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Biomedical subjects

Shuji Yamamoto

Publications and source records attributed to Shuji Yamamoto.

At least 19 recordsLinked to original sources

Computational flow dynamics in abdominal aortic aneurysm using multislice computed tomography.

Following the introduction of a new multislice computed tomography (MSCT) scanner, it has become possible to produce high-speed CT angiography (CTA), the preferred method for imaging in emergent abdominal vascular conditions. Unlike catheter angiography, multislice CTA not only depicts the vessels but also allows perfusion in adjacent organs to be assessed. To make the most effective diagnostic use of multi-detector row CTA and three-dimensional image post-processing, radiologists must be familiar with the optimal CTA protocols and the typical CT findings in various emergent vascular conditions using computational flow dynamics (CFD). This article describes a technical approach to estimating the blood flow state of human abdominal aortic aneurysms (AAA) in more detail by constructing realistic three-dimensional (3D) vessel models using CFD methods, focusing on pre- and postoperative cases.

Aged↗

Evaluation of coronary artery bypass grafts using multidetector-row CT with Japanese patients.

PURPOSE: To evaluate the patency of coronary artery bypass grafting (CABG) with multidetector-row computed tomography (MDCT) in Japanese patients, who have narrower coronary arteries than Caucasians. MATERIALS AND METHODS: Nineteen patients (12 men and 7 women, mean age: 63 +/- 12 years) with 33 coronary bypass grafts were examined with three-dimensional volume rendering (3D-VR) and curved multiplanar reconstruction (MPR) of MDCT. All grafts were compared with those obtained with selective graft angiography. RESULTS: For the 19 patients with 33 grafts, the overall sensitivity and specificity, compared with those for selective bypass angiography, were 96.7% and 100%, respectively. CONCLUSION: The patency of CABG in Japanese patients can be effectively evaluated with 3D-VR and curved MPR of MDCT.

Angiography↗

Synthesis of 26,27-bisnorcastasterone analogs and analysis of conformation-activity relationship for brassinolide-like activity.

Three castasterone (CS) derivatives with varied side-chain moieties, 26,27-bisnorcastasterone (20S-bisnorCS), 20-epi-26,27-bisnorcastasterone (20R-bisnorCS), and 21,26,27-trisnorcastasterone (trisnorCS), were synthesized stereoselectively from either stigmasterol or dehydroisoandrosterone. The 50% effective doses (ED50, nmol/plant) in the concentration-response curve for brassinolide-like activity in the rice lamina inclination assay were determined to be 0.020 nmol (pED50 = 10.7) for 20S-bisnorCS, 3.2 nmol (pED50 = 8.5) for 20R-bisnorCS, and 2.0 nmol (pED50 = 8.7) for trisnorCS. An analog containing an ester linkage between the steroid and the side-chain moiety of 20S-bisnorCS was also synthesized and its activity was evaluated to be 3.2 nmol (pED50 = 8.5), being equipotent to 20R-bisnorCS and trisnorCS. The activity of 20S-bisnorCS was 1/40 that of CS. The conformation analysis was conducted using a systematic search, showing that the activity decreases with an increase in the degree of freedom of the side chain of the steroidal skeleton.

Brassinosteroids↗

Ultrasonographic measurement of intima-media thickness of the carotid artery before coronary artery bypass grafting.

PURPOSE: We evaluated the usefulness of measuring intima-media thickness (IMT) of the carotid artery by ultrasonography before coronary artery bypass grafting (CABG). METHODS: Seventy-three patients who underwent carotid ultrasonography before CABG were selected for this study. The maximum IMT (max IMT) in the bilateral common carotid artery was used as the index of carotid ultrasonography. As a quantitative measure of coronary atherosclerosis, we calculated Gensini's coronary score (GCS) from the preoperative coronary angiography. RESULTS: There was a positive correlation between the max IMT and the GCS. Furthermore, the max IMT of the patients with myocardial infarction was significantly greater than that of the patients with angina pectoris. CONCLUSIONS: Carotid ultrasonography before CABG is useful, not only for the morphological evaluation of the stenotic lesions of the neck vessels, but also for the quantitative prediction of atherosclerosis in the native coronary artery. The max IMT may predict the progression of atherosclerotic change of the native coronary artery from angina pectoris to myocardial infarction.

Aged↗

Usefulness of three-dimensional multidetector-row CT images for preoperative evaluation of tumor extension in primary breast cancer patients.

PURPOSE: Usefulness of three dimensional (3D) multidetector-row CT (MDCT) images for preoperative evaluation of tumor extension was studied in primary breast cancer patients. METHODS: 3D-MDCT tumor images of 143 tumors in 143 patients with primary breast cancer were created with the volume rendering method. The transverse tumor size (TS) and vertical tumor size (VS) were then measured in an anterior-posterior view of the 3D-MDCT images. The pathological tumor size was determined according to a map of the tumor spread prepared by pathologists using multi-sliced (3-5 mm intervals) surgical specimens and compared with the tumor size on 3D-MDCT images. RESULTS: First, the optimal method for creating 3D-MDCT tumor images was determined for the first 40 patients (learning set), resulting in a fairly good correlation of tumor size on 3D-MDCT images with pathological tumor size (r = 0.983 for TS and r = 0.958 for VS). We then carried out a validation study on the next 103 patients (validation set). The 3D-MDCT tumor size's strong correlation with the pathological tumor size demonstrated a high rate of accuracy (r = 0.974 for TS and r = 0.977 for VS). Subset analyses according to histological type showed that correlation coefficients were r = 0.979 for TS and r = 0.981 for VS of invasive ductal carcinomas (n = 88), r = 0.948 for TS and r = 0.970 for VS of ductal carcinomas in situ (n = 10), and r = 0.984 for TS and r = 0.976 for VS of invasive lobular carcinomas (n = 5). CONCLUSION: 3D-MDCT images can assess breast cancer tumor extension highly accurately, and thus seems to be useful for planning the extent of resection in breast conserving surgery.

Adult↗

Successful repair of traumatic tricuspid valve regurgitation.

Isolated traumatic tricuspid valve regurgitation is an uncommon complication of blunt chest trauma. Tricuspid valve replacement has been ordinarily managed for this lesion. Herein, we report two cases of successful repair for traumatic tricuspid valve regurgitation, 11 and 40 years following blunt chest trauma, respectively. Tricuspid valve repairs were performed using an artificial chordae implantation with expanded polytetrafluoroethylene (CV-5) sutures and ring annuloplasty. Postoperative echocardiography revealed that the tricuspid valve regurgitation improved to mild and trivial respectively in two patients. They are presently doing well, 4 and 2 years after the repair, respectively.

Adult↗

Voxel dimensions required for micromorphologic evaluation of ground-glass opacity on lung high-resolution CT.

PURPOSE: To clarify the appropriate voxel dimensions required for pathologic evaluation of areas with ground-glass opacity on lung high-resolution computed tomography (HRCT). MATERIALS AND METHODS: Synchrotron radiation CT (SRCT) images of autopsied lung speci-mens (n=25) that showed ground-glass opacity on HRCT were reconstructed with 12 different voxel dimensions ranging from 0.006 to 0.6 mm. The specimens were micromorphologically categorized into one of three pathologic groups: alveolar, interstitial, and mixed abnormalities. Each SRCT image was independently diagnosed as one of three pathologic groups by six chest radiologists. The diagnostic accuracy required to estimate the appropriate voxel dimensions was compared among different voxel dimensions by means of the Tukey test. RESULTS: Diagnostic accuracy with voxel dimensions less than or equal to 0.06 mm was significantly higher than that with voxel dimensions of 0.18 mm or more (p<0.01). There was, however, no significance of difference in diagnostic accuracy with voxel dimensions of less than or equal to 0.06 mm. In addition, no significant difference in diagnostic accuracy was found with voxel dimensions of 0.18 mm or more. CONCLUSION: The appropriate voxel dimensions are approximately 0.06 mm for pathologic differentiation of areas with ground-glass opacity on HRCT.

Humans↗

Vogt-Koyanagi-Harada disease occurring during interferon alpha therapy for chronic hepatitis C.

Retinal abnormalities, including retinal hemorrhage and "cotton-wool" spots, often occur within the first 8 weeks in the course of interferon therapy in patients with chronic hepatitis C. Here, we describe a case of Vogt-Koyanagi-Harada disease occurring 4 months after the start of interferon alpha treatment, probably induced by the immunomodulatory effects of interferon. Therefore, we conclude that chronic hepatitis C patients, especially people with darkly pigmented skin, need to be closely monitored for ophthalmologic complications, by periodic check-up of the optic fundi, for a prolonged period, during interferon treatment.

Adult↗

A spectrum of clinical manifestations of gelatinous drop-like corneal dystrophy in japan.

PURPOSE: Typical manifestations of gelatinous drop-like corneal dystrophy (GDLD) have been documented in past studies. In practice, however, we see few typical cases and encounter many with atypical clinical manifestations. Moreover, there have been no detailed reports about the various clinical presentations. The purpose of this study is to describe a clinical subclassification for GDLD. DESIGN: Observational case series. METHODS: A retrospective, observational case series study was conducted at a single institution, Osaka University Hospital. Examined were 18 eyes of ten patients with GDLD with no prior surgery. All were found to have M1S1 mutations. Using slit-lamp examinations we performed a phenotypic classification. RESULTS: We classified GDLD patients into four groups. They included band keratopathy type (seven eyes of four patients), stromal opacity type (five eyes of three patients), kumquat-like type (four eyes of two patients), and typical mulberry type (two eyes of two patients). CONCLUSIONS: Gelatinous drop-like corneal dystrophy is thought to be the result of mutations in M1S1; however, it has various clinical manifestations. To our knowledge, this study is the first to report the range of clinical phenotypes of GDLD in a Japanese population. As most clinicians have no criteria for diagnosing GDLD, many cases are likely to be overlooked or be mistaken for other conditions. We believe that our present classification will be useful for the diagnosis of GDLD.

Adolescent↗

Novel mutations in the arrestin gene and associated clinical features in Japanese patients with Oguchi's disease.

PURPOSE: Only 2 mutations in the arrestin gene have been previously reported to be associated with Oguchi's disease, a homozygous Asn309(1-bp del) mutation in Japanese families and a homozygous Arg193stop mutation in an Indian family. The aim of this article is to report 2 novel mutations in the arrestin gene in 2 Japanese patients with Oguchi's disease and to describe the clinical features with the mutations. DESIGN: Molecular genetic study and observational case report. PARTICIPANTS: Two unrelated Japanese patients with Oguchi's disease associated with novel arrestin mutations. METHODS: Genomic DNA was extracted from leukocytes of the peripheral blood, and exons 2 through 16 of the arrestin gene were amplified by polymerase chain reaction and directly sequenced. A complete ophthalmologic examination was performed, including best-corrected visual acuity, slit-lamp and fundus examinations, fundus photography, and electroretinography (ERG). MAIN OUTCOME MEASURES: Direct sequencing of the arrestin gene, evaluation of visual acuity, refraction, and ERG. RESULTS: Three arrestin gene mutations were identified in 2 patients. A compound heterozygous mutation, Arg175stop and Asn309(1-bp del), was identified in 1 patient with Oguchi's disease. The former mutation has not been reported, whereas the latter is known to be a frequent mutation in Oguchi's disease in Japanese families. In a second patient, another novel mutation was detected in the gene, a homozygous Arg292stop mutation. Both patients demonstrated characteristic features of Oguchi's disease, including night blindness, golden-yellow discoloration of the retina, absent rod ERG response, and "negative" type bright-flash ERG after 30 minutes of dark adaptation. CONCLUSIONS: The existence of 2 novel mutations of the arrestin gene in 2 unrelated Japanese patients strongly supports the previous data that arrestin gene mutations are associated with Oguchi's disease. All of the mutations in the arrestin gene that have been identified in Oguchi's disease are null mutations, indicating that only critical gene defects in the arrestin gene are associated with Oguchi's disease.

Adult↗

Synthesis of brassinosteroids of varying acyl side chains and evaluation of their brassinolide-like activity.

Brassinosteroids containing various side chain moieties were synthesized and their activity was determined as the reciprocal logarithm of the ED(50) (50% effective dose per plant in moles) in the rice lamina inclination assay using synergist indole-3-acetic acid (IAA). The introduction of a hydroxyl group in the alpha-position to the carbonyl group of the ester structure significantly enhanced the activity. 2alpha,3alpha-Dihydroxy-17beta-[(2R,3S)-2-hydroxy-3-methylpentanoyl]oxy-B-homo-7-oxa-5alpha-androstan-6-one showed the highest activity, for which the pED(50) was determined to be 10.5 under synergistic conditions with IAA. Under identical conditions, the pED(50) values of brassinolide and castasterone were determined to be 13.6 and 12.3 respectively. With respect to the alpha-carbon of the acyl moiety, the R-form was 10 times more potent than the corresponding S-form. Substituting the terminal structure (Et) of the side chain to that of the most potent compound, brassinolide (i-Pr), did not increase the activity.

Biological Assay↗

[PACS for multi-slice CT--seamless integration implementing 3D and 4D workstations].

A PACS system for data management in multi-slice CT examination was upgraded using interactive 3D and 4D workstations and network computing technology. We categorized the original PACS (CT-PACS) as follows: (1) a fault-tolerant system linked with the hospital information system (HIS) and radiology information system (RIS); (2) an interactive network system using a workstation with real-time 3D and 4D reconstruction; (3) a system for research and development of software for 3D image analysis on the CT-PACS system. Because of the use of cooperative diagnostic supporting tools, no major problems occurred in daily clinical practice or research and education. In conclusion, CT-PACS with real-time 3D and 4D workstations was found to be helpful to radiologists and researchers in reading and analyzing large volumetric data.

Computer Communication Networks↗

Aortic root replacement with a freestyle stentless valve for aortitis syndrome with ascending aortic aneurysm and aortic regurgitation.

A 47-year-old woman who had been diagnosed as having aortitis syndrome underwent aortic root replacement for an ascending aortic aneurysm and aortic regurgitation. Because the patient has been treated with steroids for more than 20 years, a Freestyle stentless valve was used to avoid the risk of valve detachment. There were no complications observed during the postoperative course. Although long-term follow-up will be necessary to observe the valve durability, the Freestyle stentless valve seems to be useful for aortic root replacement in patients at high risk of valve detachment due to aortitis syndrome.

Aortic Aneurysm↗

Successful repair of a large pseudoaneurysm of the left ventricle late after mitral valve replacement due to rupture of the papillary muscle following acute myocardial infarction.

We present a rare case demonstrating a large pseudoaneurysm of the left ventricle late after mitral valve replacement due to rupture of the papillary muscle following acute myocardial infarction. A 52-year-old man, who had undergone mitral valve replacement 7 months previously, presented with severe congestive heart failure. Echocardiography and computed tomography of the chest demonstrated a large pseudoaneurysm of the left ventricle. The patch repair of the orifice of the pseudoaneurysm was successfully performed.

Aneurysm, False↗

Successful one-stage surgical removal of intravenous uterine leiomyomatosis with right heart extension.

We report a 49-year-old woman with intravenous and intracardiac extension of uterine leiomyomatosis. After subtotal hysterectomy and salpingo-oophorectomy, an intravenous and intracardiac tumor was removed under normothermic cardiopulmonary bypass without cardiac arrest. Postoperatively, occlusion of the artery supplying the remaining uterine cervical stump was performed by the catheter coiling technique. More than 2 years after surgery, the patient is well without recurrence.

Female↗

Prosthetic valve endocarditis with extensive aortic root abscess: full aortic root reconstruction with stentless bioprosthesis, xenopericardium and mitral valve replacement.

Prosthetic valve endocarditis with an extensive aortic root abscess usually has high mortality and morbidity. A 71-year-old male with an extended aortic root abscess following aortic valve replacement survived after full aortic root reconstruction with glutaraldehyde bovine pericardium, mitral valve replacement and full root replacement using stentless bioprosthesis. The patient is well without recurrence of infection, 18 months postoperatively. This procedure might be an alternative treatment for prosthetic valve endocarditis with an extended aortic root abscess.

Abscess↗

Intravenous droperidol causes a reduction in the bispectral index in propofol-sedated patients during spinal anesthesia.

UNLABELLED: We investigated the effect of IV droperidol on the bispectral index (BIS) in conscious and propofol-sedated patients during spinal anesthesia. Thirty minutes after the induction of spinal anesthesia, 20 patients were given 2 mg of droperidol IV without administration of other sedatives (conscious group). Another group of patients were sedated with a propofol infusion to maintain BIS at 60 +/- 5 and were administered IV saline (placebo group; n = 20), droperidol 1 mg (dro-1 group; n = 20), or droperidol 2 mg (dro-2 group; n = 20) in a randomized order and in a double-blinded fashion. Although BIS remained the same in the conscious and placebo groups, it significantly decreased after administration of droperidol in the dro-1 and dro-2 groups. The decrease in BIS was significantly larger in the dro-2 group than in the dro-1 group. These results suggest that an antiemetic dose of droperidol enhances the hypnotic effect of propofol in a dose-dependent manner during spinal anesthesia. IMPLICATIONS: An antiemetic dose of IV droperidol causes a decrease in the bispectral index in patients sedated with propofol during spinal anesthesia. We conclude that droperidol may enhance the hypnotic effect of propofol.

Adult↗