PubMed Health⌕ Search

Biomedical subjects

Y Morishita

Publications and source records attributed to Y Morishita.

At least 19 recordsLinked to original sources
PubMed1999

Postoperative flow cytometry crossmatch in living donor liver transplantation: clinical significance of humoral immunity in acute rejection.

BACKGROUND: The role of humoral immunity in acute rejection in solid organ transplantation remains controversial, although it is known that the presence of antidonor antibodies may precipitate graft rejection. We investigated the clinical relevance of antidonor humoral immunity for living donor liver transplantation (LDLT) by means of flow cytometry crossmatch (FCXM). METHODS: T cell FCXM using fresh donor peripheral lymphocytes was performed before and up to 1 month after LDLT in 58 patients. Ten patients received ABO-incompatible grafts. IgM and IgG antidonor antibodies were analyzed in relation to clinical acute rejection as defined by liver function tests with or without histological evidence. RESULTS: Pretransplantation FCXM was positive for five patients (8.6%), resulting in two cases of positive posttransplantation FCXM and two rejection episodes. Twelve patients (20.7%) showed positive posttransplantation FCXM. The incidence of acute rejection within 1 month was 100% in FCXM-positive patients and 17.4% in FCXM-negative patients (P<0.001). Thirteen (76.5%) of 17 rejection episodes in ABO-compatible cases were associated with concomitant antidonor IgM antibody. IgG antibody was also identified in six of these episodes. Antidonor antibodies disappeared after rejection treatments in all cases, but with some delay in clinical improvement. On the other hand, no antidonor antibodies were detected in any of the four rejection episodes in ABO-incompatible cases. CONCLUSIONS: Early acute rejection in LDLT is significantly associated with antidonor T cell antibody formation in ABO-compatible cases. This suggests a definite role for donor-specific humoral immunity in acute rejection. Rejection episodes without antidonor antibodies may suggest graft injury by pure cellular immunity, or possibly the presence of humoral immunity triggered by antigens not present on donor T cells.

ABO Blood-Group System↗
PubMed1999

The effect of neutrophil elastase inhibitor in hepatectomy with ischemia in dogs.

Activated neutrophils play an important role in reperfusion injury following hepatic ischemia. Neutrophil elastase is a powerful proteolytic enzyme. We investigated the possibility that ONO-5046. Na, which is a new recombinant-specific neutrophil elastase inhibitor, can reduce ischemia and reperfusion injury in the canine liver. Adult mongrel dogs (n = 19) were used in this experimental study. Seventy-five percent of the liver was resected after 60 min of vascular occlusion. The animals were divided into two groups. The ONO group (n = 8) was given ONO-5046. Na dissolved in saline starting 30 min prior to clamping the hepatic inflow and continuing for 4 h after reperfusion at a rate of 10 mg/kg/h. The nontreatment group (n = 11) received a saline solution for the same period. ALT and LDH levels were significantly lower (P < 0.05) in the ONO group than in the nontreatment group after reperfusion. Purine nucleoside phosphorylase and hyaluronic acid levels, which are markers of endothelial damage, were significantly lower (P < 0.05) in the ONO group than in the nontreatment group after reperfusion. Histologically, widely spread hepatocyte necrosis was found in dogs in the nontreatment group that died prematurely. Neutrophil infiltration of the sinusoids was less evident in the ONO group than in the nontreatment group. Neutrophil elastase inhibitor may prevent injuries of both endothelial and parenchymal cells in extended hepatectomy with vascular occlusion.

Alanine Transaminase↗
PubMed1999

Abdominal Aortic Dilatation in Japanese Residents.

The correlation between abdominal aortic dilatation and arteriosclerotic risk factors was studied in 2514 Japanese residents (947 men, 1567 women, mean age 70 years old). The aortic diameter was measured by ultrasound and an aortic dilatation was defined as above 30 mm in diameter, including abdominal aortic aneurysm (AAA). Forty-three (1.7%) patients with a dilated aorta and 2471 with a normal-sized aorta were compared. Abdominal aortic dilatation was significantly (p < 0.01) more frequent in men than in women (3% vs 0.7%). Obesity and hyperlipidemia were slightly (p < 0.1) more frequent in patients with a dilated aorta than in those with a normal-sized aorta. There were no significant differences between the two groups in mean age, frequency of smoking, diabetes mellitus, and coronary artery disease. In conclusion, male obesity and hyperlipidemia may be risk factors for aortic dilatation in Japan. Women may not be screened because of cost-effectiveness. The prevalence of aortic dilatation in Japan was lower than in European countries. However, screening for AAA using ultrasound would be advantageous when considering the grave prognoses of ruptured AAA.

Journal Article↗
PubMed1999

Induction of a critical elevation of povidone-iodine absorption in the treatment of a burn patient: report of a case.

A critical elevation of povidone-iodine absorption which occurred in a burn patient who was topically treated with 10% povidone-iodine (PI) gel is herein reported. A 65-year-old man was admitted to our hospital for deep second- and third-degree burns covering 26% of his total body surface area. The intravenous administration with lactated Ringer's solution and topical treatment with silver sulfadiazine were applied in addition to such treatments as debridement and skin grafting. However, wound infection occurred due to Pseudomonas aeruginosa. Topical treatment with PI gel was effective for this condition. Persistent nodal bradycardia with hypotension, metabolic acidosis, and renal failure occurred 16 days after the start of PI gel treatment. Iodine toxicosis caused by PI gel was suspected with a serum iodine level of 20600 microg/dl (normal range 2-9 microg/dl). The PI gel treatment was therefore discontinued immediately, and hemodialysis was scheduled. However, the patient's family refused hemodialysis and he died 44 days after admission. To our knowledge, only eight patients with iodine toxicosis have been reported in burn patients treated with PI gel.

Absorption↗
PubMed1999

Fibromyxoma of the rib: report of a case.

We present herein the case of a 36-year-old man with fibromyxoma of the rib. At the age of 33 years, an abnormal shadow of the chest was found on a radiographic examination, subsequent to which the mass grew slowly into the intrathorax, and he was referred to our hospital. An X-ray film and computed tomography scan on admission showed an extrapleural mass, 7 x 5 cm in diameter, in the left sixth rib with no evidence of destruction, cortical expansion, or rupture. The patient underwent peripheral osteotomy of the sixth rib, which was resected with a 3-cm margin around the mass. Microscopically, a diagnosis of fibromyxoma was confirmed. To the best of our knowledge, this is the first reported case of fibromyxoma originating in a rib.

Adult↗
PubMed1999

The efficacy of technetium-99m-MIBI scan and intraoperative methylene blue staining for the localization of abnormal parathyroid glands.

The efficacy of the technetium-99m-2-methoxyisobutylisonitrile (Tc-MIBI) scan and intraoperative methylene blue staining was analyzed in a consecutive series of 15 patients with primary hyperparathyroidism who underwent neck surgical exploration. A total of 17 abnormal parathyroid glands were removed, 7 of which were confirmed histologically as adenomas and 10 as hyperplasias. The Tc-MIBI scan and the thallium-201-technetium-99m subtraction (Tl/Tc) scan preoperatively localized 11 (69%) of 16, and 6 (40%) of 15 abnormal parathyroid glands, respectively. The Tc-MIBI scan correctly localized two ectopic abnormal parathyroid glands which were not localized by the Tl/Tc scan or ultrasonography (US). However, it also demonstrated false-positive accumulations caused by thyroid diseases in two patients. There were 4 abnormal parathyroid glands not detected by the preoperative imaging techniques, whereas all 17 abnormal parathyroid glands were stained with methylene blue, the infusion of which caused no adverse effects or toxicity. In conclusion, Tc-MIBI scanning and intraoperative methylene blue staining are effective techniques for the localization of abnormal parathyroid glands in patients with primary hyperparathyroidism.

Adenoma↗
PubMed1999

Pulmonary small cell carcinoma associated with sarcoid reactions: report of a case.

A 45-year-old male was admitted to our hospital for investigation of a nodular shadow in segment 5 of the right lung on a chest computed tomogram. A right middle lobectomy with mediastinal lymph node dissection was performed under a diagnosis of lung cancer, and histologic examination confirmed small cell carcinoma. There were sarcoid reactions in the resected lymph nodes and the lung parenchyma, but no signs of systemic sarcoidosis were evident. Sarcoid reactions are rarely observed in the regional lymph nodes draining malignant tumors. Moreover, while they are most common in squamous cell carcinoma of the lung, they extremely rare in small cell carcinoma. To our knowledge, this is only the third report of this unusual entity in the English and Japanese literature.

Carcinoma, Small Cell↗
PubMed1999

Primary pulmonary collision tumor including squamous cell carcinoma and T-cell lymphoma.

We report a very rare occurrence of a primary collision tumor in the lung consisting of squamous cell carcinoma and T-cell lymphoma. A squamous cell carcinoma was diagnosed histologically following a transbronchial lung biopsy in a 71-year-old woman, but the other component was diagnosed histologically and immunohistochemically only on examination of the resection specimen. The malignant lymphoma was stained by the monoclonal antibody UCHL-1 (anti-D45RO) against T-lymphocytes but was not stained by the L26 (anti-CD20) antibody against B-lymphocytes. Immunostaining for CD3 was positive, confirming a T-cell lineage. Despite systemic chemotherapy, the patient died 7 months after operation, from progression of the lymphoma. Our case, which illustrates interesting attributes of collision tumors, consisted of an ordinary squamous cell carcinoma and a rare T-cell lymphoma arising in the lung, with the latter part of the combination dictating subsequent treatment and outcome.

Aged↗
PubMed1999

Cardioprotective effects of Lazaroid U-74389G on ischemia-reperfusion injury in canine hearts.

BACKGROUND: Lazaroid, an inhibitor of iron-mediated lipid peroxidation, has been shown to reduce free radical-mediated injury after ischemia and reperfusion. The effect of Lazaroid U-74389G was investigated on ischemia-reperfusion injury of the heart through preservation and transplantation (Tx) in dogs. METHODS: Eleven pairs of adult mongrel dogs weighing 8.5 to 12 kg formed the recipient-donor combinations. Following electromechanical arrest of the heart using cardioplegia, the coronary vascular beds were washed out with a cold University of Wisconsin solution followed by 12-hour preservation and orthotopic Tx. Experimental animals were divided into 2 groups; 6 pairs formed the control group, and 5 formed the Lazaroid-treated group in which Lazaroid U-74389G at 10 mg/kg was administered intravenously 30 minutes before reperfusion of the heart. The cardiac function including cardiac output, left ventricular (LV) pressure, and LV dp/dt was assessed 2 hours after Tx by comparing it with the recovery rates (%) from cardiac function of donor dogs. Each transplanted heart was harvested for histological study. RESULTS: The recovery of cardiac function after Tx was significantly better in the Lazaroid-treated group than in the control group. Histologically, myocardial damage, evaluated by both light and transmission electron microscopy, was less evident in the Lazaroid-treated group than in the control group. CONCLUSION: Early cardiac function following Tx was significantly better and histological damage was less in the Lazaroid-treated group than in the control group, suggesting that Lazaroid U-74389G is effective in preventing ischemia-reperfusion injury after preservation and Tx.

Adenosine↗
PubMed1999

Natural history of fibroadenomas based on the correlation between size and patient age.

BACKGROUND: Several recent studies have reported that most fibroadenomas remain static or regress when they are managed conservatively; however, no such studies have evaluated the breast disorder in Japanese women. To understand the natural history of fibroadenomas in Japanese women, we examined the correlation between the sizes of the fibroadenomas and the women's age. METHODS: Fifty-eight consecutive patients (age range, 17-51 years; mean, 33.9 years) with histologically confirmed fibroadenoma were enrolled in this study. The sizes of the excised fibroadenomas were analyzed in relation to the women's ages. RESULTS: The fibroadenomas decreased significantly in size (Y, mm) with patient age (X, years) (P = 0.0012) according the equation Y = -0.340X + 27.0 (95% confidence limits for the slope, -0.139 to -0.540). From this equation, the mean sizes of the fibroadenoma in women aged 20, 30 and 40 years were expected to be 20.2 mm (95% confidence interval, 16.2-24.2 mm), 16.8 mm (95% confidence interval, 10.8-22.8 mm) and 13.4 mm (95% confidence interval, 5.4-21.4 mm), respectively. The mean annual decrease in the size of the fibroadenomas was 0.340 mm. CONCLUSIONS: Our results indicate that in Japanese women fibroadenomas increase in size more frequently in younger than in older women. Moreover, it is speculated that most fibroadenomas might stop growing when they reach an approximate maximum diameter of 20 mm, after which time they might remain static or regress.

Adolescent↗
PubMed1999

Left colon substitution with His' angle following total gastrectomy. Surgical technique using stapling devices.

To resolve the disadvantages of jejunal Roux-en-Y reconstruction following total gastrectomy, we attempted the use of left colon substitution with all anastomoses conducted using mechanical stapling devices. A His' angle was formed to reduce regurgitation esophagitis. About 25 cm of the left colon with the ascending branch of the left colic artery with an adequate blood supply was brought up to the remnant esophagus without tension on the mesentery. The colon graft was interposed between the esophagus and duodenum in an isoperistaltic fashion. Three anastomoses, esophagocolic, duodenocolic and colocolic, were completed with a circular stapling device. An end-to-side esophagocolonostomy was positioned about 3 cm distal from the blind end of the proximal colon stump. The proximal end of the left colon was pexied to the esophagus using 3-4 stitches to make a new His' angle. Gastrointestinal continuity was restored by a side-to-end colonoduodenostomy and an end-to-end colonocolonostomy. Fifteen gastric cancer patients underwent left colon substitution following total gastrectomy. The circular staple used for esophagocolonostomy and colonoduodenostomy was 25 mm in all patients, and for colonocolonostomy was 29 mm in 9 patients and 33 mm in 6 patients. No problems were encountered in any steps of the procedure, and faulty stapling was avoided. Neither anastomotic leakage nor necrosis of the interposed colon segment was seen, nor was late anastomotic stricture, in any patient. Barium radiograms of the interposed colon segment showed that the capacity and passage of the interposed colon were adequate, and regurgitation did not occur. Diet volume was satisfactory and weight loss minimal.

Adult↗
PubMed1999

Effects of a phosphate buffered extracellular (Ep4) solution in preservation and reperfusion injury in the canine liver.

The Ep4 solution, a phosphate buffered extracellular-type solution, is effective in canine lung transplantation following a 96-hour hypothermic (4 degrees C) preservation. In this experiment, we used this solution for liver preservation followed by transplantation. We compared the Ep4 solution with the lactated Ringer's (LR) and the Collins' M (CM) solution (a phosphate buffered intracellular-type solution) in two studies, 1) 48-hour liver preservation, and 2) orthotopic liver transplantation after 5-hour preservation. In the preservation study, purine nucleoside phosphorylase (PNP) levels as a marker of endothelial damage, and alanine aminotransferase (ALT) levels were significantly lower in the livers immersed into the Ep4 solution than in those immersed into other solutions at 36 and 48 hours after preservation. Microscopically, the endothelial injury occurred 24 hours after preservation in the CM solution, and 36 hours after preservation in the LR and Ep4 solutions. In the transplantation study, serum PNP and ALT levels in the livers immersed in Ep4 solution showed a lower tendency compared with those in other solutions at the time of reperfusion, but the histological differences among three groups were not apparent. The present study suggests that the liver can be stored better for a longer time using Ep4 solution than using LR and CM solutions.

Alanine Transaminase↗
PubMed1999

[Analysis of elderly patients, aged 60 years old or over, with acute lymphoblastic leukemia].

In order to obtain the realistic background information on clinical features, and the present status of treatment and outcome in elderly patients with acute lymphoblastic leukemia (ALL), we carried out random survey of patients with ALL aged 60 or over who had been admitted to 13 general hospitals in the Nagoya region from January 1990 through December 1995. Among the 20 cases collected, ages ranged from 60 to 88 (median age 68), and the male to female ratio was 11:9. Nineteen cases were L2 subtype in FAB classification. Among 17 patients, 13 had B cell series surface phenotypes (76%), 2 had T cell series (12%), one had stem cell type (6%) and one had an undetermined phenotype (6%). Ph chromosomes were detected in 4 cases among 15 analyzed (27%), whereas 5 were found to have no chromosomal abnormality. Half of the patients had some concurrent disease at diagnosis, including two with treatment-limiting complications. Common induction regimens were the combination of adriamycin (ADM) + vincristine (VCR) + cyclophosphamide (CPM) + mitoxdn trone + L-asparaginase [4 patients]. ADM + VCR + PSL [4 patients]. VCR + PSL [4 patients] and others [8 patients]. The overall remission rate was 55.0% (11/20) without any significant difference according to age. The median survival time (MST) for all cases was 205 days. (1-year survival rate:17.9%, 2-year survival rate:10.8%). There was no significant difference in survival times among patients with the Ph chromosome, those with other chromosomal abnormalities and those without them. All the patients aged 75 or over were treated with attenuated induction therapy, and they had a shorter survival than those aged less than 75, but with no statistical significance [MST:121 days versus 276 days, p = 0.307 (generalized Wilcoxon test)].

Aged↗
PubMed1999

Mutation analysis of transforming growth factor beta type II receptor, Smad2, and Smad4 in hepatocellular carcinoma.

Mutations in the transforming growth factor beta type II receptor (TGFbetaRII), Smad2, and Smad4 genes have been detected in several human cancers. However, there are no reports of mutation analysis of the entire coding regions in these genes in hepatocellular carcinoma, and the roles of these genes in hepatocarcinogenesis remain unknown. We screened 30 hepatocellular carcinomas for mutations of these genes using polymerase chain reaction single-strand conformation polymorphism. We detected no mutations, but did find 3 cases of loss of heterozygosity of chromosome 17p13.1. These results suggest that mutations of the TGFbetaRII, Smad2, and Smad4 genes are rare, and that genetic instability is uncommon in human hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1999

[Valve replacement for congenital mitral stenosis associated with double orifice mitral valve: a case report and a review of Japanese literatures].

A 3-year-old girl with congenital mitral stenosis (CMS) associated with double mitral orifice valve (DOMV) underwent successfully mitral valve replacement (MVR). DOMV is a rare form of congenital cardiovascular anomaly. To our knowledge, our patient is the first infant case of CMS due to DOMV in Japan. We present an infant case of CMS associated with DOMV who needed MVR, and discuss our patient with a review of Japanese literatures.

Cardiac Surgical Procedures↗
PubMed1999

[Intrapulmonary lymph node detected as a small coin lesion: a case report and a review of the Japanese literature].

Intrapulmonary lymph node (IPLN) is commonly identified to the level of fourth-order bronchi and is seldom recognized on a plain chest roentgenogram. We experienced a case of intrapulmonary lymph node, and presented a review of the Japanese literature. A 52-year-old female without a smoking history was discovered to have a coin lesion in a mass screening chest roentgenogram. A Chest CT scan showed a small peripheral nodule in segment 9 of the left lung. Malignancy could not be ruled out and an exploratory thoracotomy was performed, and the definite diagnosis was IPLN. We have encountered more frequent detection of small peripheral pulmonary nodules because of increasing availability of chest CT scans. Although reports of IPLN are rare, it should be considered as one of differential diagnoses for benign or malignant pulmonary nodules.

Female↗
PubMed1999

A novel aromatase inhibitor, vorozole, shows antitumor activity and a decrease of tissue insulin-like growth factor-I level in 7, 12-dimethylbenz[a]anthracene-induced rat mammary tumors.

Effects of vorozole, a potent and specific non-steroidal aromatase inhibitor, were evaluated on female Sprague-Dawley (SD) rats with 7, 12-dimethylbenz[a]anthracene (DMBA)-induced mammary tumors. Vorozole at a dose of 0.25, 1.0 and 4.0 mg/kg was orally administered once a day for 28 consecutive days. A significant regression in tumor size was observed in each treated group at 1, 2, 3 and 4 weeks after the start of treatment compared with control group. Tissue insulin-like growth factor I (IGF-I) in the DMBA-induced tumors in each treated group significantly decreased in a dose-dependent fashion compared with control group. These results show the mechanism of vorozole in DMBA-induced rat mammary tumors.

9,10-Dimethyl-1,2-benzanthracene↗