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Biomedical subjects

H Ijima

Publications and source records attributed to H Ijima.

At least 37 records · Page 2Linked to original sources

Disseminated intravascular coagulation in aortic aneurysms: assessment of consumption site using labeled-platelet scintigraphy.

BACKGROUND: It is known that disseminated intravascular coagulation (DIC) may occur along with aortic aneurysms. To assess the localization of the active consumption site we performed 111In-oxine labeled platelet scintigraphy in patients with chronic aortic aneurysms. METHODS: Images were obtained using 111In-oxine labeled autologous platelets in 45 patients. Planar images were taken twice (at 4 and 48 hrs) after injection. A visual inspection of the radioactivity uptake and special analysis in regions of interest were performed. RESULTS: Thirty-five patients (78%) showed a focal accumulation of radioactivity in the aortic aneurysm. Six of 13 patients (46%) with dissecting aortic aneurysm, and 4 of 32 patients (12.5%) with true aneurysms were evaluated as negative uptake by scintigram (p < 0.05). The aneurysm/heart ratio was 0.85 +/- 0.16 (mean +/- SD) (4 hrs) and 1.09 +/- 0.15 (48 hrs) after injection; the aneurysm/liver ratio was 0.56 +/- 0.16 (4 hrs) and 0.38 +/- 0.09 (48 hrs); the aneurysm/spleen ratio was 0.39 +/- 0.07 (4 hrs) and 0.39 +/- 0.08 (48 hrs). CONCLUSIONS: When the probability of DIC is clinically high in patients with aortic aneurysms, 111In-oxine labeled platelet scintigraphy provides useful preoperative information regarding the location of the functionally active consumption focus.

Adult↗

Formation of a spherical multicellular aggregate (spheroid) of animal cells in the pores of polyurethane foam as a cell culture substratum and its application to a hybrid artificial liver.

Monkey kidney cells (Vero), human embryonic kidney cells (293), human liver cells (PLC/PRF/5), and primary rat, dog, and porcine hepatocytes formed spherical multicellular aggregates (spheroids) in the pores of polyurethane foam which was used as a cell culture substratum. These spheroids of various cell types express high cell activity for a long period. A practical hybrid artificial live support system composed of a multi-capillary polyurethane foam packed-bed type cell culture module including primary hepatocyte spheroids was developed. The success of the system is indicated by an 80% recovery rate in hepatic failure rats which died in control experiments.

Animals↗

Does laser Doppler flowmetry aid the prevention of ischemic colitis in abdominal aortic aneurysm surgery?

Acute ischemic colitis is noted as a rare but lethal complication of abdominal aortic aneurysm (AAA) surgery. Because of its high mortality a reliable method of monitoring colonic blood perfusion to predict the possible occurrence of ischemic colitis is highly desirable for AAA surgery. We have tested the use of a laser Doppler flowmeter placed on the surface of the sigmoid colon for intraoperative monitoring in 31 patients with AAA. Although most of the patients showed the same flow levels after aorto-iliac or aorto-femoral grafting (at least unilaterally the internal iliac artery was perfused), in 6 cases poor colonic perfusion (below 50% of the basal flow) was observed and inferior mesentric arterial reconstruction was performed. In these 6 patients, sigmoid colonic blood perfusion returned from 37% to 82% of preoperative value after the reconstructions. No ischemic colitis was noted in this series of patients. We suggest that monitoring of serosal blood flow in the sigmoid colon using a laser Doppler flowmeter is useful for the management of patients during abdominal aortic aneurysm surgery.

Acute Disease↗

[Clinical characteristics and muscle histopathology in polymyositis positive anti-hepatitis with C virus antibody].

In 14 patients with polymyositis (PM), 5 patients (2 males and 3 females) were positive for anti-hepatitis C virus (HCV) antibody measured by a second generation assay. We analysed the clinical characteristics and histopathological findings of the biopsied muscles from those 5 patients. They aged from 42 to 65 years averaging 53.6 years. Two asymptomatic patients visited our hospital due to elevated muscle enzyme levels, who had slight weakness in their orbicularis oculi and neck muscles on physical examination. The other 3 patients had moderate weakness of the proximal muscles. Anti-nuclear antibody was positive in 2 of the 5 patients and anti-Jo 1 antibody was negative in all patients. The serum enzymes elevated were creatine kinase (215-2, 207 (IU/l)) and glutamate oxaloacetate transaminase (40-119 (KU)). HCV-RNA was positive in the sera of 4 patients examined. All muscle biopsy specimens revealed variation in fiber size with inflammatory cellular infiltration and observed degenerating and regenerating fibers. The scant infiltration type was observed in 2 asymptomatic patients in whom the infiltrated cells were CD4 positive. The endomysial infiltration type was observed in 3 symptomatic patients; CD8 positive cells were found focally to diffusely in 2 patients examined. The expression of class 1 molecules from the major histocompatibility complex was detected mainly in infiltrated fibers to variable degrees. All of the patients showed a good response to the initial steroid therapy. The present study suggests that autoimmune reaction related to HCV infection causes myositis, therefore anti-HCV antibody should be checked in cases of PM.

Adult↗

Stereoselective synthesis of a blood group A type glycopeptide present in human blood mucin.

N,N-Dimethyl-O-(2-acetamido-2-deoxy-alpha-D-galactopyranosyl)-(1-->3)-O- [(alpha-L-fucopyranosyl)-(1-->2)]-O-(beta-D-galactopyranosyl)-(1-->3)-O- (2-acetamido-2-deoxy-alpha-D-galactopyranosyl)-(1-->3)-L-serine, a core I glycotetraosyl peptide structure and a predominant substructure in complex glycan-glycoproteins present in human blood group A ovarian mucin, was synthesized for the first time. The title compound was synthetically accomplished via the following key manoeuvres: regio- and stereo-controlled construction of the alpha-GalNAc-(1-->3)-Gal synthon, stereoselective glycosylation generating a alpha-GalN3-(1-->3)-Ser glycopeptide synthon and alpha-selective fucosylation towards an acceptor which was derived from glycosylation of the latter two synthons. An alternative route to that of the latter, to synthesize a fully protected equivalent of the title compound, involving the coupling of a alpha-GalNAc-(1-->3)-beta-Gal-(1-->3)-GalN3X synthon to an aglycon serine derivative, is described herein.

ABO Blood-Group System↗

Cytokine profile during high-dose rhG-CSF therapy in severe congenital neutropenia.

The effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on cytokine profile was evaluated in a case of severe congenital neutropenia. The plasma levels of cytokines were measured before and during rhG-CSF therapy. These included G-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-1 alpha, interleukin-1 beta, interleukin-2 (IL-2), interleukin-3 (IL-3), interleukin-4, interleukin-6 (IL-6), and tumor necrosis factor-alpha. Soluble interleukin-2 receptor (sIL-2R) was measured serially during rhG-CSF therapy. Lymphocyte subpopulations including CD2, CD3, CD4, CD8, CD19, CD20, and CD25 were also measured, rhG-CSF was administered once daily as a 30-min infusion. The patient was treated with increasing dose levels of 100, 200, 400, 800, and 1,600 micrograms/m2/day. The level of endogenous G-CSF was elevated to 334 pg/ml before treatment and GM-CSF, IL-2, IL-3, and IL-6 were slightly elevated. Clinically, he showed a moderate response to a high dose of rhG-CSF (1,600 micrograms/m2/day). Plasma levels of G-CSF markedly increased during therapy but plasma levels of other cytokines did not show significant changes during therapy and lymphocyte subpopulations did not significantly change. A drastic increase in sIL-2R expression was observed after rhG-CSF infusion and an increase in sIL-2R expression occurred even before a major increase in granulocyte counts. These results showed that a high dose rhG-CSF therapy may influence the cytokine network as judged by the increased sIL-2R expression.

Child, Preschool↗

Increased cytokine levels and abnormal response of myeloid progenitor cells to granulocyte colony-stimulating factor in a case of severe congenital neutropenia. In vitro effects of stem cell factor.

PURPOSE: The cytokine levels and the in vitro granulopoiesis were studied to evaluate the mechanism of impaired granulopoiesis in severe congenital neutropenia (SCN). PATIENT AND METHODS: The patient was a 5-year-old boy with SCN. We assayed the colony-stimulating activity (CSA) produced by peripheral blood (PB) cells from the patient. The plasma levels of cytokines were measured using enzyme immunoassay. These included granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin 1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-3, IL-4, IL-6, and tumor necrosis factor-alpha. The effects of IL-3 and stem cell factor (SCF) on the proliferation of granulocyte-macrophage colony-forming cells (GM-CFCs) were studied. RESULTS: CSA produced by PB cells from the patient was almost the same as in the healthy control. The level of endogenous G-CSF was elevated to 334 pg/ml, and GM-CSF, IL-2, IL-3, and IL-6 were slightly elevated. The numbers of GM-CFCs were markedly depressed in the presence of G-CSF alone and showed no increment on additional stimulation by IL-3. SCF in combination with G-CSF significantly augmented the proliferation of GM-CFCs. CONCLUSIONS: These findings suggest that some cytokines including G-CSF may be elevated in SCN patients and that CSF may play an important role in the pathogenesis of SCN.

Colony-Stimulating Factors↗

Extra-anatomic bypass for aorto-iliac occlusive disease in octogenarians.

Fifteen patients over 80 years of age with aorto-iliac occlusive disease (AIOD) underwent surgical revascularization of an ischemic lower extremity by extra-anatomic bypasses. The mean age at operation was 81.7 years, ranging from 80 to 86 years. Surgical revascularization of the ischemic lower limbs could safely be performed with an extra-anatomic bypass in these patients without any major complications. The mean follow-up period was 32.7 months. Eight patients died during the follow-up, only one of them died from myo-nephropathic metabolic syndrome related to acute graft occlusion. As a long-term result, the cumulative survival after 37 months was only 23.9%, while the actual graft patency rate was 43.8% after 60 months in this series. The survival period with an improved quality of life after surgical intervention reached a level of approximately 40% of that for the general population. There should be no hesitation over whether to carry out surgical intervention for AIOD in patients over 80 years of age, because a reasonable extension of life can be obtained by an extra-anatomic bypass.

Aged↗

[Simultaneous operation of gastrectomy, cholecystectomy and coronary artery bypass grafting using right gastroepiploic artery].

We present a case who received the simultaneous surgical corrections of unstable angina, acute gastric ulcer, and cholelithiasis. A 72-year-old man was admitted to our hospital due to unstable angina. An emergency coronary angiography was performed and we found severe 2 vessels disease (RCA ostium and proximal LAD lesions). After the admission, the angina was poorly controlled and the surgical treatment had been considered. The patient developed sudden hematemesis due to the uncontrolled bleeding from gastric ulcer. Then the emergency operation was performed. Partial gastrectomy with preservation of RGEA and cholecystectomy were done followed by CABG to RCA with RGEA and to LAD with autologous saphenous vein. The postoperative course was uneventful and the patient is in good condition to date.

Acute Disease↗

Influence of fibril length upon ePTFE graft healing and host modification of the implant.

Influence of fibril length (porosity) upon synthetic vascular graft healing has not been investigated in detail. The purpose of this study was to determine the dependence of neoendothelial healing, cellular response, and biocompatibility on the fibril length of expanded polytetrafluoroethylene (ePTFE) grafts with an internal diameter of 1.5 mm. ePTFE grafts of different fibril length, 20, 40, 60, and 90 microns, were implanted into the abdominal aorta of rats (n = 5 for each group). After 5 weeks, the implants were harvested and examined for neointimal and pseudointimal coverage by light microscopy and SEM. The hydroxyproline content of the implants was measured, and the distribution of collagen types was examined. The neointimal and pseudointimal coverage was related to the fibril length, and the neoendothelial healing was better on 60-microns and 90-microns grafts than on 20-microns and 40-microns grafts. The amount of hydroxyproline was also related to the fibril length, however, no significant difference could be observed between 60-microns and 90-microns grafts. Collagen types I and III were almost identically located in the middle portion of the implants. Our results demonstrate that the fibril length of ePTFE grafts affected neoendothelial healing and its affinity to collagen.

Animals↗

A case of congenital leukemia with monosomy 7.

A case of congenital leukemia with monosomy 7 is reported. Immunological study of the blast cells using monoclonal antibodies was suggestive of both myelomegakaryocytic and T-lymphoblastic leukemia. Chromosomal analysis of the bone marrow cells showed monosomy 7. Chemotherapy was initiated with a combination of adriamycin, cytosine arabinoside, 6-mercaptopurine, and prednisolone. The patient obtained complete remission, which has been maintained for 4 years and 1 month. He receives no chemotherapy now. Our case shows that monosomy 7 in congenital leukemia is rare, but the presence of monosomy 7 in congenital leukemia does not necessarily indicate a poor prognosis.

Antineoplastic Combined Chemotherapy Protocols↗

[A successful surgical treatment of chronic traumatic mid-descending thoracic aortic aneurysm].

A 48-year-old woman with chronic mid-descending thoracic aortic aneurysm was successfully repaired. She received a blunt chest trauma due to automobile accident at July in 1988. Left upper lobectomy was performed for her lung contusion. March 1990, she admitted our hospital with abnormal shadow revealed by a chest roentgenogram. A computed tomogram of the chest and an aortogram revealed two false aneurysms. One of them was located at mid-descending thoracic aorta and another was aortic isthmus. Under a partial femoral veno-arterial bypass, a Dacron graft replacement of mid-descending thoracic aorta was performed and aneurysm of isthmus was wrapped by Teflon mesh after the left pneumonectomy. 2 months after the operation, bronchopulmonary fistula occurred at the left bronchial stump. The fistula was successfully covered with major omentum. The mid-descending thoracic aortic aneurysm due to blunt chest trauma is rare. The traumatic aortic aneurysms commonly occur aortic isthmus or ascending aorta. Initial diagnosis of traumatic mid-descending thoracic aortic aneurysm is often missed or delayed. Careful follow up is need and when an abnormality is revealed by chest roentgenogram, computed tomogram and aortogram should be obtained to make diagnosis of chronic traumatic aneurysm.

Aorta, Thoracic↗

[MRSA pyothorax due to bronchopleural fistula after grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta--a successful treatment by open drainage and omentopexy].

Treatment of postpneumonectomy pyothorax due to bronchopleural fistula (BPF) is troublesome, especially with methicillin-resistant staphylococcus aureus (MRSA) infection. Moreover, in a bypass-grafting case, the management becomes more complicated. We reported a successful treated case of MRSA pyothorax due to BPF after grafting and pneumonectomy. In a 48-year-old woman performed grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta, MRSA pyothorax due to BPF occurred. BPF was successfully closed by fibrin-glueing under bronchofiberscopy. However pyothorax was not improved by thoracic irrigation for a month. Therefore, open pleural drainage underwent. At the same time, bronchial stump and graft surface was covered with the omental pedicle flap. The open wound had become sterile in two months, and the thoracic window was closed three months after the open drainage.

Aorta, Thoracic↗

[Biventricular heart assist using centrifugal pump and roller pump in profound ventricular failure after open heart surgery: a case report].

A forty-seven-year-old female with profound biventricular heart failure probably caused by coronary artery spasm after open mitral commissurotomy was successfully survived by mechanical circulatory support. Centrifugal and roller pumps were applied to left and right side circulatory assist respectively. Recovery of cardiac function was evaluated by transesophageal echocardiography and hemodynamic parameters during intentional low flow assist. Finally, she was weaned from assist after 136 hours. No systemic thromboembolism was recognized after pump removal. Combination of centrifugal and roller pumps could be applicable to biventricular heart assist without crucial complication.

Cardiac Output, Low↗

Erythroleukemia in a child associated with monosomy 7.

A case of erythroleukemia (EL) associated with monosomy 7 is reported. The EL was diagnosed 20 months after the initial diagnosis of monosomy 7 was made. An immunologic study of the blast cells using a monoclonal antibody was positive for glycophorin A, which suggested that they were of erythroid origin; this was confirmed by electron microscopy. Chemotherapy was started with low dose cytarabine. However, the patient had severe bone marrow suppression and died of pneumonia. Our case shows that monosomy 7 is an abnormality of the pluripotential stem cells, including erythroid cells, that resulted in a true erythroid neoplasm.

Child, Preschool↗

High albumin production by multicellular spheroids of adult rat hepatocytes formed in the pores of polyurethane foam.

Adult rat hepatocytes formed spherical multicellular aggregates (spheroids) when they were cultured in the pores of polyurethane foam (PUF). The diameter of the spheroids was within the range 100-200 microns. These spheroids partly attached and immobilized in the PUF pores for at least 2 weeks. The albumin production rate by the spheroids increased up to 17.0 micrograms/10(6) nuclei per day during the first 6 days and maintained at a high level for 2 weeks. In contrast, the albumin production rate by the monolayer markedly decreased after 3 days. The spheroid culture using PUF seems to be a convenient and simple method for maintaining some differentiated functions of hepatocytes and for making a bioreactor using the function of spheroids.

Albumins↗