Biomedical subjects
Publications and source records attributed to T Anzai.
A 53-year-old patient with Guillain-Barré syndrome preceded by herpes simplex virus infection developed bilateral tonic pupils with light-near dissociation. Pharmacological tests for pupils suggested postganglionic involvement of the parasympathetic and sympathetic nerves. A demyelinating process of peripheral autonomic nerves was suspected to be the cause of the tonic pupils and autonomic dysfunction.
A 80-year-old woman with right ventricular wall perforation and extraction into the left thoracic cavity by a permanent endocardial pacemaker (PM) lead was presented. The patient underwent an insertion of a permanent endocardial lead into the apex of the right ventricle for the treatment of sick sinus syndrome. The right ventricular perforation of the PM lead was incidentally diagnosed by recognizing it into the left thoracic cavity three months after the operation. Another PM lead could be inserted without removal of the former one.
A 75-year-old woman presented with anemia, lymphadenopathy, hepatomegaly and lingual tumor, but no constitutional symptoms. The laboratory data showed pancytopenia and polyclonal hypergammaglobulinemia. A bone marrow aspirate represented an apparent myelodysplastic syndrome (MDS) feature, specifically, refractory anemia with excess of blasts. A lymph-node biopsy revealed the disappearance of normal architecture, small arborizing blood vessels, large lymphoid cells with prominent cytoplasm (so-called pale cells) and a clonal proliferation of T-lymphocytes. The patient was diagnosed as having MDS associated with immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma. She was subsequently treated with cyclophosphamide, adriamycin, vincristine and prednisolone for lymphoma which successfully induced a remission of not only the T-cell lymphoma but also the MDS. The case suggested that MDS might be a paraneoplastic complication of IBL-like T-cell lymphoma.
We evaluated the changes of the bone lesions and their relative bone findings before and after parathyroidectomy in 23 patients with secondary hyperparathyroidism. Before the operation, all patients had bone and/or joint pain. In radiographic findings, subperiosteal bone resorption of the hand and a salt and pepper coloration of the skull were observed in all patients. Rugger jersey spine and the disappearance of the lamina dura were observed in about 90% of the patients. The bone mineral contents measured by single photon absorptiometry and digital image processing method had decreased in all of the patients compared with the mean values in sex- and age-matched controls. After the operation, the bone and/or joint pain had disappeared excluding three patients with recurrent hyperparathyroidism. The bone changes of the hand and the skull had improved in about 90% of the patients. However, the improvement rate was low in the vertebral and dental bone changes. The bone mineral contents increased significantly compared with the preoperative values. In recurrent cases, transient increase of the bone mineral contents was observed postoperatively. However, their values, were decreased gradually with the elevation of parathyroid hormone level. The evaluation of the bone lesions before and after parathyroidectomy not only indicates the effectiveness of the operation but also illustrates the function of the autotransplanted parathyroid tissues. We conclude that regular examination of the bone lesions after parathyroidectomy, paying attention to recurrent hyperparathyroidism and/or graft function, is mandatory.
Electropherotypes (ET), serotypes, and subgroups of equine rotaviruses isolated from foals in Japan were determined. The ETs of 136 isolates from 1981 through to 1991 were divided into six groups: ET-A-ET-F. The ET-A, -B, -C, -D, -E, and -F were present in 3, 1, 121, 9, 1, and 1 strains, respectively. Representative viruses of ET-A, -B, -C, and -D were identified as serotype G3. Viruses of ET-E and -F were identified as serotypes G 10 and G 5, respectively. The four representative viruses of serotype G 3 did not belong to either subgroup I or II. The two viruses of serotypes G 5 and G 10 belonged to subgroup I. Serotype G 3 strains possessing ET-C were prevalent among the foals throughout the study period.
The purpose of this study is to elucidate morphological changes in septicemic mice induced by an injection of E. coli into the abdominal cavity and to discuss the relationship between the clinical findings and morphological ones. The liver of septicemic mice was morphologically demonstrated, a) Kupffer cells entrapped bacteria and erythrocytes, and large lysosomes were found in Kupffer cells, b) hepatocytes with low dense cytosol increased, and in the hepatocytes, many conglomerations of lysosome and cytolysome, and degeneration of rER, sER and mitochondria were identified, c) intercellular bile canaliculus became narrow. The conclusion is as follows: 1) the increase of the serum level of T. bili is caused by the increase of the phagocyte of erythrocytes by Kupffer cells and by the dysfunction of bile transformation and transportation in hepatocytes, 2) the increase of the serum level of GOT, GPT and LDH is caused by the degeneration of mitochondria in hepatocytes, 3) the decrease of the capacity to synthesize protein and lipid is due to the degeneration of cell organelles in hepatocytes.
A left ventricular (LV) thrombus grew rapidly over chronic endocarditis 2 months after anterior myocardial infarction. Echocardiograms demonstrated a rapidly growing LV thrombus an eventual obstruction. Despite anticoagulant/thrombolytic therapy, the patient died of acute LV failure. Histopathologically, a fresh thrombus overlay thickened endocardium with massive T lymphocyte infiltration over healed infarction.
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We report a rare case of tricuspid regurgitation due to nonpenetrating chest trauma 33 years previously. A 79-year-old man suffered a blunt trauma due to a piece of wood at work in 1958. He suffered multiple rib fractures on the right side and was admitted. Since then, he began having shortness of breath on exertion and was treated with medication. The patient was transferred to the Division of Cardiology, Hakodate National Hospital in 1984. A chest x-ray film revealed a marked cardiomegaly. Cardiac catheterization showed severe tricuspid regurgitation. Hepatomegaly and pancytopenia was observed. He was readmitted because of general fatigue in July 1991. Two-dimensional echocardiography demonstrated systolic excursion of septal and posterior tricuspid leaflets with ruptured chordae tendineae into the right atrium, and a remarkably enlarged right ventricule, right atrium and vena cava interior. Cardiac catheterization was performed. The right atrial pressure-wave form resembled the right ventricular pressure recording (ventricularization of the atrial pressure). Right ventricular cineangiography revealed severe tricuspid regurgitation, grade 4. Laboratory data showed pancytopenia. Thrombocytopenia progressed (3 x 10(4)/mm3), and a hemorrhagic tendency developed. The liver edge was palpable 4 finger breadths below the right costal margin. Pancytopenia due to congestive hepatomegaly and hypersplenism would have complicated this case.
To assess exercise energy metabolism of forearm flexor muscles in rowers, six male student rowers and six control subjects matched for age and sex were studied using phosphorus-31 magnetic resonance spectroscopy (31P-MRS). Firstly, to adjust for the effect of differences in cross-sectional muscle area, the maximal cross-sectional area (CSAmax) of the forearm flexor muscles was estimated in each individual using magnetic resonance imaging. Multistage exercise was then carried out with an initial energy production of 1 J.cm-2 CSAmax for 1 min and an increment of 1 J.cm-2 CSAmax every minute to the point of muscle exhaustion. A series of measurements of 31P-MRS were performed every minute. The CSAmax was significantly greater in the student rowers than in the control subjects [19.8 (SD 2.2) vs 17.1 (SD 1.2) cm2, P less than 0.05]. The absolute maximal exercise intensity (J.min-1) was greater in the rowers than in the control subjects. However, the maximal exercise intensity per unit of muscle cross sectional area (J.min-1.cm-2) was not significantly different between the two groups. During mild to moderate exercise intensities, a decrease in phosphocreatine and an increase in inorganic phosphate before the onset of acidosis were significantly less in the rowers, indicating a requirement of less adenosine 5'-diphosphate to drive adenosine 5'-triphosphate production. The onset of acidosis was also significantly delayed in the rowers. No difference was observed in forearm blood flow between the two groups at the same exercise intensity (J.min-1.cm-2).(ABSTRACT TRUNCATED AT 250 WORDS)
We observed the change of hearing for 1 year in a patient with Wegener's granulomatosis. We also studied anti-human neutrophil cytoplasm antibody (ANCA), which is believed to be specific for this disease and to be associated with disease activity. From these progresses, changes in hearing were considered to be generally related with the general condition and with the ANCA titer level. Because hearing loss in our case was improved by steroids and immunosuppressants, and because ANCA is the autoantibody observed in angiitis syndrome, hearing loss in this case of Wegener's granulomatosis was suspected of being caused by angiitis of the middle and inner ear induced by autoimmune reaction.
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The purpose of this study was to construct a simple ergometer for the 31P NMR spectroscopic study of dynamic forearm exercise in a whole body magnetic resonance imaging system and to evaluate the total system and the physiological response to this type of exercise using a multistage protocol. The system consisted of a completely nonmagnetic assembly including a rope, pulley and weights. The work of lifting weights was quantitated. The exercise protocol of 1-min increments in work load enabled subjects to reach maximal effort. Phosphocreatine decreased linearly with an increase in work load and was accompanied by a fall in pH and an increase in lactate level in the antecubital vein of the exercising forearm; concomitantly, there was a slight increase in whole body oxygen uptake and heart rate. Spectroscopy gave reproducible results using this exercise protocol. These results demonstrate that this system provides a reliable means for performing 31P magnetic resonance spectroscopy studies during forearm exercise.
A 46-year-old female with mitral insufficiency complicated by hereditary hemorrhagic telangiectasia (Osler's disease) underwent successfully mitral valve replacement. The patient had a history of repeated large-volume nasal bleeding. Mitral valve replacement using a xenograft was safely performed with various attempts for preventing abnormal postoperative hemorrhage.
We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.
A case of diastematomyelia with meningomyelocele is presented here. The patient was a newly born infant with a soft tumor in the lumbo-sacral region. The lower extremities were not paretic, but anal reflex was negative. A plain X-ray and a CT scan of the spine showed a bone spur at L3, 4. An MRI showed a longitudinal slit in the spinal conus. The removal of the septum and repair of the cele was carried out. The operative view showed a bony septum which divided the spinal conus into two parts and nerves had spread out on the cele wall. After removal of the septum, the tethered cord was released. The postoperative condition remained stable. The reason for the occurrence of a combined case of diastematomyelia with meningomyelocele is not clear. We presume that abnormality of the mesoderm at the embryonic stage may have an effect on this sort of disorder.
The purpose of this study is to know the effects of Dobutamine (DOB) and Isoproterenol (ISP) on the systemic hemodynamics and myocardial metabolism in the acute phase after open heart surgery in children. Twelve patients with congenital heart disease were administered 5 and 10 micrograms/kg/min (gamma) of DOB, then 0.005 and 0.01 gamma of ISP, and the systemic hemodynamic and metabolic data were taken before and after the administration of the drugs. DOB: DOB increased HR and SVI, so CI rose up markedly. The systolic, diastolic and mean blood pressure also rose up after both doses. CVP and PCWP were depressed at both dosage levels. SVRI and PVRI did not show an appreciable change. ISP: ISP increased HR, CI and systolic blood pressures significantly. On the other hand, SVRI, PVRI and PCWP were decreased at both dosage levels. Myocardial metabolism: The two drugs tested did not exhibit any effect on the progress of anaerobic myocardial metabolism. The myocardial oxygen uptake rate was decreased with DOB and ISP. These phenomena probably suggest that DOB and ISP dilate the coronary vascular bed. From the above data, the following effects can be expected by the use of each drug after open heart surgery in children; 1) powerful inotropic and chronotropic action by DOB, and 2) chronotropic action and after-load reduction by ISP.
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