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Biomedical subjects

K Inoue

Publications and source records attributed to K Inoue.

At least 1,135 records · Page 63Linked to original sources
PubMed1996

[A case of the giant and pedunculated thrombus formation in the left atrium with normal mitral valve].

Occurrence of thrombus formation in the left atrium is rare without accompanying abnormalities at the mitral valve. Only a few cases of giant and pedunculated thromboses in the left atrium have been reported in the Japanese literatures. This is a case report of giant thrombus in the left atrium treated surgically. Patient was 61 years old male suffering from palpitation. Physical examination of the heart revealed increased first sound and diastolic rumbling at the apex. ECG revealed atrial fibrillation and LVH. Echocardiography and chest CT demonstrated a huge tumor like mass in the left atrium attached to the septal area. There were no abnormalities found at mitral valvular structures or motion. Catheterization studies revealed no disturbance of valvular functions. Angiographic examination demonstrated smooth surfaced tumor mass occupied left atrium. Coronary angiography revealed significant stenosis in segments 6, 7, 9, 12 and 14. Prior to surgery, patient was diagnosed myxoma of the left atrium and ischemic heart disease. Removal of the mass and CABG were carried out at a same time. Pathology revealed giant and pedunculated globular thrombus. Contributional factors possibly growing of such huge thrombus formation explained resulting from atrial fibrillation and decreased contractile force of the hypertrophied ventricle.

Heart Atria↗
PubMed1996

[Malignant lymphoma of the chest wall in a patient with chronic empyema].

A 76-year-old man presented with the chief complaints of appetite loss and general fatigue. He was admitted with the initial diagnosis of empyema necessitatis, and right thoracic drainage was performed. Nevertheless, the subcutaneous mass in the right side of the chest wall did not shrink, and examination of a specimen obtained by percutaneous needle biopsy resulted in the diagnosis of non-Hodgkin's lymphoma, intermediate lymphocytic type. The patient was treated with Adriamycin, vincristine, prednisolone, and cyclophosphamide, but died of pneumonia and cachexia five months after symptoms first appeared. The diagnosis of intermediate lymphocytic lymphoma, B cell type was made at autopsy. Only 53 cases of malignant lymphoma associated with chronic empyema have been reported in Japan. Surgery was often not done because of the patient's advanced age or poor pulmonary function; diagnosis was often difficult. However, review of the 53 reported cases suggested that resection of the tumor, if possible, would improve the prognosis. Malignant lymphoma should be considered when there is chronic empyema, because such cases are now being reported more frequently.

Aged↗
PubMed1996

[Regional distribution of the muscarinic cholinergic receptor in the human brain studied with 11C-benztropine and PET using an anatomical standardization technique].

We measured regional distribution of the muscarinic cholinergic receptor in the normal human brain with 11C-benztropine (BZT) and positron emission tomography (PET) using an anatomical standardization technique. Seven normal volunteers who gave informed consents were involved in this study. Immediately after intravenous injection of 11C-BZT into the subjects, we started dynamic PET scanning and serial frequent arterial blood sampling. Analyses of plasma metabolites were also performed at selected time points and plasma time activity curves (TAC) of unmetabolized ligand were generated. From these PET and TAC data, we obtained Patlak plot slope calculation images. Using the HBA (human brain atlas) system, the Patlak plot slope calculation image of each subject was transformed into the shape of the standard brain. Mean and standard deviation (SD) calculation images were generated from those anatomically standardized images. On these mean and SD images, we placed regions of interest which were previously outlined on a MR image of the standard brain. From those data, we found the highest receptor distribution in the striatum and occipital cortex, as well as high distribution in the frontal, parietal, and temporal cortices, which were consistent with previous reports. These results suggested that anatomical standardization of PET receptor images with 11C-BZT will be useful for delineating the physiological or pathological alterations of the muscarinic cholinergic receptor in the human brain.

Adolescent↗
PubMed1996

[Visual evaluation of liver function with 99mTc-GSA scintigraphy: interobserver variation and intraobserver variation].

We introduced a new imaging grade to evaluate liver function with 99mTc-GSA and studied its diagnostic value using interobserver variation and intraobserver variation. One hundred four patients with liver disease were injected 185 MBq/3 mg of 99mTc-GSA. Anterior images of cardiac blood-pool and liver at 5 min after injection were divided into four grades on the basis of following four categories. Faint cardiac blood-pool image, without clear demonstration of its peripheral boundary was classed in grade I; weaker cardiac blood-pool than liver was grade II; almost same appearance of blood-pool with liver was grade III and stronger blood-pool than liver was grade IV. Three radiologists reviewed the images independently. They followed the same process three months after initial evaluation. kappa-Test was employed to evaluate the goodness of agreement. Three pairs in the first reading showed excellent interobserver agreement (0.88, mean kappa-value) and another three pairs in the first and second reading also showed excellent intraobserver agreement (0.87, mean kappa-value). Quantitative indices obtained from time-activity curves for blood-pool and liver showed significant differences across four groups. Plasma retention rate of indocyanine green also showed significant difference between grade II and grade III. Imaging grade possesses high intra- and interobserver agreement and provides a good discrimination for liver function.

Adolescent↗
PubMed1996

[Evaluation of area at risk by 123I-BMIPP in patients with acute myocardial infarction].

The purpose of this study was to investigate the detection of area at risk of acute myocardial infarction (AMI) by 123I-BMIPP (BMIPP). 99mTc-tetrofosmin (TF) scintigraphy was performed on 13 patients with AMI with total coronary occlusion. BMIPP scintigraphy was done on the same patients within 1 week after successful reperfusion by direct PTCA. Activity of both tracers was scored in 8 basal, 8 midventricular and 2 apical segments, using a four-point grading system as defect score: 3 = defect, 2 = severely low uptake, 1 = slightly low uptake, 0 = normal. Extent score (ES) was defined as a total number of segment which deteriorated of uptake, and severity score (SS) was defined as a total score of defect score. ES of BMIPP was 6.5 +/- 2.4 and that of TF was 7.5 +/- 2.4. ES of BMIPP was smaller than that of TF. A ratio of BMIPP/TF was 0.86 +/- 0.18. SS of BMIPP was 16.2 +/- 6.0 and that of TF was 19.2 +/- 5.6. SS of TF was larger than that of BMIPP. A ratio of BMIPP/TF was 0.83 +/- 0.18. A correlation of ES and SS between TF and BMIPP was excellent. BMIPP showed ischemic area by culprit lesion and infarct area clearly. We concluded that BMIPP could indicate area at risk.

Aged↗
PubMed1996

[Prognostic factors of resected pulmonary metastases of osteogenic sarcoma].

From December 1979 to December 1994, 22 patients with osteogenic sarcoma underwent a total of 34 thoracotomies for resection of pulmonary metastases in our department. We did a retrospective study to identify prognostic factors. The tumor doubling time (TDT) calculated for 21 patients before the first (if multiple) resection was not correlated with days of survival after resection of the primary tumor, nor was it correlated with days of survival after the first (if multiple) resection of the pulmonary metastatic tumors. Of the nine patients who underwent at least two thoracotomies, the TDT calculated from X-ray films taken before the second (or later) thoracotomy was significantly shorter than the TDT calculated before the preceding thoracotomy (p < 0.05). The disease-free interval (DFI) after resection of the primary tumor was correlated with the days of survival after that resection (p < 0.001) and also with survival after resection of the pulmonary metastatic tumors (p < 0.01). This DFI of patients who survived at least 2 years from the date of the resection of the primary tumor was significantly longer than in patients who survived less than 2 years from that date (p < 0.05). The most significant prognostic factor was this DFI. The cumulative survival rate was 42.4% at three years and 33.9% at five years, with an operative mortality of 0%.

Adolescent↗
PubMed1996

[Myocardial protective effect of rapid cooling shock at reperfusion].

Hypothermia in a heart in which coronary circulation is sustained produces positive inotropism of the myocardium. The effects on cardiac function and intracellular Ca profile of rapid cooling shock (RCS) immediately after reperfusion were evaluated in terms of their ability to inhibit the onset of myocardial stunning and to rapidly improve function. RCS administered to isolated hearts of Langendorff perfusion rats for 3 minutes induced positive inotropism after 32 +/- 4 seconds, with LV Developed Pressure (LVDP) increased a normal 120 +/- 10% (mean +/- SE, n = 16). Based on the result in which the positive inotropism was confirmed, an experiment using rats was performed as follows: after 30 minutes of ischemia at 37 degrees C, 25 degrees C or 10 degrees C, the hearts were reperfused for 1, 2 or 3 minutes and RCS was administered for 1, 2 or 3 minutes. LVDP was satisfactorily reversed early in rats treated with RCS for 3 minutes after 3 minutes reperfusion of the ischemic hearts at 25 degrees C. In this group, no significant change in Ca concentration in myocardial cells was observed at reperfusion: +/- 3% of the baseline level. Intracellular Ca overload at reperfusion and decreased intracellular Ca level, which have the effect of suppressing the CICR channel, which plays a role in Ca release into the sarcoplasmic reticulum at contraction, are important causative factors in the development of myocardial stunning, as are free radicals. RCS improved myocardial function rapidly because it inhibited change in Ca level.

Animals↗
PubMed1996

Nitrate kinetics in patients with compensated cirrhosis: correlation with hemodynamics.

OBJECTIVES: The serum nitrate concentration is known to be increased in patients with cirrhosis. This study was designed to determine the kinetics of nitrate in the splanchnic vascular areas and its relationship with hepatic hemodynamics in patients with compensated cirrhosis. METHODS: We measured the serum nitrate concentration of various sites, including the femoral artery, hepatic vein, azygos vein, and pulmonary artery, and compared these values with hepatic hemodynamics. RESULTS: The nitrate concentrations of hepatic vein and azygos vein were significantly greater in cirrhotic patients compared with those of control subjects. The values were particularly elevated in patients with Child-Pugh's class B. In control subjects, hepatic vein and azygos vein nitrate concentrations were significantly lower than arterial nitrate concentrations whereas nitrate concentrations were significantly greater in the hepatic and azygos veins than femoral artery in cirrhotic patients, and nitrate kinetics was that of the net release of nitrate from the hepatic and azygos veins. The portal vein blood flow positively correlated with the nitrate concentration of azygos vein, pulmonary artery, and femoral artery. CONCLUSIONS: The present results implicate the enhanced production of nitric oxide in the mesenteric vascular beds in patients with cirrhosis. The positive correlation between portal vein blood flow and serum nitrate concentrations suggests that endogenous nitric oxide may have an important role in the regulation of portal hemodynamics in these patients.

Blood Flow Velocity↗
PubMed1996

Spouse concordance of obesity, blood pressures and serum risk factors for atherosclerosis.

Familial aggregation of atherosclerotic risk factors is well known, however inter-spouse relation of the risk factors has remained controversial. As spouses are not blood-related, any risk factor relation probably does not reflect genetic factors, but the environmental factors to which the couple is exposed. Moreover, the effect of assortative marriage should be considered. The present study enrolled 97 married couples who attended a general health screening in 1993 in a mountain village of Japan. The screening was conducted between April and November at a single outpatient clinic in the village. Data on weight, height, blood pressure (BP), serum risk factors for atherosclerosis and marriage year were obtained as part of the screening programme. They were divided into three groups according to marital duration. The simple correlation coefficients for systolic/diastolic BP between the spouses were 0.22/0.19. The coefficients declined to 0.05/0.08 after controlling. The correlation coefficients for serum lipoproteins were low and between -0.06 and 0.11 after controlling. The correlation coefficients for blood sugar were -0.05 and -0.13 after controlling. In subgroup analyses stratified by marital duration, the correlation coefficients for BP, body mass index (BMI) and blood sugar were increased in both the short and long marital duration groups. The correlation coefficients for high-density lipoprotein (HDL) cholesterol and triglycerides increased with longer marital duration. Although a larger population study will be needed to confirm these findings, these results suggest the presence of interspouse correlation and reflect the influence of assortative marriage and environmental factors on spouse concordance.

Aged↗
PubMed1996

Computed tomography of pancreatic adenocarcinoma: comparison of tumor size measured by dynamic computed tomography and histopathologic examination.

Our objective was to assess the detection rate and the accuracy of tumor size determination in pancreatic ductal adenocarcinoma using dynamic computed tomography (CT). Preoperative dynamic CT was evaluated in 35 surgically resected pancreatic ductal adenocarcinomas and the findings were compared with the results of histopathological examination. Pancreatic adenocarcinoma was visualized by dynamic CT as a low-density mass in 97% of cases. All three lesions < or = 2 cm in size were demonstrated in good contrast to normal pancreatic parenchyma. The tumor size measured on dynamic CT showed a good correlation with that measured histopathologically, especially in small tumors. Dynamic CT was useful for evaluating the extent of pancreatic adenocarcinoma, especially for small tumors. The detectability of lesions by CT depended on the manner of tumor extension and the degree of associated pancreatitis as well as the tumor size.

Adenocarcinoma↗
PubMed1996

[A case of poorly differentiated ovarian serous adenocarcinoma responding favorably to etoposide and cisplatin].

A case of primary ovarian cancer responding favorably to EP therapy is reported. The patient is a 41-year-old woman with stage IV poorly differentiated serous papillary adenocarcinoma of the ovary. At 21 days after the optimal initial surgical exploration, multiple tumor nodules recurred in peritoneal cavity, and one of them had a diameter of 5 cm. Since we had found previously that poorly differentiated adenocarcinoma of the ovary responded to etoposide by a disease-oriented screening system, the patient was treated by combination chemotherapy (etoposide 100 mg/body/day x 5 days + cisplatin 20 mg/body/day x 5 days) as first line chemotherapy. After 2 cycles of chemotherapy, the tumor disappeared on CT, and the serum CA 125 level decreased to 14 U/ml from 2,050 U/ml. She was evaluated as a complete response after 5 cycles of combination chemotherapy, and only mild side-effects were recognized. These results demonstrate that the combination chemotherapy of etoposide and cisplatin might be recommended as first-line chemotherapy for poorly differentiated serous adenocarcinoma of the ovary.

Adult↗
PubMed1996

Role of human cytochrome P4502A6 in C-oxidation of nicotine.

Nicotine is primarily metabolized to cotinine in humans. In this study, human cytochrome P450 (CYP) isoform involved in cotinine formation was identified. The formation of cotinine in 16 human liver microsomes was determined with a 50 microM nicotine concentration and with a cytosol preparation as a source of aldehyde oxidase. Cotinine formation in human liver microsomes significantly correlated with immunochemically determined CYP2A6 levels (r = 0.663, p < 0.05), coumarin 7-hydroxylase activities (r = 0.831, p < 0.01), and cotinine 3'-hydroxylase activities (r = 0.735, p < 0.01) that are responsible for CYP2A6. In inhibition studies, cotinine formation in human liver microsomes was inhibited by coumarin and rabbit anti-rat CYP2A1 antibody specifically. When the capability of microsomes of B-lymphoblastoid cells expressing human CYPs to perform biotransformation of nicotine to cotinine was determined, cDNA-expressed CYP2A6 exhibited the highest cotinine formation. The KMapp values from microsome expressing CYP2A6 cDNA were similar to the value obtained from human liver microsomes. The large interindividual variabilities in cotinine formation and immunochemically determined CYP2A6 levels were observed in human liver microsomes, suggesting genetic polymorphism of CYP2A6. Nicotine is a new in vivo probe for phenotyping of CYP2A6 in humans.

Aryl Hydrocarbon Hydroxylases↗
PubMed1996

[A case of congenital cystic adenomatoid malformation of the lung in childhood].

A 2-year-old boy was admitted for elevation of infiltrative shadow in the left middle lung field on a chest X-ray. The clinical diagnosis was emphysematous bullae with inflammation of left upper lobe. He received chemotherapy with antibiotics prior to the operation. Left inferior lingual segmentectomy was performed on April 18, 1989. The histopathological examination of specimen revealed congenital cystic adenomatoid malformation (Stocker type II) of the lung. However, relapse of the CCAM was observed 3 years later. Left completion upper lobectomy was performed on December 8, 1992. The patient has been well for 30 months postoperatively.

Child↗
PubMed1996

[Clinical evaluation of urinary leukotriene E4 levels in asymptomatic bronchial asthma].

To evaluate the significance of peptide leukotrienes (LTC4, D4, E4) in asymptomatic asthmatic patients, we measured urinary LTE4 levels which is thought to reflect in vivo production of peptide LTs. Urinary LTE4, was extracted using C18 solid phase column and measured by radioimmunoassay. There was no significant difference in urinary LTE4 levels among asthmatics with different severity or between atopic and non-atopic asthmatics. Urinary LTE4 levels were significantly elevated in asthmatics compared with normal controls (p < 0.05). When compared with normal controls, urinary LTE4 levels were significantly elevated in moderate to severe asthma (p < 0.05), and non-atopic asthmatics (p < 0.001). Urinary LTE4 levels were significantly elevated in aspirin-sensitive asthmatics compared with aspirin-tolerant asthmatics (p < 0.05). There was no significant difference in urinary LTE4 levels among aspirin-sensitive asthmatics with different severity. These results suggest that increased production of peptide LTs is a characteristic in aspirin-sensitive asthma, and that the severity and type of asthma and the presence of aspirin-sensitive asthma should be taken into consideration in the analysis of urinary LTE4 levels.

Adult↗
PubMed1996

[A case of catamenial pneumothorax with elevated level of serum CA 125].

A 40-year old woman had experienced repeated spontaneous pneumothorax on the right side at the beginning of each menstrual period for one year. The level of serum CA125 was high at 60 ng/ml. Right thoracotomy revealed the presence of multiple darkly-pigmented spots and several pinhole like perforations near the central tendon of the diaphragm. The partial resection of the diaphragm was done, endometrial tissues were detected histologically. Tha patient has been asymptomatic after operation and the level of serum CA125 is normal.

Adult↗
PubMed1996

[Flap of the musculus latissimus dorsi to prevent alveolar air leakage from sectional plane of the lung after resection of metastatic pulmonary and chest wall tumor].

Alveolar air leakage after pulmonary resection usually heals with adequate pleural drainage, but must be more actively treated if leakage may be severe. If left untreated, the postresection space can lead to empyema. We used a muscle flap to prevent alveolar air leakage from a large sectional plane of the lung resected because of metastases in the lung and chest wall. A 48-year-old man complained of pain and a mass on the right side of his back. He had undergone resection and chemotherapy for clear cell sarcoma that originated on the back of the left hand when 43 years of age, wedge resection of the right lower lobe of the lung for a metastatic pulmonary tumor at 46 years, and lobectomy of the same lobe for a recurrence of the metastatic pulmonary tumor at 47 years. The diagnosis was of a metastatic tumor to the right chest wall with peripheral pulmonary tumors of the right upper and middle lobes. Resection of the chest wall and the lung including the tumors was done. Much air leakage from the extensive sectional plane of the right upper and middle lobes was seen intraoperatively, and this plane was therefore covered with a flap of the musculus latissimus dorsi. Chest tubes were removed on day 7 postoperatively when air leakage was no longer seen. Subcutaneous emphysema, which appeared on day 14 postoperatively, required redrainage of the pleural air space, but pleurodesis was effective. Use of a muscle flap was simple and effective for covering of a sectional plane of the lung, and should be considered when alveolar air leakage may be extensive.

Humans↗
PubMed1996

[A case of MPO-ANCA related vasculitis with transient leukoencephalopathy and multiple cerebral hemorrhage].

Recently, it has become clear that anti-neutrophil cytoplasmic autoantibody (ANCA) can be detected in patients with idiopathic necrotizing and crescentic glomerulonephritis or necrotizing angitis, and can be used as a serological marker for vasculitic syndrome. Described is a 56-year-old woman who had peripheral neuropathy, intestinal hemorrhage, generalized tonic-clonic convulsions, during the course of a rapidly progressive glomerulonephritis syndrome due to myeloperoxidase (MPO)-ANCA related vasculitis. The cranial MRI showed transient leukoencephalopathy in the parieto-occipital lobes bilaterally. The following MRI revealed multiple cortical and subcortical hemorrhage in the left occipital and right temporal lobe. The neurologic examination showed a slight left hemiparesis and a right homonymous hemianopsia, but, she experienced no subjective symptoms. In the case of MPO-ANCA related vasculitis, there is the possibility of intracranial disorders seen as this case. Thus, MPO-ANCA in related vasculitis should be always considered as a differential diagnosis in cases of transient localized leukoencephalopathy or cortical-subcortical cerebral hemorrhage.

Antibodies, Antineutrophil Cytoplasmic↗