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Biomedical subjects

N Anzai

Publications and source records attributed to N Anzai.

At least 19 recordsLinked to original sources
PubMed1992

Myelodysplastic syndrome (MDS)-associated inhibitory activity on haematopoietic progenitor cells: contribution of monocyte-derived lipid containing macrophages (MDLM).

We studied myelodysplastic syndrome-associated inhibitory activity (MDS-IA), which inhibited colony formation in vitro of normal granulocyte-macrophage progenitors (CFU-GM). When adherent marrow cells were incubated with fetal calf serum for 21-24 d, monocyte-derived lipid containing huge macrophages (MDLM) developed. MDLM from MDS marrow (MDS-MDLMs) and their conditioned medium (MDLM-CM) consistently suppressed the growth of normal CFU-GM colony formation. MDS-IA was active on CFU-GM during the S-phase and relatively resistant to heating. Monoclonal antibody against H subunit (acidic) ferritin and polyclonal antibody against placental ferritin neutralized the inhibitory activity of MDS-MDLMs. In addition, cell lysates of MDS-MDLMs reacted to both monoclonal anti-H subunit ferritin and polyclonal anti-placental ferritin in Western blotting analysis, indicating that the inhibitory activity was predominantly acidic isoferritin. On the other hand, MDLMs obtained from normal bone marrow had a CFU-GM enhancing activity. These results suggest that MDS-MDLMs may be responsible for the suppression of granulopoiesis in patients with MDS and that the suppression may be mediated by soluble factors, notably H subunit isoferritin.

Adolescent↗
PubMed1992

A right atrial thrombus, attached to the inferior limb of the fossa ovalis.

A right thrombus was incidentally found in a 65-year-old male during mitral valve surgery. A mushroom-like thrombus was attached to the inferior limb of the fossa ovalis with broad based stalk. It developed in sinus rhythm and in the absence of evidence of blood stasis in the right atrium. The most likely pathogenesis of right atrial thrombus formation in this case is endocardial damage from right heart catheterization prior to surgery.

Aged↗
PubMed1992

[A case of myocardial infarction with normal coronary arteriogram in combined valvular disease].

In this report, we presented a case of myocardial infarction with angiographically normal coronary artery, possibly caused by coronary thromboembolism due to combined mitral and aortic valvular lesions. Embolism arising from the mitral valve or left atrium might preferentially enter the coronary arteries because of the turbulence produced by the associated aortic valve lesion. Her impaired cardiac function, due to valvular lesions and myocardial infarction, has improved after double valve replacement.

Adult↗
PubMed1992

[A successful surgical case of acute myocardial infarction in total obstruction of the left main coronary arterial ostium].

Cardiogenic shock due to acute myocardial infarction in an 81-year-old man with total obstruction of the left main coronary arterial ostium was successfully treated with coronary artery bypass grafting. Although this procedure was successful there are some problems in the surgical management of this condition with regard to myocardial protection and preoperative evaluation of poorly visualized left coronary system. It is necessary to infuse first a large volume of high pressure cardioplegic solution and then follow it with another infusion of the solution, through the vein graft, at the regular volume and pressure. Furthermore, the complete revascularization of the left coronary system by vein grafts is recommended.

Aged↗
PubMed1991

Diagnostic reliability and significance of irregular beta patterns.

We designated EEGs with marked and irregular beta waves in basic patterns as "irregular beta patterns" on the basis that these patterns are related with particular symptoms such as dysphoria, irritability and autonomic symptoms and they implicate choice of therapeutic agents. Because of good response to antiepileptic agents in patients with "irregular beta patterns" along with EEG characteristics, we hypothesized that the prevalence of "irregular beta patterns" is higher in epileptics than in other psychiatric patients. In the present study, we tested this hypothesis, investigating actual frequencies of these patterns among different diagnostic categories for all patients whose EEG were recorded in all the first-visit patients to the Outpatient Clinic, Department of Neuropsychiatry of the Tokyo University Hospital during one year period of 1986. Before starting this investigation, we checked the interrater reliability for these patterns. Therefore, two studies are reported here. In Study 1, five raters judged 98 EEG recordings blindly (43 epileptics and 55 healthy subjects). As a result, the generalized Kappa of 0.473 was obtained, indicating our agreement level was moderate or fair. This result lends support to our contention that irregular beta patterns are reliably judged. In Study 2, we judged the EEG recordings (137 schizophrenics, 62 affective disorders, 43 epileptics and 55 healthy controls) and calculated the prevalence rate of "irregular beta patterns" among the diagnostic categories. The results show that the prevalence rates of "irregular beta patterns" among psychiatric disorders and normal controls were 13% (18/137) in schizophrenics, 11% (7/62) in affective disorders, 14% (6/43) in epileptics and 4% (2/55) in healthy controls. These rates did not differ significantly among the three disorders. Thus, our hypothesis was not supported. The clinical significance of these patterns is discussed.

Adult↗
PubMed1990

Psychiatric patients showing irregular beta activities in EEGs and treatment with antiepileptic drugs: a report of 15 cases.

Fifteen psychiatric cases are reported who were clinically diagnosed as schizophrenic, affective disorders, or neurotic, but resisted standard medication regimens, all showing irregular beta activities on EEGs. The cases tended to display symptoms in common, such as dysphoria, emotional instability or frequent physical complaints. These characteristic symptoms share something mutually with the symptoms shown in some epileptic patients or psychiatric patients with epileptic EEG abnormalities without clinical seizures. Antiepileptic drugs seemed more specifically effective to the above symptoms. More than half of these cases showed improvement on EEG findings such as a decrease in irregular beta activities and an increase in rhythmicity or regularity of alpha activities along with clinical improvement with the administration of adjunctive antiepileptic drugs. These results suggest that the adjunctive administration of antiepileptic drugs to patients with irregular beta activities on EEGs is clinically useful and an EEG examination has much value in psychiatric practice to find the criteria of drug therapy.

Adult↗
PubMed1990

[Multiple myeloma causing obstructive jaundice by extramedullary plasmacytoma after Bence Jones protein loss--an autopsy case report].

A 63-year-old man was admitted to our hospital with a chief complaint of general malaise in March 1986. A diagnosis of Bence Jones protein (kappa) type of multiple myeloma was made from increased atypical plasma cells in the bone marrow, urinary BJP (kappa) and osteolytic lesions. Urinary BJP (kappa) was decreased by MP and VENP therapies. In April 1987, he visited us again with the complaint of pain on the left shoulder. An examination revealed multiple osteolytic lesions and bilateral pleural effusion containing atypical plasma cells. Jaundice was developed at the end of July 1987. An ultrasound examination revealed a hypoechoic mass in the area of pancreatic head. The effusion was gradually increased without response to the treatment. He died of respiratory failure on July 31, 1987. On autopsy, extramedullary plasmacytoma was found in the head of pancreas. It was a rare case of multiple myeloma in which pleural effusion and multiple plasmacytomas, and finally obstructive jaundice were developed although urinary BJP (kappa) was reduced by treatment.

Bence Jones Protein↗
PubMed1990

[Cerebral and myocardial infarcts due to deterioration of cloth-cover of Starr-Edwards mitral valve 16 years after replacement].

A 55 year-old woman whose mitral valve had been replaced 16 years previously with a Starr-Edwards cloth-covered ball valve was admitted to our hospital, complaining of memory disturbance and bilateral pretibial edema. Her CT scan findings showed a low density area in the left anterior and temporal lobes, hippocampus, and insula. A right coronary angiogram demonstrated total obstruction at the midportion. In addition to these cerebral and myocardial infarctions due to cloth-wear of the Starr-Edwards ball valve, her laboratory data indicated intravascular hemolysis. Her malfunctioning Starr-Edwards valve was successfully replaced with a Björk-Shiley valve. An aggressive attitude toward urgent replacement is suggested in cases of suspected cloth-wear.

Cerebral Infarction↗
PubMed1989

Treatment by pacemaker in familial amyloid polyneuropathy.

Amyloid deposits often involve the heart and cause disturbances in conduction and impulse formation in patients with familial amyloid polyneuropathy (FAP). Seven patients with FAP required pacemaker treatment during eight years. The most frequent bradyarrhythmias requiring pacing were sinus node dysfunction with junctional failure. Our seven patients had attacks and symptoms of bradyarrhythmias. A pacemaker relieved symptoms of bradycardias with recurrence of dislocation of electrode, exit block, and relatively high threshold. However, pacing did not improve the ultimate prognosis of FAP, because of progressive inanition of FAP. In our series, pacing should have been started earlier before advanced stage according to the ECG findings as in other diseases with bradycardias.

Adult↗
PubMed1987

Rupture of an aneurysm of the aortic sinus of Valsalva into the right ventricle. A case presenting an unusual hemodynamic manifestation.

Rupture of an aneurysm of the aortic sinus of Valsalva into the right ventricle is described. Surgery revealed a small aneurysm ruptured into the right ventricle near the tricuspid valve without aneurysmal involvement of the tricuspid valve. The cineangiogram revealed a shunt from the aortic sinus into the right atrium not during systole but during diastole, and increased oxygen saturation was found in the right atrium. The unusual hemodynamics in this case was most probably due to the closure of the small aneurysmal opening due to myocardial contraction during systole, so that the shunt flow through the aneurysmal tract occurred only during diastole and was directed toward the right atrium due to the location of the aneurysm. Thus, even without aneurysmal involvement of the tricuspid valve or tricuspid regurgitation, the oxygen saturation increased in the right atrium.

Adult↗
PubMed1987

Intraatrial conduit repair in Scimitar syndrome.

A 26-year-old woman with partial anomalous pulmonary venous drainage into the right atrium (Scimitar syndrome) was successfully operated upon by incorporating an intra-atrial conduit. The single right pulmonary vein present was connected to the right atrial inferior vena cava junction. The atrial septum was extremely deviated to the left, and the left atrium was located entirely on the left of the spine. A small patent foramen ovale was found. The distance between the orifice of the right pulmonary vein and the enlarged atrial septal defect was too great to use an intracardiac patch, so a 14 mm woven Dacron graft, 6 cm long, was interposed between them. The patient is doing well 21 months following the operation.

Adult↗
PubMed1986

Double orifice mitral valve associated with endocardial cushion defect.

Duplication of the mitral valve is a rare congenital cardiac anomaly. We encountered a case of duplication of the mitral valve associated with a partial form of endocardial cushion defect in a 6-year-old girl. The mitral orifice was separated by a fibrous tissue and each orifice provided papillary muscle and complete subvalvular mechanisms except for the cleft region. The fibrous tissue also provided a subvalvular apparatus. The cleft was repaired without complication. The short axis view of the two-dimensional echocardiogram demonstrated two separate holes in the mitral valve, which constituted the most obvious diagnostic sign prior to surgery.

Child↗