Biomedical subjects
Publications and source records attributed to K Yoshie.
Acute infectious mononucleosis is a typical self-limited lymphoproliferative illness characterized by fever, tonsillar pharyngitis, and lymphadenopathy in adolescents and young adults. Thickening of the gallbladder wall is rarely observed. We report a case of infectious mononucleosis in which marked thickening of the gallbladder wall was detected by ultrasonography and computed tomography.
A 56-year-old man developed severe lower gastrointestinal bleeding. He was classified as Child-Pugh grade C. Colonoscopy revealed multiple angiodysplasia-like lesions and mucosal friability throughout the entire colon (portal hypertensive colopathy, PHC). Haemostasis was immediately achieved with octreotide treatment, although melaena recurred after discontinuation of the infusion. Propranolol treatment before discontinuation of octreotide infusin prevented the recurrence of bleeding from PHC. Octreotide is a safe and effective treatment for severe acute bleeding from PHC, especially if the patient is not a candidate for transjugular intrahepatic portosystemic shunt (TIPS) or treatment with a beta-blocker due to the severity of liver disease or haemodynamic instability. However, a sufficient reduction of portal pressure by propranolol or other medical treatment may be needed in order to discontinue octreotide infusion without the recurrence of bleeding.
The first comprehensive study on the kinetics of nanocrystal growth in a hot amphiphile medium is presented. An example is given with CdSe semiconductor nanocrystals grown after the injection of precursor (a mixture of Cd- and Se-reagents) in concentrated tri-octylphosphine oxide matrix (heated to more than 300 degrees C). The particle size distribution is reconstructed as a function of time from the absorption and photoluminescence spectra collected during the synthesis process. For this purpose a new expression is used relating the exciton energy due to quantum confinement with the nanocrystal radius. The growth kinetics is considered as a two-stage process in order to describe the time variation of nanoparticle size. During the first stage, called reaction-limited growth, the size of initial nucleus rapidly increases due to a sort of surface reaction exhausting the precursor in the nanoparticle vicinity. The growth in such conditions favors also a remarkable narrowing of the size distribution. The nanocrystal develops further on account of a slow precursor transfer from a distant space driven by the concentration gradient--classical diffusion-limited growth. The width of size distribution also increases proportional to the average particle size. Any growth will stop after the precursor concentration reaches a minimum value defining the limit for the final nanocrystal size in a batch. Solving the kinetic equations for the growth rate in each case of kinetics derives analytical expressions for the mean radius and variance of size distribution. Then the respective expressions are matched in a uniform solution valid during the entire synthesis. The theoretical model is in a good quantitative agreement with the experimental data for independent syntheses. Important characteristic scales of the processes (time-constant and length) and microscopic parameters of the reacting system (interfacial energy and reaction rate constant) are estimated from the data. It turns out that the fast reaction-limited growth is important to obtain well-defined nanocrystals of high optical quality by using less energy, time and consumable. However, to make them reproducibly uniform one should control also the ultra-fast nucleation process preceding the nanocrystal growth, which is still unknown. Nevertheless, our current findings allow the conceptual design of a new continuos-flow reactor for the manufacturing of a large amount of uniform nanocrystals.
AIMS: To evaluate haemodynamic and vascular changes in non-alcoholic (viral) cirrhosis on conventional computed tomography (CT), CT arteriography (CTA) and CT arterial portography (CTAP), and to determine the cause of the observed reticular stain on angiography. METHODS: Using surgically resected liver specimens from 31 patients with viral hepatitis associated hepatocellular carcinoma, images of conventional CT, CTA, CTAP and the sinusoidal phase of hepatic arteriography were retrospectively analysed and compared with pathology of the non-cancerous portion of the liver. RESULTS: Computed tomography arteriography showed inhomogeneous enhancement (diffuse, low-density nodules) in a total of 16 samples (52%); in eight of 10 (80%) cirrhotic livers, three of six (50%) precirrhotic livers, five of 12 (42%) livers with chronic active hepatitis and none of three with no active liver disease. The frequency of inhomogeneous enhancement became significantly higher with increasing severity of parenchymal damage (P < 0.05). In contrast, conventional CT and CTAP showed homogeneous enhancement in all 31 (100%) patients. There was no correlation between inhomogeneous enhancement on CTA and reticular staining on sinusoidal-phase hepatic angiograms. Inhomogeneous enhancement was frequently seen in patients with hepatitis B surface antigen and/or anti-hepatitis C virus antibody compared with those without them (P < 0.05). CONCLUSION: The CTA was much more sensitive in detecting haemodynamic changes in the cirrhotic liver than CTAP, conventional CT and sinusoidal-phased hepatic angiography. Further study is required to clarify the mechanism of inhomogeneous enhancement on CTA and homogeneous enhancement on CTAP seen in cirrhosis.
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The purpose of the present study is to elucidate the characteristics of lipoprotein disorders in diabetes mellitus. By analytical ultracentrifugation, non-insulin-dependent diabetic patients (NIDDM) with type IIa hyperlipoproteinemia (HLP) showed significantly higher incidence of multidisperse low density lipoprotein (LDL) than non-diabetics with type IIa HLP. Furthermore, LDL multidispersity in diabetic subjects seemed to be directly related to neither triglyceride (TG) levels in very low density lipoprotein (VLDL) nor the degree of glycemic control. Diabetics with multidisperse LDL had a lipoprotein profile that was different from the subjects with paucidisperse LDL as follows: (1) enrichment in the cholesterol content of VLDL, (2) TG-rich LDL with small flotation coefficient, (3) low cholesterol levels in high density lipoprotein2 along with enrichment in TG, and (4) high plasma concentrations of apoprotein B. Although the underlying mechanism behind the prevalence of multidisperse LDL in NIDDM with type IIa HLP remains unknown, it seems important that lipoprotein disorders in diabetics with multidisperse LDL were potentially atherogenic.
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Ninety neonates who presented variable decelerations during labor were divided into two groups, according to the one-minute Apgar scores of greater than or equal to 8 and 7 less than or equal to. Only neonates of singleton pregnancies and cephalic presentations of 34 weeks gestation or more were included in the study. Several parameters of this fetal heart rate (FHR) pattern and the presence or absence of meconium staining were compared. Followings were found to be statistically significant. 1) The duration of the variable deceleration (less than 2 hours). 2) The FHR deceleration/uterine contraction ratio (less than 80%). 3) The absence of meconium staining. An effort was made to establish safe limits of variable decelerations. These are shown in parentheses. Based on both these data and findings of others, a multifactorial scoring system named a variable deceleration score was proposed for the proper management of this FHR pattern. Five variables were selected for the system. These were: The duration of variable decelerations, the FHR deceleration/uterine contraction ratio, the duration and amplitude of dips, and the presence or absence of meconium staining. The system scores from 0 to 2 for each of five factors, and was designed to be able to predict depressed neonates with the numerical increase of the score.
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