DSpace Collection: 1999-12-15

Subserosal Inflammatory Pseudotumor Causing Intussusception

Thu, 13 Mar 2008 06:09:19 GMT

Title: Subserosal Inflammatory Pseudotumor Causing Intussusception Authors: Nagata, Hiroshi; Murase, Kunihiko; Nishiyama, Jin; Aramaki, Takahisa; Mukai, Shigenori; Nagae, Takaaki; Fujiwara, Takashi; Kanazawa, Shigeo; Ishigaki, Masaru; Isomoto, Hajime; Takeshima, Fuminao; Mizuta, Yohei; Higami, Yoshikazu; Shimokawa, Isao; Murata, Ikuo; Kohno, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.73-76 Abstract: We present an adult case of intussusception caused by subserosal inflammatory pseudotumor of the terminal ileum. Enteric intussusception was diagnosed by characteristic Xray finding, so called "beak-like" filling defect in the terminal ileum. An exploratory laparotomy revealed focal subserosal thickening in the terminal ileum, and partial ileocolectomy was performed. Microscopically, we identified a pseudotumor that extended through the muscularis propria into serosa. The pseudotumor was composed of fibrous stroma and chronic inflammatory cells with calcification.

Successful Resuscitation from Ventricular Fibrillation during Jogging in a Young Patient with Hypertrophic Cardiomyopathy

Thu, 13 Mar 2008 06:09:17 GMT

Title: Successful Resuscitation from Ventricular Fibrillation during Jogging in a Young Patient with Hypertrophic Cardiomyopathy Authors: Kose, Noriyuki; Fujiwara, Hideki; Honda, Yuzuru; Doi, Yoshiyuki; Toda, Genii; Yano, Katsusuke; Miyahara, Yoshiyuki; Kohno, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.67-72 Abstract: A 15-year-old girl, who was previously in good health, suddenly collapsed while jogging. Immediate cardiopulmonary resuscitation (CPR) was initiated, and she arrived at our hospital 13 minutes later. The ventricular fibrillation (VF) on admission was reverted to sinus rhythm 18 minutes after collapse by the second cardioversion. The echocardiogram revealed hypertrophic nonobstructed cardiomyopathy (HNOCM), although the 24hr ambulatory electrocardiographic, electrophysiologic and exercise stress tests could not define the exact cause of VF. Exercise-induced ischemia with sustained mild hypokalemia was suspected to be the cause of VF. The patient recovered consciousness three days after admission, and followed an uneventful course of treatment with oral atenolol not associating with disabling neurological deficit. Immediate basic life support and delivery of automatic external defibrillator on the spot is needed to rescue patients with out-of-hospital cardiac arrest.

Decreasing the Pressure Gradient of the Left Ventricular Outflow Tract by Single-lead VDD Pacing in a Patient with Hypertrophic Obstructive Cardiomyopathy

Thu, 13 Mar 2008 06:09:16 GMT

Title: Decreasing the Pressure Gradient of the Left Ventricular Outflow Tract by Single-lead VDD Pacing in a Patient with Hypertrophic Obstructive Cardiomyopathy Authors: Ikeda, Satoshi; Yoshinaga, Takayuki; Obase, Kikuko; Sonoda, Kouichirou; Shioguchi, Kousuke; Kawahara, Eisuke; Senjyu, Norihiko; Nishijima, Kyouji; Miyahara, Yoshiyuki; Fujiwara, Tsuneo; Koga, Hironobu; Kohno, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.61-66 Abstract: A 59-year-old woman with hypertrophic cardiomyopathy of 8 years duration, who had been taking ﾎｲ-blocker, was admitted to our hospital for exertional dyspnea and previous syncope. Cardiac catheterization showed a prominent left-ventricular outflow tract (LVOT) pressure gradient, and hypertrophic obstructive cardiomyopathy (HOCM) was diagnosed. To reduce LVOT obstruction, we implanted a single-lead VDD-mode pacemaker. Cardiac catheterization after the implantation revealed a remarkable decrease in the LVOT pressure gradient with short atrioventricular delay, 80 msec, and her symptoms disappeared. A singlelead VDD pacemaker is also a useful treatment for an HOCM patient due to the relative ease with which it can be implanted.

Adrenomedullin is not Related to Acute Hypoxic Pulmonary Vascular Response in Patients with Chronic Respiratory Disease

Thu, 13 Mar 2008 06:09:14 GMT

Title: Adrenomedullin is not Related to Acute Hypoxic Pulmonary Vascular Response in Patients with Chronic Respiratory Disease Authors: Furukawa, Katsuyuki; Ikeda, Satoshi; Iwasaki, Tadasu; Matsushita, Tetsuro; Yakabe, Kazuaki; Yamaguchi, Kenji; Miyahara, Yoshiyuki; Kohno, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.55-60 Abstract: In the present study, acute hypoxia was induced in 19 patients with chronic respiratory disease to evaluate the corre lation between pulmonary circulation kinetics and adrenomedullin (AM) levels. Using radioimmunoassay (RIA), pulmonary circulation kinetics were evaluated before and after hypoxic loading (13% oxygen for 15 minutes) by determining AM levels in plasma obtained from the pulmonary artery (PA) and the right femoral artery (FA). There were no significant differences in pre-hypoxia plasma AM levels between samples obtained from the PA and FA, and plasma AM levels did not change after hypoxic loading. Subjects were classified into two groups [responders (R) and non-responders (NR) ] to evaluate changes in the mean pulmonary arterial pressure(笆ｳMPAP). There were no changes in AM levels between these two groups in either the PA or FA after hypoxic loading. These results suggest that AM do not appear to be related to hypoxic pulmonary vascular response to acute hypoxic loading in patients with chronic respiratory disease.

Relationship between the Duration of Stay in Japan of Malaysian Subjects and the Suppression of Sweat Gland Sensitivity by lontophoretically Applied Acetylcholine

Thu, 13 Mar 2008 06:09:12 GMT

Title: Relationship between the Duration of Stay in Japan of Malaysian Subjects and the Suppression of Sweat Gland Sensitivity by lontophoretically Applied Acetylcholine Authors: Saat, Mohamed; Lee, Jeong-Beom; Matsumoto, Takaaki; Kosaka, Mitsuo; Ohwatari, Nobu; Motomura, Katsuaki; Kaneda, Eiko; Taimura, Akihiro; Yamauchi, Masaki Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.49-54 Abstract: Tropical African and Thai Subjects regulate core temperature with less amount of sweat against heat compared to temperate Japanese subjects. Reduced sweating in tropical subjects was attributed to suppression of both central and peripheral sudomotor mechanisms. The objective of the study is to compare the local sweating response activated by acetycholine (ACh) applied iontophoretically among the Malaysians (n=12) of varying duration of stay in Japan. Based on their length of stay, Malaysian subjects were divided into 2 groups, MS (n=6) with a duration of stay of 3 to 15 months and ML (n=6) with 27 to 60 months. ACh, the primary transmitter for sudomotor innervation, was iontophoretically administered on the forearm. Sweating response elicited directly (DIR) and indirectly via axon reflex (AXR) were evaluated by quantitative sudomotor axon reflex test. Although the sweat onset time was tend to reduce with longer duration of stay among Malaysian subjects, there was no significant difference among the two groups. AXR (1), sweat volume elicited by axon reflex for 0-5 min was 0.96ﾂｱ0.11 mg/cm2 in MS and 1.40ﾂｱ0.23 mg/cm2 in ML. AXR(2), that for 6-11 min, was 1.09ﾂｱ0.13 mg/cm2 and 1.45ﾂｱ0.20 mg/cm2. DIR, sweat volume directly induced by ACh for 6-11 min, was 3.40ﾂｱ0.18 mg/cm2 and 3.96ﾂｱ0. 24 mg/cm2 in MS and ML , respectively. A slight positive correlation between DIR and the duration of stay in Japan was observed in Malaysian subjects, though not significant (p=0.14). From these results, suppressed neuroglandular response to ACh was confirmed in Malaysians. It is suggested that long-term heat-acclimatization acquired in tropical subjects may decay after immigration to temperate area.

Cancer Specific Long-term Survival After Surgery for Carcinoma of the Splenic Flexure

Thu, 13 Mar 2008 06:09:10 GMT

Title: Cancer Specific Long-term Survival After Surgery for Carcinoma of the Splenic Flexure Authors: Nakagoe, Tohru; Sawai, Terumitsu; Tsuji, Takashi; Jibiki, Masaaki; Nanashima, Atsushi; Yamaguchi, Hiroyuki; Yasutake, Toru; Ayabe, Hiroyoshi; Ishikawa, Hiroshi Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.45-48 Abstract: Purpose: Carcinoma of the splenic flexure is uncommon and it is associated with a high risk of obstruction. However, survival after resection of this tumor is controversial. The aim of this study was to evaluate cancer specific long-term survival after surgery for splenic flexure cancers compared to survival for the colon cancer at other sites. Patients and Methods: Of 500 patients undergoing surgery for colon cancer, 16 (3.2%) had cancers of the splenic flexure. Clinicopathological features and cancer specific longterm survival after curative resection were evaluated. Results: Splenic flexure carcinomas were found to be associated with a high risk of obstruction (4 out of 16; 25.0%) and a high risk of penetration/perforation (1 out of 16; 6.2%) compared with colon cancers at other sites (P <0.0001 and P=0.0128, respectively). Operative mortality rate for patients with carcinomas of splenic flexure was significantly higher than that of other sites (6.3% versus 0.8%; P=0.0319). However, resection for splenic flexure tumors was usually possible, and there was no difference in cancer specific long-term survival after surgery between the patients with splenic flexure cancers and the other site colon cancers (P=0.3505). Conclusions: Carcinoma of the splenic flexure has a similar prognosis to colon cancer at other sites.

Response to Urinary Trypsin Inhibitor Therapy in Ulcerative Colitis is Associated With a Decrease in Mast Cell Count in the Colonic Mucosa

Thu, 13 Mar 2008 06:09:08 GMT

Title: Response to Urinary Trypsin Inhibitor Therapy in Ulcerative Colitis is Associated With a Decrease in Mast Cell Count in the Colonic Mucosa Authors: Nishida, Yoshiyuki; Murase, Kunihiko; Furusu, Hisashi; Isomoto, Hajime; Omagari, Katsuhisa; Mizuta, Yohei; Takeshima, Fuminao; Makiyama, Kazuya; Kohno, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.39-44 Abstract: BACKGROUND: Urinary trypsin inhibitor (UTI, ulinastatin (R)) inhibits proteinases and has been used for the treatment of ulcerative colitis (UC). We investigated the therapeutic effect of UTI in patients with UC and correlated this effect to mast cell (MC) and macrophages (M) counts in the colonic mucosal wall. DESIGN: Patients with UC resistant to corticosteroids (n=16) and normal control subjects (n=10) were included in this study. Biopsy specimens obtained from the sigmoid colon of patients before and after UTI therapy were immunostained with antibodies to tryptase (AA1, MC) and CD68 (M). The number of MC and M in the lamina propria (LP) was determined and expressed per mm2 of LP. RESULTS: Nine patients with UC responded to UTI treatment. The mean number of MC in the upper part of LP in responders(440ﾂｱ51/mm2)was higher than nonresponders (312ﾂｱ76/mm2)and normal controls(200ﾂｱ47/mm2). MC counts in the lower part of the LP were not different in responders and nonresponders, although the counts in both groups were significantly higher than control. The number of M in the lower part of LP was similar in responders and nonresponders, but were higher than control subjects. M counts in the upper part of LP were similar in both groups of patients and control. Effective treatment with UTI in responders was associated with a significant fall in the number of MC in the upper layer of LP but not in M. CONCLUSION. Our results showed that UTI is an effective therapy in steroid-resistant UC. Our results also showed effective therapy with UTI was associated with a reduction in MC counts in the colonic mucosa, suggesting that the control of these cells may mediate, at least in part, the therapeutic effects of UTI in UC.

Rapid Loss of Graft Immunogenicity and Transient Hyporesponsiveness to The Donor Antigen After Rat Liver Transplantation

Thu, 13 Mar 2008 06:09:06 GMT

Title: Rapid Loss of Graft Immunogenicity and Transient Hyporesponsiveness to The Donor Antigen After Rat Liver Transplantation Authors: Gu, Weili; Yamaguchi, Junzo; Hashimoto, Toshiaki; Yamamoto, Takao; Nakayama, Eiichi; Kanematsu, Takashi Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.31-38 Abstract: In orthotopic liver transplantation from Lewis (LEW) into Wistar Furth (WF) rats, a transient acute rejection response is usually followed by spontaneous tolerance of the graft. In this study, we investigated the alloimmunostimulatory ability of the graft and recipient spleen after liver transplantation, and studied the kinetic response of the recipient to the donor antigen. Alloimmunogenicity of the liver graft and recipient spleen, and kinetic response of the recipient were investigated in in vivo system. Alloimmunostimulatory ability of the liver graft disappeared by day 3 after transplantation. Alloimmunostimulatory capacity of recipient spleen was maximum 12 hours after grafting and rapidly disappeared thereafter. Challenge with normal LEW lymphocytes into recipient WF rats at 14, 28, 56 days after liver transplantation induced a progressive increase in rejection response. Our results suggest that rapid loss of graft immunogenicity and transient hyporesponsiveness to the donor antigen occur after grafting in our model.

Evaluation of Aortic Disease with Spiral CT Angiography and Multiplanar Reconstructions: Comparison with Catheter Angiography

Thu, 13 Mar 2008 06:09:04 GMT

Title: Evaluation of Aortic Disease with Spiral CT Angiography and Multiplanar Reconstructions: Comparison with Catheter Angiography Authors: Horikami, Kensaku; Sakamoto, Ichiro; Matsuoka, Yohjiro; Uetani, Masataka; Hayashi, Kuniaki Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.21-30 Abstract: Purpose: To assess the usefulness of spiral CT angiography (CTA) in the evaluation of aortic aneurysm (AA) or dissection (AD). Methods: Ninety-eight patients with AA (n = 78) or AD (n = 20) were examined with CTA. Imaging results were correlated with angiographic (n = 98) findings in all cases and surgical findings in AA cases (n = 64). The spiral CT angiography were analyzed by an experienced radiologist without knowledge of the result of the catheter angiography, to evaluate the same features. The catheter angiograms were individually interpreted by two experienced radiologists. Results: In AA, all of major aortic branches were depicted on CTA except two of seven accessory renal arteries and six of 26 inferior mesenteric arteries. CTA correctly assessed aneurysm involvement of left subclavian (LSA), renal (RA), and iliac arteries (IA) in all patients. In AD, CTA correctly assessed Stanford classification in all patients, and the relationship between 70 major aortic branches and true/false lumen in all but two branches. CTA showed 23 of 30 intimal tears in double barreled AD. Conclusion: CTA might replace catheter angiography in evaluation of AA and AD except in cases of type A dissection. Index Terms: computed tomography - CT angiography - aorta, aneurysm - aorta, dissection - Catheter angiography

MR Imaging of Intra-articular / Juxta-articular Mass Lesions

Thu, 13 Mar 2008 06:09:02 GMT

Title: MR Imaging of Intra-articular / Juxta-articular Mass Lesions Authors: Hashmi, Rashid; Uetani, Masataka; Hayashi, Kuniaki; Aso, Nobuya; Kawahara, Yasuhiro; Nakahara, Nobuya Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.7-19 Abstract: A wide variety of pathologies can arise in intraarticular/ juxta-articular region. This can be a potential source of confusion in a clinical set-up. These entities are diverse in origin and can emanate from bone, synovium, soft tissue and other surrounding structures. The purpose of this essay is to present an overview of imaging features of these entities with emphasis on the usefulness and limitations of the magnetic resonance imaging (MRI) in the work-up. For the purpose of description the lesions are divided on the basis of their origin in separate groups.

Milk-Borne Transmission of Human T-Cell Lymphotropic Virus Type I (HTLV-I) and Its Intervention in Nagasaki

Thu, 13 Mar 2008 06:08:59 GMT

Title: Milk-Borne Transmission of Human T-Cell Lymphotropic Virus Type I (HTLV-I) and Its Intervention in Nagasaki Authors: Katamine, Shigeru Issue Date: 1999-12-15 Citation: Acta medica Nagasakiensia. 1999, 44(3-4), p.1-6 Abstract: Summary Human T-cell lymphotropic virus type I (HTLV-I), a causative virus of adult T-cell leukemia (ATL), transmits through both horizontal and vertical pathways. Since ATL develops in only carriers infected early in life, vertical transmission cycle is the most important target of intervention for the purpose of the prevention of ATL. Epidemiological studies in an endemic area, Nagasaki, Japan, and animal experiments identified milk-borne maternal transmission as the major vertical pathway. The prefecture-wide intervention in Nagasaki since 1987 has revealed that the refraining from breast-feeding by carrier mothers can prevent about 85% of maternal HTLV-I transmission. Pathways for the remaining 15% await for elucidation. However, our studies argued against the possibilities of intrauterine transmission and infection via saliva. Perinatal transmission remains to be evaluated as the alternative pathway. At present, refraining from breast-feeding is the most effective measure to break the cycle of maternal HTLV-I transmission in endemic areas. It is estimated that the intervention in Nagasaki for the past 10 years has prevented 1,000 maternal transmission and 50 future ATL cases. I am reasonably confident that incidence of ATL in Nagasaki will decline to the national average level over the next few generation if the intervention program stays alive.