of renal volume determined by CT and contrast clearance/volume). Dynamic CT can provide quantitative renal physiological information on a regional basis non-invasively.
Adult↗
The portal component of hepatic perfusion measured by dynamic CT: an indicator of hepatic parenchymal damage.
CT can measure absolute hepatic arterial and portal venous perfusion; pilot data suggests these are raised and lowered, respectively, in cirrhosis. This study examined the value of functional CT in assessing cirrhosis, using the prothrombin ratio (PTR) as a marker for hepatic parenchymal damage. Twenty subjects with viral-induced cirrhosis (11 men and 9 women; 55.41 +/- 7.86 years) and 14 controls (8 men and 6 women; 48.36 +/- 17.67 years) were studied. A single section through the liver was scanned after bolus intravenous injection of 40 ml ioversol 320 mgI/ml. Hepatic arterial and portal perfusion was measured using a previously described technique. Hepatic portal perfusion was decreased in patients (0.66 +/- 0.21 ml/min/ml) compared with controls (1.11 +/- 0.23 ml/min/ml; P < 0.0001). A strong correlation was seen between PTR and portal perfusion (r = 0.662, P = 0.0038) in cirrhotics. Hepatic arterial perfusion did not differ between patients (0.088 +/- 0.082 ml/min/ml) and controls (0.091 +/- 0.067), and did not correlate with PTR. In conclusion, portal perfusion is reduced in cirrhosis, and this reduction correlates with PTR. It could thus be used as a marker of hepatic parenchymal damage. This technique may be useful in the follow-up of chronic liver disease, potentially reducing the need for serial liver biopsy.
Adult↗
Transient splenomegaly in acute pancreatitis.
Serial changes in splenic volume of 25 patients (18 men and seven women; 53.4 +/- 20.8 years old, range 25-83) with acute pancreatitis who underwent CT examinations were retrospectively studied. Abdominal CT was performed within 3 days after the onset and there was at least one follow-up CT examination after this time. The percentage changes of splenic volume in the first (4-30 days) and second (31-100 days) follow-up CT were calculated. Splenic volume increased in the first follow-up CT (mean +/- SD: 197.8 +/- 121.0 cm3) compared with the initial CT (124.8 +/- 70.0; p < 0.0001), and then decreased in the second follow-up CT (179.7 +/- 100.7; p < 0.002). The average splenic volume increased 65.5 +/- 88.7% (range -10.4-377.4%) between the initial and first follow-up CT examinations. Five of 25 cases (20%) in whom size of spleen increased more than twice had severe acute pancreatitis (p < 0.05), complicated pseudocyst requiring surgical drainage (p < 0.05), pleural effusion (p < 0.01), splenic vein thrombosis or compression (p < 0.05) and longer hospital stay (p < 0.02) compared with patients with a smaller increase in splenic volume. In conclusion, transient splenomegaly was commonly seen in acute pancreatitis, especially in severe or complicated cases. Congestive splenomegaly caused by obstruction or stenosis of the splenic vein and non-specified acute splenitis were suspected of contributing to the transient splenomegaly.
Acute Disease↗
Identification of the Marek's disease virus serotype 2 genes homologous to the glycoprotein B (UL27), ICP18.5 (UL28) and major DNA-binding protein (UL29) genes of herpes simplex virus type 1.
We determined the nucleotide sequence of non-pathogenic Marek's disease virus serotype 2 (MDV2) strain HPRS24 glycoprotein B (gB) (UL27), ICP18.5 (UL28) and major DNA-binding protein (MDBP) (UL29) genes homologous to herpes simplex virus type 1 (HSV-1). The sequence data revealed that important motives in the proteins are conserved in MDV2 ICP18.5 and MDBP, however the sequence of viral DNA replication origin which exists in the regions between the UL29 and UL30 genes of other alphaherpesviruses was not found in the regions of the MDV2 genome. By northern blot analyses, we also demonstrated that 8.9, 5.0 and 2.6 kb transcripts were actually transcribed from the sequenced region in MDV2-infected cells. The MDV2 UL28 and UL29 genes have not been reported in other serotypes of MDV.
Amino Acid Sequence↗
Identification and structure of the Marek's disease virus serotype 2 glycoprotein M gene: comparison with glycoprotein M genes of Herpesviridae family.
We determined the nucleotide sequence of a portion of BamHI-C fragment of Marek's disease virus serotype 2 (MDV2) strain HPRS24 which was suspected to contain the homologue of the herpes simplex virus type 1 (HSV-1) gene UL10, encoding glycoprotein M (gM). An open reading frame whose translation product exhibited significant similarities to HSV-1 gM protein and respective proteins of other herpesviruses of 37.5% and 45.5% to 31.8%, respectively, was identified. A number of distinct transcriptional consensus sequences were found upstream of the first putative start codon of MDV2 UL10 protein. In transcriptional analysis, the gene was transcribed into an 1.5 kb RNA. The primary translation product comprises 424 amino acids with a predicted molecular weight of 46.9 kDa. The predicted MDV2 UL10 protein contains eight hydrophobic domains with sufficient length and hydrophobicity to span the lipid bilayer conserved in the genomes of all herpesviruses which have been sequenced so far. In the region located between the first and second hydrophobic domains, two potential N-linked glycosylation sites were presented. Interestingly, highly charged residues were abundantly possessed in the carboxy-terminal part of the MDV2 UL10 protein. By comparison of the amino acid sequence of the MDV2 UL10 gene with the homologues from other herpesviruses, the data might contribute for further evidence of the evolution of herpesviruses from a common progenitor and an ancient example of MDV2 belonging to the Alphaherpesvirinae subfamily. In addition, the existence of corresponding genes in human, mammalian, and avian herpesvirus genomes, suggests indirectly an important role for gM in the natural life cycle of the virus.
Amino Acid Sequence↗
Identification and DNA sequence analysis of the Marek's disease virus serotype 2 genes homologous to the herpes simplex virus type 1 UL20 and UL21.
We determined 3,135 bp of the nucleotide sequence located in an 8.5 kb EcoRI-E fragment in the unique long (UL) genome region of Marek's disease virus serotype 2 (MDV2), and identified UL20 and UL21 homologous genes of herpes simplex virus type 1 (HSV-1). The UL20 and UL21 homologous genes of MDV2 are arranged colinearly with the prototype sequence of HSV-1. In addition, an open reading frame (MDV2 ORF 273), which has been identified within the UL21 homologous gene of MDV2, has no apparent relation to any other known herpesvirus genes. Northern blot analysis and reverse transcriptase polymerase chain reaction confirmed the existance of RNA transcripts related to the UL20 and ORF 273 genes in MDV2-infected cells, except no transcript related to the UL21 gene being detected. The putative protein product of the MDV2 UL20 gene had a relatively low homology but that of the MDV2 UL21 gene had a moderate homology among herpesviruses. Further, the possible functions and features of the predicted proteins encoded within the sequenced region are discussed.
Amino Acid Sequence↗
Identification and sequence analysis of the Marek's disease virus serotype 2 gene homologous to the herpes simplex virus type 1 UL52 protein.
The gene of Marek's disease virus serotype 2 (MDV2) homologous to the UL52 gene of herpes simplex virus type 1 (HSV-1) was identified and characterized. The MDV2 UL52 homologous gene encodes 1,071 amino acids with a molecular weight of 118.7 kDa, which includes putative metal-binding site and overlapping region with the UL53 homologous gene. Although a putative polyadenylation signal sequence was found in the downstream of the MDV2 UL52 gene, a MDV2 UL52 DNA probe reacted only with the polycistronic 6.3 kb transcript, representing the UL52 and the downstream genes of UL53 and UL54. Transcriptional pattern of this region of MDV2 was somewhat different from corresponding regions of HSV-1 and infectious laryngotracheitis virus.
Amino Acid Sequence↗
Identification and sequence analysis of the Marek's disease virus serotype 2 homologous genes of the herpes simplex virus type 1 UL25, UL26 and UL26.5 genes.
We identified and determined the nucleotide sequence of Marek's disease virus serotype 2 (MDV2) UL25, UL26 and UL26.5 homologous genes of herpes simplex virus type 1 (HSV-1). The UL25, UL26 and UL26.5 genes of HSV-1 encode virion proteins (UL25 and UL26.5) and serine protease (UL26). The deduced amino acid sequences of the three proteins show a high degree of homology to counterparts of HSV-1. By northern blot analyses we found that four transcripts whose sizes are 4.9, 3.9, 2.0 and 1.3 kb are transcribed from the domains of MDV2 genome containing the three genes. This is the first report dealing with UL25, UL26 and UL26.5 homologues of HSV-1 in MDV serotypes.
Amino Acid Sequence↗
[Optimal dosage of contrast material in brain enhanced CT].
PURPOSE: To assess the optimal contrast dosage for brain enhanced CT. MATERIALS AND METHODS: A total of 150 patients were randomly assigned to two groups. The patients were also divided by body weight into three groups (< 50 kg, 50-59.9 kg and > or = 60 kg). A total of 100 ml (in 77 patients) or 50 ml (in 73 patients) of contrast material (iopamidol 300 mgI/ml) was intravenously administrated at a speed of 1 ml/sec. Three diagnostic radiologists evaluated image quality by five- or two-stage scoring systems with special attention given to enhancement of the anterior and middle cerebral arteries. CT values of the basilar artery were also measured. RESULTS: In visual evaluation by the five-stage scoring system, image quality with 100 ml of contrast material was better than that with 50 ml in all body-weight groups, although no difference was observed with the two-stage scoring system in patients weighing less than 60 kg. CT values of the basilar artery were higher in patients given 100 ml than in those given 50 ml regardless of weight groups. CONCLUSION: The image quality of brain CT using 50 ml of contrast material is sufficient for correct diagnosis in patients with a body weight of less than 60 kg.
Adolescent↗
[New screening method for coagulation abnormality including AT III deficiency during CABG].
In our institute, 1 ml of heparin is administered to the patients undergoing CABG before dissection and mobilization of the internal thoracic arteries (ITAs) and/or right gastroepiploic artery (GEA) to prevent possible thrombosis or coagulation tendency. Two patients with AT III deficiency underwent CABG and one of them died. The aim of this study is to know whether ACT check before and after administration of 1 ml of heparin is useful as a screening test of coagulation abnormalities including AT III deficiency. One hundred patients (84 males and 16 females) undergoing CABG were studied. Age ranged from 41 to 79 years (mean 64.8 +/- 8.0 years). One ml of heparin was administered to all the patients before ITAs and/or GEA were dissected and mobilized. ACT was doubly checked before (control ACT: c-ACT) and after (heparinized ACT: h-ACT) administration of heparin. ACT extension was defined as follows: ACT extension = (c-ACT)-(h-ACT). Mean c-ACT was 124 +/- 12 sec., h-ACT 188 +/- 26 sec. and ACT extension 64 +/- 24 sec. There were only 3 cases which ACT extension were less than 30 sec.: two of them were combined with AT III deficiency and the other was due to insufficient administration of heparin. In conclusion, examination of ACT after 1 ml administration of heparin is new, simple and convenient screening method for coagulation abnormalities including AT III deficiency during CABG.
Adult↗
[Clinical study of emergency coronary artery bypass surgery].
Between January, 1996 and December, 1998, 29 patients were undergone emergency coronary artery bypass grafting (CABG) in our institute. Age ranged 34 to 85 years (mean 65 +/- 11 years, male:female = 25:4). Of 29 emergency cases, 3 were hospital death. Hospital mortality rate was 10.7%, which was significantly higher than the hospital mortality of elective CABG (1.4%) during the same period. The necessity of IABP before CABG was 72% in emergency cases (elective surgery: 0%). Thus the use rate of arterial grafts were 86.2% in emergency cases (elective surgery: 100%), the patency of the arterial grafts were 100%. It is important to make stable condition of the patients before the operation, and therefore it is important to make contact closely with the cardiologists for making stable condition and for lowering the operative mortality. And, we should use arterial grafts for the long term result as much as possible if it is an urgent operation.
Adult↗