Biomedical subjects

Y Kanzaki

Publications and source records attributed to Y Kanzaki.

At least 19 recordsLinked to original sources

PubMed1997

Angioimmunoblastic lymphadenopathy-like T-cell lymphoma. A case report and immunologic study.

BACKGROUND: Angioimmunoblastic lymphadenopathy (AILD) is rare in the head and neck and its definition remains controversial. METHOD: A case of AILD with an ulcer of the lateral pharyngeal wall was studied for viral infection, immunohistologic findings and T-cell receptor (TCR) V beta rearrangement. RESULTS: We observed elevation of antibodies against herpes simplex virus and herpes zoster virus as well as Epstein-Barr virus considered closely associated with AILD. The affected neck lymph node showed a preponderance of T-cells, predominantly CD4+ over CD8+ T-cells and all V beta gene families were expressed in the T-cells without enhancement of any particular TCR gene usage. CONCLUSION: Viral infection may occur easily in patients with AILD, possibly owing to immunodeficiency. Assessment of TCR V beta gene usage indicated T-cells to non-specifically become lymphomatous in AILD-like T-cell lymphoma.

Aged↗

PubMed1997

[A case of extracardiac noncoronary sinus Valsalva aneurysm associated with aortic regugitation].

A case of extracardiac noncoronary sinus Valsalva aneurysm was reported. A 11-year-old male with history of mild AR was admitted to the hospital due to severe AR. Echocardiography revealed that the severe AR and an aneurysm in the posterior part of the ascending aorta. Angiography revealed that the origin of the aneurysm was noncoronary sinus. Operative findings showed that the aneurysm sized 23 mm by 25 mm was an extracardiac type which grew posteroinferiorily at the left side of noncoronary sinus and that the dilation. Neither aortic valve nor the aortic route showed degenerative change. The ptosis of the valvular ring due to aneurysmal dilation of the noncoronary sinus caused AR. Then, valve repair composed by commissuroplasty and commissural suspension was carried out. And intraluminal patch closure technique in which the longitudinal diameter of patch was half of that of the aneurysm was effective on suspension of the valvular ring. Postoperative echocardiography showed decreasing of AR.

Aortic Aneurysm↗

PubMed1997

[Early repair of ventricular septal rupture in patients over 80 years of age: infarction exclusion technique].

Since 1994, three patients more than 80 years of age underwent early repair of ventricular septal rupture complicating acute myocardial infarction at our hospital. The infarction exclusion technique introduced by David and Komeda was employed. Average aortic clamp time, cardiopulmonary bypass time and operation time were 83 minutes, 129 minutes and 228 minutes, respectively. No hemostatic suture were required to the left ventricular suture line. All patients survived. One patient with posterior ventricular septal rupture had residual shunt and necessitated transient hemodialysis but recovered. Thus, the infarction exclusion technique seems to be useful in the elderly with unfavorable tissue fragility.

Aged↗

PubMed1996

[Surgical treatment for subacute left ventricular free wall rupture complicating acute myocardial infarction--pericardial patch gluing method].

We reviewed 22 cases with surgical repair for subacute left ventricular free wall rupture complicating acute myocardial infarction. Different operative technique was used. Direct closure or patch repair with infarctectomy was preformed in first patients with a great difficulty in hemostasis. Since 1988 we sutured a large pericardial patch covering the infarcted myocardium under extra corporeal circulation in 11 patients (pericardial patch suture technique). From 1993 we began to glue a pericardial patch with Aron alpha without cardiopulmonary bypass (pericardial patch gluing technique). There were eight early death and four late death. Most common cause of death was low cardiac output syndrome (LOS). With medical therapy 13 patients in cardiogenic shock improved before surgery and only three developed postoperative LOS, but all six patients with sustained shock developed LOS without survivor (p = 0.007). Two of the five patients underwent direct closure or infarctectomy and seven of the 11 employed pericardial patch suture technique developed LOS, but none of the six used pericardial patch gluing technique developed LOS. Medical treatment such as intraaortic balloon pumping, catecholamine and subxyphoid drainage in order to improve hemodynamic condition before surgery is extremely important. Pericardial patch gluing technique seems to be useful since cardiac function would be maximally preserved.

Aged↗

PubMed1995

[Pericardial effusion following surgery using cardiopulmonary bypass].

Of 156 patients who underwent cardiac or aortic surgery using cardiopulmonary bypass, postoperative pericardial effusion was detected in 89 patients (57%). They were divided into four groups according to the size of pericardial effusion: No effusion (group N, n = 66), small effusion (group S, n = 42), moderate effusion (group M, n = 22) and large effusion (group L, n = 25). In group L, 68% of patients had symptoms and 44% had complications such as subxiphoid drainage and constrictive pericarditis. Fewer patients with perioperative pleurotomy were found in group L than group N (p < 0.05). Postoperative anticoagulation did not affect the size of pericardial effusion. Postoperative amount of drainage were larger in groups, S, M, L than group N (p < 0.05, p < 0.05, p < 0.005). The CRP reelevation rate of each group was equal but the maximum CRP value was higher in group L than group N (p > 0.05). These results suggest that some relationship exists among postoperative drainage, inflammatory response and postoperative pericardial effusion. Since large pericardial effusion is often symptomatic and accompanied by various complications, earlier detection of pericardial effusion and appropriate treatment seems to be essential.

Adult↗

PubMed1995

[A case of surgical treatment of acute aortic dissection without an intimal tear].

We experienced a case of acute aortic dissection without an intimal tear. A 55-year-old woman with SLE presented with acute chest pain. TEE study showed dissection of the ascending aorta, and accompanied by pericardial effusion. An emergency operation was performed four hours after onset. Intraoperatively, thrombus was encountered in the false lumen of the ascending aorta and the proximal arch. However, intimal tear was not found. She underwent graft replacement of the ascending aorta and the total aortic arch, and had an uneventful postoperative course. Histological examination of a segment of ascending aorta showed no evidence of mucinous degeneration and pathological rupture of the elastic fiber.

Acute Disease↗

PubMed1995

A case of isolated acute DeBakey II redissection occurring in a postoperative survivor who underwent an arch replacement for acute DeBakey IIIb dissection.

A case of isolated acute DeBakey II redissection which occurred in a postoperative survivor who underwent an arch replacement for acute DeBakey IIIb dissection is reported. The operative findings revealed that there was an intimal tear above the left coronary cusp, that there was a false lumen in the native ascending aorta, and that a residual false lumen caused by the initial operation had not been detected. Redissection caused mainly by the operative procedure, such as the failure to include the site of the intimal tear in the original repair and the formation of a new dissection as a result of anastomotic failure, is frequently seen. However, isolated redissection is a rare condition. In this paper we discuss classification, diagnosis and treatment of redissection.

Aortic Dissection↗

PubMed1995

[Roll repair of nonconfluent pulmonary artery].

We reviewed the repair of nonconfluent pulmonary artery using a roll to clarify indication of this operation, operative technique (especially the material and the size of conduit) and possibility of total correction. Eleven patients (mean age: five years) and 13 operations including two reoperations were reviewed. The material of the roll was xenopericardium in nine and artificial graft in four operations. No operative death and late death occurred. Five patients required reoperations from three occlusion and two severe stenosis of the roll. Three of nine xenopericardial roll needed reoperations and in two reoperated cases, the roll had been placed behind the aorta. In contrast, one artificial graft needed reoperation. The diameter of the roll was compared with that of normal pulmonary artery estimated from the body surface area. If the roll was too large (more than 125% normal) or too small (less than 100% normal), the luminal diameter of the roll became significantly smaller than appropriate-sized roll (p = 0.002). The size of nonconfluent side of the pulmonary artery also affect the result of repair. In occluded or stenotic cases, the unilateral PA index was significantly smaller than good patent cases (p = 0.014). Total correction was possible in eight cases (73%) including four Rastelli operation, two right ventricular outflow patch enlargement, and two modified Fontan operations without operative death. Thus preoperative evaluation of the pulmonary artery size and anatomy, selection of roll material and size matching seemed to be important for successful roll repair of nonconfluent pulmonary artery.

Adolescent↗

PubMed1995

A case of traumatic pseudoaneurysm of the ascending aorta occurring in a postoperative patient who underwent arch replacement and Bentall's operation.

A case of traumatic pseudoaneurysm of the ascending aorta occurring in a postoperative patient who underwent an arch replacement and Bentall's operation was reported. A bleeding point was clear at the graft of the ascending aorta, and a pseudoaneurysmal formation was suspected following an echocardiogram. An aortogram demonstrated the presence of an aneurysm approximately 8 cm by 4 cm in size originating 5 cm above the right coronary ostia. An emergency operation was carried out. A Trans-femoral bypass was established before sternotomy. The Operative findings showed that adhesive connective tissue covered a pseudoaneurysm 8 cm by 4 cm in size, and that there was a tear in the anastomosis of the grafts between the ascending aorta and the arch 5 cm above the coronary ostia. Direct suture was performed, using hypothermic circulatory arrest. In this paper, We discuss the mechanism, classification, and operative strategy of traumatic pseudoaneurysm.

Adult↗

PubMed1994

Analysis of T cell receptor variability in fresh tumor-infiltrating lymphocytes from human head and neck cancer.

In this study, we analyzed T cell receptor (TCR) gene rearrangements in tumor-infiltrating lymphocytes (TIL) freshly obtained from 15 patients with head and neck cancer using the reversely transcribed polymerase chain reaction (RT-PCR) method. These TILs showed preferential expression of V alpha 10, V alpha 8 and V alpha 1, detected in 13 (87%), 11 (73%), and 9 cases (60%), respectively. The TCRV beta gene revealed diversity without preferential usage. The head and neck region is exposed to bacteria and viruses, so it is possible that the tumor site can become infected and accumulate T cells involved in infection and inflammation. Therefore, we also investigated TCR gene usage in T cells infiltrating in chronic sinusitis mucosa to address the question of whether the V alpha 1, V alpha 8, and V alpha 10 subfamilies are characteristic in TIL from squamous cell carcinoma of head and neck. TCR V alpha 10 gene usage was also the most common in V alpha segment in T cells infiltrating the sinus mucosa, but V alpha 1 and V alpha 8 were not detected in the T cells in sinusitis. These results indicate that the V alpha 10 subfamily, the preferred T cell population in both TIL and T cells in inflammatory disease, might be involved mainly in inflammation or infection. On the other hand, V alpha 1 and V alpha 8 appear to be relatively specific populations for antitumor immunity in head and neck cancer.

Adult↗

PubMed1994

Disposition of recombinant human insulin-like growth factor-I in normal and hypophysectomized rats.

The pharmacokinetics of recombinant human insulin-like growth factor-I (rhIGF-I) was examined in normal and hypophysectomized (Hypox) rats after i.v. administration. The plasma concentration of rhIGF-I administered i.v. (0.32, 1.0 and 3.2 mg/kg) declined biexponentially in both normal and Hypox rats. Half-lives of the beta-phase were not significantly different among the doses examined in both animal groups, but were shorter in Hypox rats. In Hypox rats, the values of the area under the plasma concentration-time curve, the mean residence time, the variance of residence time and the apparent volume of distribution at steady-state decreased, while the total body clearance (CLtotal) increased. The distribution of rhIGF-I after i.v. administration (1.0 mg/kg) was examined in normal rats. High distribution to the kidney was observed at early time points (5 min and 1 h), but no significant distribution was found in other tissues. The ligation of renal vasculature greatly reduced the CLtotal, suggesting that the kidney is the main elimination organ. In spite of the rapid distribution of rhIGF-I to the kidney, the urinary excretion of intact rhIGF-I was negligible. Thus, the metabolism of rhIGF-I in the kidney was examined in vitro, and the results showed extensive metabolism in the brush border and lysosomal fractions of tubular cells. In the plasma of normal rats, rhIGF-I formed the 50 kDa complex first, and the 150 kDa complex was formed slowly.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Drug absorption from large intestine: physicochemical factors governing drug absorption.

Profiles of absorption versus drug molecular weight and absorption versus drug lipophilicity were investigated in both the small and large intestines of rats by an in situ loop method. The absorption-molecular weight profiles examined using different-sized polyethylene glycols (PEGs) were different between the small and large intestines; the large-intestinal absorption of PEGs with molecular weights larger than 300 was poor, while PEGs with molecular weights up to 600 were relatively well absorbed in the small intestine. It is suggested that the paracellular route for drug penetration in the large intestine is restricted more than in the small intestine. The absorption-lipophilicity profiles were also examined in various regions (loops of 6 cm) of rat intestine using three acylsalicylic acids, acetyl-, propionyl- and butyrylsalicylic acids. The absorption rates of the acylsalicylic acids were different in the intestinal regions: the jejunum > the ileum > the colon > the rectum. In each region, the absorption rate increased with the drug lipophilicity. However, it was shown that the absorption rates in the small intestine tended to reach a ceiling at the high lipophilicity. To confirm this tendency, the absorption rates of acetaminophen and indomethacin were compared in the four intestinal regions. The absorption rates of highly lipophilic indomethacin were similar in the large and small intestines, while intermediately lipophilic acetaminophen was more rapidly absorbed in the small intestine than in the large intestine. A thicker unstirred water layer adjacent to the small-intestinal mucosa would be one of the factors which cause such varying absorption-lipophilicity profiles.

Animals↗

PubMed1994

[Modified Fontan procedure for complex cardiac anomaly with nonconfluent pulmonary artery].

Modified Fontan procedure was successfully performed in two patients with complex cardiac anomaly and nonconfluent pulmonary artery. A nonconfluent portion of the pulmonary artery was interposed with a xenopericardial roll. In one patient, the central pulmonary artery was completely absent. Two-staged reconstruction of the central pulmonary artery was carried out through a left thoracotomy and a median sternotomy before the Fontan procedure. In the other patient, a juxtaductal segment of the pulmonary artery was nonconfluent. Correction of the nonconfluent pulmonary artery was performed concomitantly with the Fontan procedure. Fenestrated Fontan procedure seemed to be the beneficial modification for survival. Both patients have been day well during the midterm follow-up period.

Cardiac Surgical Procedures↗

PubMed1994

[A case report of modified Bentall procedure, aortic arch replacement and mitral valve replacement for a patient with Marfan's syndrome].

A 20-year-old man of Marfan's syndrome who had mitral valve regurgitation, annuloaortic ectasia with aortic valve regurgitation and aortic arch aneurysm was successfully treated with radical operation. Mitral valve replacement was performed with superior wall incision of the left atrium directly. Complete transection of the aortic root made it easy to reach the mitral valve. The diameter of his ascending aorta was 70 mm, and modified Bentall' procedure, Carrel patch method, was performed. Aortic arch was 40 mm in diameter, and total aortic arch replacement was performed under hypothermic circulatory arrest. After the combined operation, patient was recovered uneventfully.

Adult↗

PubMed1993

Audiological study in guinea pigs with type I allergy induced in the inner ear.

Time course studies of electrocochleography and the auditory brain stem response were performed in guinea pigs that were passively sensitized by sera containing antidinitrophenyl reaginic antibody and specifically challenged by dinitrophenyl-bovine serum albumin injected through the stylomastoid foramen. A negative summating potential on electrocochleography was observed from 12 to 48 hours, but not at 72 hours, after the specific challenge. A threshold increase on the auditory brain stem response was observed 15 minutes after the specific challenge; the threshold recovered to the prechallenge level within 7 days. Further, we used Tranilast, a blocking agent of chemical mediator release from mast cells, before the specific challenge. A negative summating potential and head deviation were not observed after the use of this agent. These results suggest that the auditory change provoked in the inner ear of the sensitized guinea pig may have been induced by type I allergy.

Animals↗

PubMed1992

Type I allergy in the inner ear of the guinea pig.

Guinea pigs were passively sensitized by sera containing antidinitrophenyl reaginic antibody and specifically challenged by dinitrophenyl-bovine serum albumin injected through the stylomastoid foramen. Nystagmus, head deviation, negative summating potentials on electrocochleography, and an increase of threshold and wave I peak latency on auditory brain stem response testing were observed after local challenge. These physiologic changes were reversible and resolved within several days. We also used Tranilast before the specific challenge. It is a blocking agent of chemical mediator release from mast cells. Negative summating potentials and head deviation were not observed after the use of this agent. In the animals that showed physiologic changes, we observed endolymphatic hydrops, mast cell degranulation, and eosinophil infiltration histologically in the challenged side of the inner ear. These results suggest that the physiologic and histologic changes provoked in the inner ear of the sensitized animals may have been induced by type I allergy.

Animals↗

PubMed1992

[A case report of left ventricular myxoma].

We reported a case of successful surgical extirpation of a left ventricular myxoma arising from the anterior wall of the left ventricle. A 17-year-old asymptomatic boy had been followed due to premature ventricular contractions. Two-dimensional echocardiography revealed a small mass in the left ventricle. He underwent transaortic extirpation of the mass under extracorporeal circulation in November, 1989. The gelatinous mass of 11 by 9 by 5 mm and weighing 0.4 g was a myxoma pathohistologically. His postoperative course has been uneventful. Left ventricular myxomas are very rare. In the literature, 26 cases in English and 6 in Japanese have been reported. Recurrence was reported in one case, thus careful follow-up is necessary.

Adolescent↗

PubMed1989

[Unilateral pulmonary vein atresia].

A case of unilateral pulmonary vein atresia in a 20-month-old girl is described in this report. A chest X-ray revealed a reticular shadow on the right side, while an electrocardiogram revealed right ventricular hypertrophy. After cardiac catheterization and angiography, a diagnosis of a ventricular septal defect, patent ductus arteriosus, severe pulmonary hypertension, and atresia of the right pulmonary vein was made. The patient underwent an operation for the ventricular septal defect and ligation of the patent ductus arteriosus. During the operation, the right pulmonary vein was found to be atretic, and unrepairable. Pneumonectomy was not performed because the pulmonary arterial pressure decreased to 41 mmHg after the surgical treatment of the intracardiac lesions. Pneumonectomy will be necessary if one or more complications such as persistent hemoptysis, repeated pulmonary infections or the development of pulmonary hypertension, may occur in future.

Ductus Arteriosus, Patent↗