Search PubMed⌕ Search

Biomedical subjects

Y Wada

Publications and source records attributed to Y Wada.

At least 541 records · Page 30Linked to original sources

Biliary hamartomas simulating multiple hepatic metastasis on imaging findings.

We encountered a 62-year-old female with advanced gastric cancer, in whom multiple nodular lesions in the liver, which were depicted as small low density areas, less than 5 mm in diameter, on computed tomography and demonstrated as a heterogenic pattern on ultrasonograms. This patient was suspected to have multiple liver metastases of gastric cancer. She deteriorated gradually and died of respiratory failure due to lung metastasis. At autopsy these hepatic nodular lesions were biliary hamartomas. Biliary hamartoma is a lesion usually identified microscopically, and there have been only 8 cases including ours, which were depicted on images. Along with a remarkable advance in imagings, it should become more important to differentiate biliary hamartoma from malignant hepatic neoplasms on images.

Bile Duct Diseases↗

Method for quantitative estimation of position perception using a joystick during linear movement.

We designed a method for quantitatively estimating self-motion perceptions during passive body movement on a sled. The subjects were instructed to tilt a joystick in proportion to perceived displacement from a giving starting position during linear movement with varying displacements of 4 m, 10 m and 16 m induced by constant acceleration of 0.02 g, 0.05 g and 0.08 g along the antero-posterior axis. With this method, we could monitor not only subjective position perceptions but also response latencies for the beginning (RLbgn) and end (RLend) of the linear movement. Perceived body position fitted Stevens' power law, where R=kSn (R is output of the joystick, k is a constant, S is the displacement from the linear movement and n is an exponent). RLbgn decreased as linear acceleration increased. We conclude that this method is useful in analyzing the features and sensitivities of self-motion perceptions during movement.

Acceleration↗

Sympathetic outflow response to muscle during vestibular stimulation in humans.

To observe the effects of caloric vestibular stimulation on muscle sympathetic nerve activity (MSNA) in humans, 14 healthy volunteers were monitored in a supine position by electrocardiogram (ECG), blood pressure (BP), electro-oculogram (EOG). MSNA was monitored by a double recording technique of microneurography from the bilateral tibial nerves. Caloric vestibular stimulation was loaded by injecting 50 ml 44 degrees C warm water and 50 ml 10 degrees C cold water alternately into the external meatus for 1 min. Nystagmus was evoked in all cases by cold stimulation and in some cases by hot stimulation. The nystagmus evoked by cold stimulation was more intense than that by hot stimulation. MSNA was enhanced by either cold or hot stimulation; however, the enhancement mode differed between cold and hot stimulation. Cold stimulation evoked two peaks of MSNA while hot stimulation elicited only one peak. The first peak (404.5 +/- 115.4% with control value set at 100%, mean +/- SE) was estimated to be caused by cold stimulation on the skin of the external meatus while the second peak (379.2 +/- 65.3%) seemed to be the result of vestibular stimulation. With hot stimulation, the response peak of MSNA was 243.3 +/- 28.1%. In general, MSNA was enhanced after vestibular stimulation with MSNA increases was proportional to the stimulated level of the vestibular system.

Adult↗

[Surgical treatment for ascending aortic aneurysm using a transthoracic left ventricular venting].

Three patients with ascending aortic aneurysms underwent graft replacement using deep hypothermic circulatory arrest with continuous retrograde cerebral perfusion. In all three cases, preoperative radiographic examination revealed that the aneurysm was large, thin, and adherent to the back of the sternum. For this reason, left ventricular venting was performed through a left thoracotomy before median sternotomy, to decrease both the risk of rupture of the aneurysm and the difficulty of cannulation. This new method, called transthoracic left ventricular venting, was very useful for performing a median sternotomy under hypotensive and hypothermic conditions adequate to reduce the risk of rupture and to manage any rupture immediately through deep hypothermic circulatory arrest.

Aged↗

[A case of predominant right thalamic infarction with severe verbal memory disturbance].

We encountered a 45-year-old right-handed man who had suffered a predominant right thalamic infarction and complained of memory loss. Performance on the Miyake Test (recall of ten pairs of related and unrelated words), the Rey Osterrieth Complex Figures, the Benton Test of Visual Retention and the Wechsler Memory Scale-R disclosed a severe verbal memory disturbance associated with a little, if any, visual memory disturbance. An MRI study revealed bilateral lesions limited to the thalamus involving most of the right anterior nucleus (AN), mediodorsal nucleus (MD), ventrolateral nucleus (VL), and centromedial nucleus (CM), as well as a small part of the left MD, and CM. HM-PAO-SPECT scans showed areas of decreased cerebral blood flow not only in the right thalamus but in the medial and basilar region of the right temporal lobe. It is noteworthy that our patient had a predominant right thalamic lesion and exhibited a severe verbal memory disturbance rather than visual memory disturbance. This suggests that the right hemisphere is dominant for verbal memory function in this patient.

Cerebral Infarction↗

[Three cases with juvenile rheumatoid arthritis who showed hypocomplementemia related to disease activity].

We encountered three cases of juvenile rheumatoid arthritis which showed a depressed serum complement level during the clinical course. Circulating immune complex and increased secondary fibrinolysis were detected in all cases. The laboratory data suggested the presence of vesculitis. Cutaneous vasculitis was observed by biopsy in 2 cases and abnormal respiratory function in one cases. These 3 cases were in contrast to other 95 JRA cases treated in our department who showed normal serum complement levels. Estimation of serum complement may, therefore be useful to predict the vascular complication and refractoriness to therapy in JRA.

Adolescent↗

[Clinical problems in surgical treatment for active infective endocarditis].

From October, 1982, to December, 1995, 22 patients with active infective endocarditis underwent surgical treatment. Of 22 patients, 12 patients (group P) demonstrated microorganisms on blood culture obtained at the operation and/or in the excised valve, and 10 patients (group N) showed acute inflammatory reaction in the excised valve microscopically. Operative mortality in group P was significantly higher than that in group N (50% versus 0%,p < 0.01). Especially in group P, five of six patients (83%) with uncontorolled infection for more than eight days died within 30 days of operation. This showed that prolonged preoperative periods of uncontrolled infection influenced the surgical outcome of active infective endocarditis. In conclusion, patients who do not promptly response to antibiotic treatment must be considered for early operation within seven days of the diagnosis of infective endocarditis to decrease operative mortality. The plasma level of CRP and definition of sepsis may be useful as indicators of uncontrolled infection.

Adult↗

[Seven cases of hemophagocytic syndrome complicated with childhood collagen diseases].

We encountered seven children with hemophagocytic syndrome complicated with collagen diseases of whom five were JRA and two SLE, HPS was seen as one of initial symptoms in 6 cases excluding one case of JRA. Hematologically, cytopenia in 2 cell lines (RBC and platelets) was seen in most cases. Active hemophagocytosis by matured large histiocytes was observed in all cases. All patients had moderately to extremely high serum ferritin levels and LDH levels. Although both lives did not correlated with prognosis in HPS with collagen disease, the higher serum total cholesterol/serum triglyceride ratio, the worse was the prognosis. Those findings suggested that HPS in collagen diseases may be a different entity from other types of HPS.

Adolescent↗

[Xanthine oxidase (xanthine dehydrogenase)].

Xanthine oxidase (xanthine dehydrogenase) is composed of two identical subunits of approximately 150,000 daltons. Each subunit contains four oxdation-reduction active cofactors/monomers. In vivo, the enzyme exists mostly as the dehydrogenase type (the NAD-dependent type). The cDNA has been cloned from human liver, and the amino acid sequence has been determined. As xanthine oxidase seems to produce superoxide in postischemic reperfusion, the relation between the superoxide and postischemic tissue injury has been discussed. It has also been reported that inhibition of xanthine oxidase by allopurinol may cause severe 6-mercaptopurine toxicity.

DNA↗

[Xanthine oxidase deficiency (hereditary xanthinuria), molybdenum cofactor deficiency].

Hereditary xanthinuria is a rare autosomal recessive disorder, with xanthine oxidase deficiency. Patients often display renal symptoms because they excrete a large amounts of xanthine in urine. An high-fluid-intake, alow-purine-food, and alkalinization of urine are effective in the patients. Molybdenum cofactor is essential for xanthine oxidase, sulfite oxidase and aldehyde oxidase. Patients with molybdenum cofactor deficiency display severe neurological symptoms, such as severe convulsions. The patients increase urinary excretions of xanthine and sulfite. Treatments are ineffective for neurological symptoms.

Central Nervous System Diseases↗

[Left ventricular lesions in arrhythmogenic right ventricular dysplasia and 12-lead electrocardiographic findings].

Left ventricular lesions in arrhythmogenic right ventricular dysplasia have not been well described, and the relationship between the left ventricular lesions and the 12-lead electrocardiographic findings has not been analyzed. This study examined whether the presence of left ventricular lesions and the extent of right ventricular lesions due to arrhythmogenic right ventricular dysplasia are predictable by 12-lead electrocardiographic findings. The 12-lead electrocardiograms during sinus rhythm and left and right ventriculography were studied in 29 patients (27 males and 2 females, mean age 42.6 +/- 15.5 years) diagnosed by the current criteria for this disease. After evaluation, patients were divided into two groups: those with normal left ventricles (normal group) and those with left ventricular wall motion abnormalities (abnormal group). Seventeen of the 29 patients (59%) were classified into the abnormal group. Left ventricular wall motion abnormalities were located in the posterolateral (4 patients), apical (1), and posterolateral and apical regions (12). QS patterns of abnormal Q waves in lead I, aVL or V5, V6 rS patterns (R/S ratio < 1) in leads I and V6, and/or R or Rs patterns (R/S ratio > 1) in lead V1 were observed in all patients in the abnormal group, but in none in the normal group. There was a positive correlation between the right ventricular end-diastolic volume index and the number of precordial negative T waves (r = 0.746, p < 0.0001), and the time from onset of the QRS to the terminal portion of the epsilon wave in lead V1 (r = 0.627, p < 0.001). The correlation coefficients showed no significant differences between the groups. A left ventricular lesion associated with arrhythmogenic right ventricular dysplasia was not unusual (59%), and our study suggests that the posterolateral and apical regions are the most frequent sites. The presence of these lesions were predictable by the QRS abnormalities. Moreover, regardless of the presence of such a lesion, the extent of the right ventricular lesion is also predictable by the 12-lead electrocardiographic findings.

Adult↗

[Mechanism of cisplatin and peplomycin therapy on head and neck carcinoma].

Results of chemotherapy for head and neck cancer are now improving owing to the development of concomitant use of chemotherapeutic agents such as cisplatin or peplomycin. Concomitant use of the two agents has been favored clinically. However, fundamental study on the combination therapy has not been carried out sufficiently. In the present study we studied the cell kinetics of tumor cells by the combination of cisplatin and peplomycin using flowcytometric analysis and electron microscopy. Survival of tumor cells was lowest, when peplomycin was administrated 3 days after cisplatin. Cell kinetics showed an accumulation at the S and G2M stage in this situation, By the electron microscopic study, microvilli of tumor cells disappeared and the blebbing of tumor cells was observed, when cisplatin alone was administrated. However, when the combination of cisplatin and peplomycin was administrated to the tumor cells, tumor cells enlarged. The results suggest that the mechanism of combination therapy differed from the mechanism of cisplatin alone.

Antineoplastic Combined Chemotherapy Protocols↗

Possible prediction of adverse reactions to pyrimidine chemotherapy from urinary pyrimidine levels and a case of asymptomatic adult dihydropyrimidinuria.

Deficiency of dihydropyrimidine dehydrogenase or dihydropyrimidinase, enzymes that catalyze the breakdown of pyrimidine chemotherapy agents such as 5-fluorouracil, may cause serious adverse reactions to these agents. We attempted to establish the reference range for urinary pyrimidines in adults to detect individuals with abnormal pyrimidine metabolism. We analyzed urinary pyrimidine levels in 1133 adults to establish a reference range for persons ages 20 years or older. Urinary dihydrouracil and uracil levels were determined by high-performance liquid chromatography with column switching. The reference range obtained was found to be 0-59.3 micromol/g creatinine for dihydrouracil and 0-129.8 micromol/g creatinine for uracil. In addition, an asymptomatic man with suspected dihydropyrimidinase deficiency was detected on the basis of dihydropyrimidinuria. Although only three cases of this disease have been found worldwide, including one infant reported previously by our group, it may not be so rare as has been thought. In this man, a 10 mg/kg oral uracil loading test yielded a peak blood dihydrouracil level of 192.1 micromol/liter and a peak uracil level of 67.8 micromol/liter. Eight h after loading, the uracil level was still 11.1 micromol/liter, about 17 times that in healthy subjects. Additional research on dihydropyrimininase deficiency may help to prevent adverse reactions to pyrimidine chemotherapy agents in susceptible individuals.

Adult↗

Cloning of the gene encoding a putative serine/threonine protein kinase which enhances spermine uptake in Saccharomyces cerevisiae.

Polyamine uptake in Saccharomyces cerevisiae was modulated by extracellular magnesium; in a magnesium-limited medium, polyamine, especially spermine, was overaccumulated into the interior, whose level was then toxic for the growth of this organism (Maruyama, T., Masuda, N., Kakinuma, Y., and Igarashi K. (1994) Biochim. Biophys. Acta 1194, 289-295). Here we isolated a mutant (strain YTM22-8) whose growth was tolerant to spermine in magnesium-limited medium. This mutant was defective in polyamine uptake and did not overaccumulate spermine. From a yeast genome library we cloned a gene (POT1) which restored the spermine uptake of this mutant and the sensitivity of the growth to spermine. The nucleotide sequence of the POT1 gene indicated that it encodes a putative serine/threonine protein kinase and is located on chromosome XI. The results suggest that spermine uptake by this organism is probably regulated by phosphorylation and dephosphorylation.

Amino Acid Sequence↗

Automated screening system for purine and pyrimidine metabolism disorders using high-performance liquid chromatography.

An automated screening system for purine and pyrimidine metabolism disorders using high-performance liquid chromatography (HPLC) with column switching is described. The system consists of a reversed-phase column, a cation-exchange column, a column switch, four sets of ultraviolet absorbance detectors, a microcomputer and other conventional equipment. As this system permits the simultaneous determination of urinary orotic acid, uracil, dihydrouracil, pseudouridine, xanthine, 2,8-dihydroxyadenine and succinyladenosine, it offers a useful method for the detection of orotic aciduria, dihydropyrimidine dehydrogenase deficiency, dihydropyrimidinuria, xanthinuria, adenine phosphoribosyltransferase deficiency and adenylosuccinase deficiency.

Adenine↗

Hereditary spherocytic anemia with deletion of the short arm of chromosome 8.

We describe a 30-month-old boy with multiple anomalies and mental retardation with hereditary spherocytic anemia. His karyotype was 46,XY,del(8)(p11.23p21.1). Genes for ankyrin and glutathione reductase (GSR) were localized to chromosome areas 8p11.2 and 8p21.1, respectively. Six patients with spherocytic anemia and interstitial deletion of 8p- have been reported. In these patients, severe mental retardation and multiple anomalies are common findings. This is a new contiguous gene syndrome. Lux et al. [1990: Nature 345:736-739] established that ankyrin deficiency and associated deficiencies of spectrin and protein 4.2 were responsible for spherocytosis in this syndrome. We reviewed the manifestations of this syndrome. Patients with spherocytic anemia and multiple congenital anomalies should be investigated by high-resolution chromosomal means to differentiate this syndrome.

Adolescent↗