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Biomedical subjects

Y Yagi

Publications and source records attributed to Y Yagi.

At least 127 records · Page 7Linked to original sources

Curatively resected primary malignant melanoma of the esophagus: report of a case.

We report herein a rare case of primary esophageal malignant melanoma in a 49-year-old Japanese woman who presented with a 3-week history of dysphagia. Esophagogram and esophagoscopy demonstrated a polypoid tumor in the upper to mid-thoracic portion of the esophagus, and a radical subtotal esophagectomy was performed through a right thoracotomy. Histological and immunohistochemical studies proved this tumor to be a primary esophageal malignant melanoma. She received no postoperative adjuvant therapy and no signs of recurrence have been clinically observed for the 22 months since her operation.

Esophageal Neoplasms↗

Usefulness of resting thallium-201 delayed imaging for detecting myocardial viability in patients with previous myocardial infarction.

To test the feasibility of resting thallium-201 (201Tl) initial and delayed scintigraphy for detecting the area of viable myocardium, we performed single photon emission computed tomography (SPECT) in 57 patients with previous myocardial infarction (MI). All had received coronary arteriography (CAG) and left ventriculography (LVG). Initial and delayed myocardial imagings were carried out 10 min and 2 hours, respectively, after the injection of 201Tl at rest. Redistribution was judged by visual interpretation and/or the circumferential profile curve, and found in the infarcted or its adjacent area in 40 of the 57 cases (70.2%). A negative washout (net increase of 201Tl uptake in delayed image) was detected in 17 of these 40 cases. In 10 of the 57 patients, both exercise and rest-injected 201Tl myocardial images were obtained at exercise and rest, and compared visually. The areas of abnormal perfusion were smaller in the resting delayed images than those seen after exercise in 9 of the 10 cases, and were equal in one case. Thus, resting 201Tl delayed myocardial scintigraphy appears to reduce the underestimation of the size of the viable myocardium by the usual 201Tl images obtained after exercise or by single initial images obtained at rest in patients with previous MI.

Adult↗

Extravascular lung water measured with 99mTc-RBC and 99mTc-DTPA is increased in left-sided heart failure.

Extravascular lung water (EVLW) was quantitatively measured in 81 patients consisting of 10 subjects with normal cardiac function and 71 patients with left-sided heart diseases, using 99mTc-RBC as a non-diffusible indicator and 99mTc-DTPA as a diffusible indicator in the equilibrium phase. EVLW averaged 3.0 +/- 1.4 (ml/kg, mean +/- SD) in subjects with normal cardiac function (n = 10), 4.3 +/- 1.7 in New York Heart Association functional class I patients (n = 30), 4.8 +/- 2.4 in NYHA functional class II patients (n = 33) and 9.4 +/- 5.4 in NYHA functional class III (n = 8) patients. EVLW was greater in NYHA class III than in normal controls or NYHA classes I or II (p < 0.01). Lung thermal volume (LTV) was also measured in 31 of the 81 patients using a double indicator dilution technique with sodium and heat. LTV averaged 6.0 +/- 1.2 (ml/kg) in normal subjects (n = 4), 8.6 +/- 2.0 in NYHA functional class I patients (n = 11), 9.7 +/- 3.0 in NYHA functional class II patients (n = 13), and 15.9 +/- 8.2 in NYHA functional class III patients (n = 3). The correlation between EVLW and LTV was significant (EVLW = 0.79 x LTV - 72.8, r = 0.80, p < 0.01). There were significant differences in EVLW/LTV ratio between NYHA class III (0.93 +/- 0.16) and NYHA class I (0.62 +/- 0.22). Thus, it was shown that EVLW was increased in left-sided heart failure and that LTV overestimated the EVLW.

Aged↗

Thallium-201 myocardial SPECT findings at rest in sarcoidosis.

In 41 patients with sarcoidosis (diagnosed according to criteria recommended by the Committee on Diffuse Pulmonary Disease, Ministry of Health and Welfare, Japan 1988), thallium-201 (201Tl) myocardial SPECT was performed to investigate: (1) the ability of 201Tl SPECT to detect cardiac involvement of sarcoidosis with images recorded at rest and 2 hours later, and (2) the relationships between 201Tl myocardial SPECT findings and the activity of sarcoidosis or endomyocardial biopsy findings. As to the abnormal findings in 201Tl myocardial SPECT, (1) a low density area was seen in 13 of 41 cases (31.7%) and non-uniform uptake was found in 17 cases (41.5%), (2) the mean washout ratio (n = 39) was 16.5 +/- 7.4%, which is significantly (p < 0.05) lower than that found in normal subjects, 23.9 +/- 7.5% (n = 10). Of the 19 patients judged visually to be normal, 5 patients had a reduced mean washout ratio less than 12%. Thus, the incidence of abnormal findings including all types of abnormality, on 201Tl myocardial SPECT in sarcoidosis was 63.4% (26/41 cases). In studying the relationship between 201Tl myocardial SPECT findings and the activity of sarcoidosis (as measured by the serum ACE (angiotensin converting enzyme) or lysozyme level, or the presence of more than 30% symphocyte fraction in BALF (broncho-alveolar lavage fluid)), 20 (80%) of 25 cases with 201Tl abnormality were judged to be active sarcoidosis, while only 6 (37.5%) of 16 cases with normal findings on 201TI SPECT were judged to be active.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Hemodynamic effects of atrial interaction.

BACKGROUND: Ventricular pressure and volume overload may induce hemodynamically important ventricular interactions mediated by the thick interventricular septum. The purpose of this study was to determine whether analogous hemodynamically manifest atrial interactions occur across the thinner interatrial septum. METHODS: Right atrial (RA) and left atrial (LA) pressures were measured with micromanometer-tipped catheters before and after atrial pressure and volume overload elicited by sequential right ventricular (RV), RA, and septal ischemia induced in nine open-chest dogs. RESULTS: Following RV ischemia, RA pressure increased and RA contraction and relaxation were enhanced, as indicated by an augmented A wave and X descent. Despite decreased LV diastolic size, LA pressure increased, with similar increases in its A wave and X descent. RA ischemia depressed RA contraction and relaxation, resulting in diminished A wave and X descent. Parallel changes occurred in the LA waveform. Following septal ischemia, LA contraction and relaxation were enhanced, as reflected in an augmented A wave and X descent. Despite persistent RA ischemia, the RA A wave and X descent increased. CONCLUSIONS: These findings demonstrate interatrial transmission of pressure and waveform changes that may influence hemodynamic evaluation and cardiac function.

Animals↗

Alpha-1 adrenoceptor subtypes in canine aorta.

The present study was designed to demonstrate the existence in canine aorta of alpha 1-adrenoceptor subtypes, alpha 1High and alpha 1Low, that have different binding affinities for 3H-prazosin and to assess the binding affinity of several drugs for each subtype by a displacement experiment. A radioligand binding assay with 3H-prazosin revealed the presence of two alpha 1-adrenoceptor subtypes in the canine aorta. One of them which has a high affinity for prazosin was designated as alpha 1High (Kd: 12.40 pM, Bmax: 21.88 fmol/mg protein), and the other type was designated as alpha 1Low (Kd: 506.03 pM, Bmax: 88.22 fmol/mg protein). The pKi values of several drugs for each subtype were determined, and all drugs used in the present study, except for benoxathian and chlorethylclonidine, showed significant differences between the pKi values for alpha 1High and those for alpha 1Low. Although it is difficult to characterize each alpha 1High and alpha 1Low into alpha 1A or alpha 1B by only the displacement potency, one structural characteristic to distinguish between alpha 1High and alpha 1Low could be evaluated.

Adrenergic alpha-Antagonists↗

Prognostic significance of posturally induced crackles. Long-term follow-up of patients after recovery from acute myocardial infarction.

We found that on pulmonary auscultation, fine crackles could be induced by changing the posture from sitting to supine and/or from supine to supine with passive leg elevation in patients without obvious congestive heart failure. We named these crackles "posturally induced crackles (PIC)." To investigate the relationship between PIC and long-term prognosis after myocardial infarction, we followed up 262 patients who recovered from acute myocardial infarction for a mean period of six years. Cardiac death occurred in three of 78 PIC-negative patients and in 28 of 143 PIC-positive patients. PIC-negative patients had a significantly better long-term prognosis than PIC-positive patients according to the Kaplan-Meier survival curves for cardiac death (p < 0.01). In a multilogistic model based on 70 appropriate cases, PIC was the third most important prognosticator after recovery from myocardial infarction and the number of diseased coronary vessels and the pulmonary capillary wedge pressure ranked first and second, respectively.

Adult↗

[Four cases of advanced adenocarcinoma showing marked response to EAP (etoposide, ADM, CDDP) treatment].

Four cases of unresectable adenocarcinoma due to multiple metastasis were treated by EAP (etoposide, ADM, CDDP). The first was a 49-year-old male with gall bladder cancer, who was admitted to the hospital with metastatic umbilical tumor and intraabdominal dissemination. After 2 courses of treatment, the tumor was significantly decreased and the dissemination was diminished. The second was a 42-year-old female of breast cancer, involving lung, adrenal gland and bone metastasis. After 2 courses of treatment, all metastasis responded remarkably. Case 3 was a 42-year-old female with recurrent rectal cancer. Her lung metastasis completely disappeared after EAP treatment. Case 4 was a 42-year-old breast cancer patient with multiple liver metastasis, who also exhibited a remarkable response. In spite of severe side effects, EAP treatment was remarkably effective in all four cases of unresectable advanced adenocarcinoma.

Adenocarcinoma↗

Efficacy and safety of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution.

The efficacy and safety of a quick drying rubbing type disinfectant (HAD Hand Wash) composed of a povidone-iodine (PVP-I) and ethanol were evaluated in the disinfection of transient skin flora on fingers of 30 medical staff of our department. Three millilitres of HAD solution was rubbed onto the hands for three minutes several times a day over a four week period. Bacteriological effects were evaluated twice, on the first day and after four weeks, by the palm stamp method. The rate of colonies sterilized (bacterial reduction rate) after the use of HAD Hand Wash was 86.9 +/- 21.2% (mean +/- SD) on the first measurement, and 91.5% +/- 12.8% at four weeks. Staphylococcus epidermidis was isolated most frequently and this was eradicated in 83.3% of subjects, the bacterial reduction rate 99.7%. Staphylococcus aureus was originally isolated in 14 subjects and was eradicated in 13; the bacterial colony reduction rate was 99.9% showing high antiseptic efficacy. Although the bacterial reduction rate for Bacillus sp. was a rather low, 75.8-100%, this result was not considered problematic from the clinical standpoint. There were no side effects like chapping in spite of an average 104 applications of HAD Hand Wash during the 4-week test period. From these results, HAD Hand Wash was considered highly effective and safe.

Antisepsis↗

[Hemodynamics and respiratory function in heart failure].

We discussed the pathophysiology of left-sided heart failure with special reference to the pulmonary "venous" system and further discussed the relationship between the capacitance of the pulmonary "venous" system and the pulmonary function. The slope of the pressure-volume line (compliance) in the pulmonary "venous" system was flat in NYHA class II and III patients as compared to class I. Elevated pulmonary "venous" pressure leads to a decrease in the compliance of the pulmonary "venous" system and consequently to a decrease in the static pulmonary compliance and this causes a respiratory dysfunction and an increase in the ventilation-perfusion imbalance. These changes may finally lead to an increase in the work of breathing, resulting in clinical symptoms such as dyspnea.

Heart Failure↗

[The influence of pulmonary "venous" compliance on the static pulmonary compliance: a study of patients with left-sided heart disease with normal respiratory function].

In heart diseases, such as mitral stenosis and angina pectoris, the static pulmonary compliance has been reported to be decreased. By definition, the pulmonary "venous" system consists of the pulmonary veins and the left atrium. It plays an important role as the reservoir for the left ventricle. In this laboratory, the pulmonary "venous" compliance (Cp"v") has been evaluated as delta V/delta P of a short segment of the P"V" volume-pressure curve. To evaluate the influence of Cp"v" on the static pulmonary compliance and to speculate about the mechanisms of the reduction in static pulmonary compliance in left-sided heart disease, hemodynamic data and static pulmonary compliance (Cst) were measured in 27 patients with left-sided heart disease. Cst was measured with esophageal balloon technique in a sitting position. The static volume-pressure curve was fitted by a sigmoid model: V = Vm/(1 + e(A-P)/kappa), where kappa is a shape constant and an index of the lung stiffness. The pulmonary blood volume (PBV) was estimated with our own method, using radionuclide (RN) angiocardiography. The mean pulmonary artery wedge pressures (PAW) were measured using a floating catheter. Cp"v" was calculated as the delta V/delta P from the increment of pulmonary "venous" volume (delta V) and that of PAW (delta P) that occurred during passive elevation of the legs. Pulmonary arterial compliance (Cpa) was obtained from an analysis of the diastolic decline in pulmonary arterial pressure wave forms.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

[Comparison between leucovorin and cisplatin as a modulator of 5-fluorouracil].

Currently, biochemical modulation for 5-fluorouracil (5-FU) by leucovorin (LV) and cisplatin (CDDP) seems one of the most successful chemotherapy for gastro-intestinal tract cancers. The mechanism of the modulation is thought to increase intracellular 5, 10-methylenetetrahydrofolate (CH2-H4 folate) levels. The purpose of this study is to examine the effect of LV and CDDP as a modulator of 5-FU. Either 10, 200, 400 mg/kg of LV or 2, 4, 6 mg/kg of CDDP were administered intravenously to mice bearing Sarcoma-180. Two hrs. later, CH2-FH4 folate levels were measured in tumor, muscle and intestine by thymidylate synthase (TS) binding assay. As the results, after administration of 200, 400 mg/kg of LV or 4, 6 mg/kg of CDDP, CH2-H4 folate level was elevated. This elevation was dose-dependent in LV. In contrast, no more elevation was observed after 6 mg/kg of CDDP injection. There was much smaller increase of CH2-H4 folate level was observed in the muscle and intestine. We conclude that the elevation of CH2-H4 folate levels depends on the organ and this leads to the tumor specificity in these chemotherapy.

Animals↗

Importance of left ventricular function and systolic ventricular interaction to right ventricular performance during acute right heart ischemia.

To determine whether modulation of systolic ventricular interaction influences right ventricular performance during right heart ischemia, the effects of septal ischemia and inotropic stimulation were studied in 15 dogs in an open chest preparation. Right coronary branch occlusions led to right ventricular dilation and free wall dyskinesia, reversed septal curvature and reduced left ventricular diastolic volume. In systole, the septum thickened but bulged paradoxically into the right ventricle generating an active but depressed right ventricular systolic pressure (28.9 +/- 5.5 to 22.1 +/- 4.5 mm Hg), with associated decreases in right ventricular stroke work (5.66 +/- 0.94 to 1.92 +/- 0.53 g.m/m2) and left ventricular systolic pressure (123 +/- 11 to 80 +/- 10 mm Hg). Septal ischemia induced systolic septal thinning, left ventricular dilation and decreased left ventricular systolic pressure (80 +/- 10 to 55 +/- 10 mm Hg) and stroke work. Although the extent of paradoxic septal displacement increased, there were further decrements in right ventricular systolic pressure (22.1 +/- 4.5 to 18.7 +/- 4.3 mm Hg) and stroke work (1.92 +/- 0.53 to 0.7 +/- 0.2 g.m/m2). Dopamine infusion augmented left ventricular free wall contraction and increased left ventricular systolic pressure (55 +/- 10 to 172 +/- 17 mm Hg) and stroke work. Although systolic septal thinning persisted, the extent of paradoxic septal displacement increased strikingly and, despite continued right ventricular free wall dyskinesia, right ventricular systolic pressure increased (18.7 +/- 4.3 to 39.6 +/- 6.2 mm Hg) as did right ventricular stroke work (0.7 +/- 0.2 to 7 +/- 1.6 g.m/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

Increase in serum cardiac myosin light chain I associated with elective percutaneous transluminal coronary angioplasty in patients with ischemic heart disease.

Changes in serum myosin light chain I (MLCI) due to elective percutaneous transluminal coronary angioplasty (PTCA) were studied after PTCA (0, 8 and 48 hours) in 57 patients with old myocardial infarction (MI group) and 20 patients with angina pectoris (AP group). The AP group showed no increase after PTCA. In contrast, in the MI group there were 16 patients in whom MLCI at 48 hours was increased by 1.0 ng/ml or more (MI1 group) and another group of 41 patients who showed no increase in MLCI (MI2 group). The MI1 group had a significantly higher incidence of (1) non-Q wave myocardial infarction (62.5% vs. 17.1%, p < 0.01), (2) 99% stenosis of a coronary artery (50.0% vs. 12.2%, p < 0.01), and (3) redistribution in a hypoperfusion area found in the delayed image of resting thallium-201 (201Tl) myocardial scintigraphy (85.7% vs. 15.8%, p < 0.01). The left ventricular ejection fraction (LVEF) was significantly improved in the MI1 group, 3 to 4 months later (from 0.49 +/- 0.12 to 0.58 +/- 0.11, p < 0.01), in contrast to the patient of MI2 group who did not show any improvement. The AP group was not considered to have a bulk of myocardium impaired enough to show a release of MLCI due to PTCA-associated transient coronary occlusion. In the MI1 group, however, MLCI was probably released from the chronically under-perfused, but still salvageable, portion of the myocardium. This is consistent with the improvement in LVEF observed 3 to 4 months after the relief of severe coronary stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗

Estimation of right ventricular volume by modified echocardiographic subtraction method.

To evaluate the accuracy and clinical utility of right ventricular volume estimated by a modified echocardiographic subtraction method versus Krebs' original subtraction method, an experiment was performed on hearts excised from 25 animals (dogs, pigs, and cows) followed by a clinical study of 41 patients with heart disease. Right ventricular volume was measured by subtracting the left ventricular volume from that of the whole heart based on echocardiographic apical two- and four-chamber views by means of the area-length method. In the animal heart study, the coefficient of variation between the right ventricular volume estimated by the modified method and the true volume was +/- 13%. The regression equation was y = 0.94x + 4.15 (r = 0.987, p less than 0.001) and showed good correlation, whereas the right ventricular volume obtained by the original method underestimated the true volume (coefficient of variation = +/- 25%, y = 0.59x + 1.11; r = 0.976, p less than 0.001). In the clinical study, the coefficient of variation between right ventricular volume estimated by the modified echocardiographic method and RV volume estimated by radionuclide ventriculography was +/- 15%. The regression equation was y = 0.80x + 13.3 (r = 0.935, p less than 0.001). This correlation was better than that obtained by the original method (coefficient of variation = +/- 16%), where the regression equation was y = 0.60x + 2.43 (r = 0.888, p less than 0.001). Thus the accuracy of the modified subtraction method was validated, and this method showed a better correlation than the original method both experimentally and clinically.

Adolescent↗

Plasma high density lipoprotein in anemic cattle infected with Theileria sergenti.

Changes in plasma concentration of lipid composition were analysed in cattle with anemia due to Theileria sergenti infection. Plasma levels of phospholipids, cholesterol, free cholesterol, high density lipoprotein cholesterol, and vitamin E decreased to 40-67% of the pre-infection levels, corresponding to the decrease of PCV due to the infection. However, no definite changes were detected in plasma level of triglyceride. By gradient centrifugation, it was confirmed that lipid components, other than triglyceride, occur in high density lipoprotein (HDL) and these decreases lowered the HDL value. There was no correlation between this phenomenon and liver function. As similar changes in lipid composition were also observed in phlebotomized calves, it was considered that this phenomenon might partially depend on the acceleration of erythropoiesis as a reaction to anemia caused by T. sergenti infection.

Anemia↗

[An experimental study on the determinants to the effects of self-affirmation].

The purpose is twofold: first to examine whether an experience that affirms a valued aspect of the self eliminates the negativity of failure and second, to identify what is the most effective condition of self-affirmation. A 2 x 3 factorial design was employed: Immediately after having failed and prior to rating the beneficialness of failure experience, 72 subjects were allowed to affirm the real-self that they had built up, or the pseudo-self made by the experimenter. The situation of self-affirmation was (1) that subjects affirmed the self in private or (2) that the experimenter also affirmed the subject's self or (3) that the experimenter added information of another one who had the same aspect of self the subjects had affirmed. The self-affirmation effect was most clear-cut, when the real-self was affirmed, and was also affirmed by the experimenter. This effect was especially pronounced for high self-esteem subjects. Joint effects of high self-esteem, clearer real-self, and its publicity elevated level of self-affirmation.

Adult↗