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Biomedical subjects

A Hayashi

Publications and source records attributed to A Hayashi.

At least 343 records · Page 19Linked to original sources
PubMed1989

Pathogenesis of cholesteatoma based on clinical results of anterior tympanotomy.

A new conception of the pathogenesis of cholesteatoma is proposed based on clinical results of anterior tympanotomy, a procedure developed in order to prevent recurrence of cholesteatoma following retraction pocket formation after canal-up operation. In the cholesteatomatous ear, there is always a long, thick bony septum between the epitympanum and the supratubal recess. This septum is called the anterior attic bony plate, forming the tympanic diaphragm together with the tensor tympani mucosal fold. In anterior tympanotomy, this bony plate is removed finishing intact canal wall mastoidectomy, making a new ventilating route to the eustachian tube. With this technique, the rate of recurrence was reduced from 17 to 5%. Based on these results it is proposed that the real pathogenesis of cholesteatoma is not tubal dysfunction, but the osseous tympanic diaphragm.

Cholesteatoma↗
PubMed1989

Tuberous sclerosis: aberrant proline sensitivity of skin fibroblasts.

Cultured skin fibroblasts from patients with tuberous sclerosis were analyzed as to their sensitivities to proline, glutamic acid and arginine, and their analogues by means of a cell growth study. A difference was observed between tuberous sclerosis and normal cells when proline was added. Skin fibroblasts derived from normal-appearing skin of tuberous sclerosis patients exhibited sensitivity to proline. Skin fibroblasts derived from tumorous skin of tuberous sclerosis patients exhibited resistance to proline in the cell growth study and was found to be rather sensitive to proline in a colony formation study. This aberrant sensitivity to proline of tuberous sclerosis cells may indicate abnormal proline metabolism in tuberous sclerosis patients.

Arginine↗
PubMed1989

Structural analysis of choline phospholipids by fast atom bombardment mass spectrometry and tandem mass spectrometry.

The structures of intact choline phospholipids were determined by positive and negative ion mode fast atom bombardment mass spectrometry, tandem mass spectrometry, and B2/E and B/E constant linked scan mass spectrometry. The molecular weight of the choline lipid could be clearly determined by the appearance of [M + H]+ or [M + Na]+ in the positive ion mode and triplet ions, e.g., [M - 15]-, [M - 60]-, and [M - 86]-, in the negative ion mode. The structures of the triplet ions were assigned to [M - CH3]-, [M - HN(CH3)3]-, and [M - CH2 = CHN(CH3)3]-, respectively, by the MS/MS of each triplet ion, and the origin of the triplet ions was found as the matrix-ion adduct to the target molecule by using the B2/E linked scan technique. The polar group could be identified by the existence of ions indicating glycerophosphocholine and its cleavage products and by the presence of the triplet ions in the negative ion mode. Positional determination of the distribution of constituent fatty acyl groups was carried out by comparing the intensity of deacylated ions from positions 1 and 2 in the positive ion mode and of the ions produced by MS/MS of the triplet ions. From the mass number of the [RCOO]- ion which appeared in the negative ion mode, the molecular weight and degree of unsaturation of the fatty acyl group were determined. The position of double bond(s) in the acyl group was determined from the MS/MS of the [RCOO]- ion.

Lysophosphatidylcholines↗
PubMed1989

The "reduced" latissimus dorsi musculocutaneous flap.

This report introduces a new device among latissimus dorsi flaps: the "reduced" latissimus dorsi musculocutaneous flap. This flap consists of a proximal musculocutaneous unit and a distal, thin fasciocutaneous unit (the "reduced" portion). The former unit carries a reliable blood supply from the thoracodorsal artery and is able to cover deeper recipient defects, while the latter provides a well-contoured reconstruction of the defect. If needed, an extended portion and/or a thin cutaneous flap can be carried along with the flap according to the defect. In our clinic, we have so far used four pedicled and one free reduced latissimus dorsi musculocutaneous flap in the repair of a variety of defects. All flaps survived, and satisfactory contour of the recipient site was achieved in each case. These clinical experiences clarify that a reduced portion 10 cm in length can be safely carried, and it is suggested that survival of this flap does not depend on its width-to-length ratio.

Adult↗
PubMed1989

Rapid identification of serotypes of Mycobacterium avium-M. intracellulare complex by using infected swine sera and reference antigenic glycolipids.

The species of 136 strains of acid-fast bacteria isolated from swine with mycobacteriosis were identified by numerical taxonomy and chemotaxonomy on the basis of mycolic acid subclass composition as members of the Mycobacterium avium-M. intracellulare (MAI) complex. The isolates were further classified by using both thin-layer chromatography of the antigenic glycopeptidolipids (GPL) obtained from the bacteria by the method of Tsang et al. (A. Y. Tsang, I. Drupa, M. Goldberg, J. K. McClatchy, and P. J. Brennan, Int. J. Syst. Bacteriol. 33:285-292, 1983) and the seroagglutination test devised by W. B. Schaefer (Am. Rev. Respir. Dis. 92[Suppl.]:85-93, 1965). For the reference standard, purified antigenic GPL of serotypes 4, 8, and 9 were isolated and their structures were analyzed by negative fast-atom bombardment-mass spectrometry. The fast-atom bombardment-mass spectrometric spectra of the intact GPL antigens of serotypes 4, 8, and 9 agreed with the structures reported earlier by Brennan et al. (P. J. Brennan and M. B. Goren, J. Biol. Chem. 254:4205-4211, 1979; P. J. Brennan, G. O. Aspinall, and J. E. Nam Shin, J. Biol. Chem. 256:6817-6822, 1981). With these antigenic GPL, the thin-layer chromatographic behaviors of the alkali-stable lipids of the above-described isolates were examined. These MAI complex isolates fell into the serotype 8 (85 strains), 4 (33 strains), and 9 (7 strains) and untypeable (11 strains) categories. Furthermore, an enzyme-linked immunosorbent assay (ELISA) based on type-specific glycolipid antigens and infected swine sera was used to diagnose the serological types of the MAI complex isolates. Of 14 cases typed by both the seroagglutination reaction and thin-layer chromatography, 13 showed clear agreement with the ELISA results. The results demonstrated that ELISA using infected sera was especially useful, and it can be recommended on the basis of simplicity, sensitivity, and specificity as an adjunct to the seroaggulutination test and thin-layer chromatography for identification of mycobacteria belonging to the MAI complex.

Agglutination Tests↗
PubMed1989

Dependency of histamine induced phasic and tonic contractions on intracellular and extracellular calcium in guinea pig tracheal smooth muscle.

Dependency of histamine induced phasic and tonic contractions on intracellular and extracellular calcium in guinea pig tracheal smooth muscle was investigated. In Ca++-free Krebs-Ringer solution, the phasic contraction caused by 10(-5)M histamine was not affected, but the tonic contraction declined much faster than that in normal Krebs-Ringer solution (KR). The phasic contraction in KR containing 3 x 10(-4) M dantrolene was depressed, but reached a level similar to that in normal KR, and the tonic contraction was maintained similarly with or without dantrolene. In KR containing organic calcium channel blockers, 10(-5) M nilvadipine (FR34235), 10(-5) M verapamil or 10(-5) M diltiazem, neither phasic contraction nor tonic contraction was affected. No contraction was observed in Ca++-free KR containing 3 x 10(-4) M dantrolene. These results suggested that the phasic contraction by histamine depended on the intracellular calcium and the tonic one, on the extracellular calcium, and the organic calcium channel blockers had no effect on both phasic and tonic contractions caused by histamine.

Animals↗
PubMed1989

[Coronary artery spasm under thoracic epidural anesthesia].

Three paroxysmal episodes of ST-segment elevation in lead II of ECG were observed during bullectomy and chest closing under epidural anesthesia supplemented with enflurane in compressed air in a patient who had history of variant angina with 50% obstruction of right coronary artery. The first and the third episodes were followed by ventricular tachycardia, complete A-V block and hypotension. These attacks were preceded by decreases in heart rate and blood pressure. It was suspected that coronary artery spasm developed with increased vagal tone under thoracic epidural block. The first and the second attacks were successfully treated with intravenous injection of nitroglycerin and lidocaine. The third attack needed additional treatments which included intravenous administrations of atropine, epinephrine, isoproterenol and phenylephrine and direct heart massage through the thoracic incision. Postoperative serial examinations of ECG showed inverted T in lead V1-V4, and serum enzymes (GOT, GPT, LDH, CPK, CPK-MB) were elevated. However ratio of CPK-MB to total CPK was only 1.5%. The patient was discharged two weeks after the operation with normal ECG and serum enzymes. It is speculated that coronary artery spasm was induced by hypotension and vagal stimulation under epidural anesthesia which blocks cardiac sympathetic nerves.

Aged↗
PubMed1989

[Basic study on MRI guided stereotaxic surgery].

In 1987, we started MRI guided stereotaxic surgery using BRW-MRI apparatus. As distortion of image had been noted around the periphery of MRI due to the characteristic static magnetic field, we examined accuracy of data before clinical application. The MRI machine was a MRT-15A, 0.15 Tesla resistive type made by Toshiba. The stereotaxic apparatus consisted of a head ring, which was fixed to the patient's head, a cubical localizer frame which was attached to the head ring for the scanning phase, and a programmed computer. The localizer frame had multitubular channels, which could be fixed and drained easily with whatever paramagnetic fluid was desired. Since the beginning of our use of the instrument, we have used petroleum jelly. This material produced sufficient localizer image for us to fully determine any MRI scan plane. Once the MRI scan target had been identified, it could be approached stereotaxically in a same way as was done in the CT-related one. In the examination, at first, we studied the MRI image of a grid phantom, or the localizer frame placed on the center of the magnetic field. In the MRI, distortion of the image was seen only at the periphery of the Z axis. Secondly, we calculated the three-dimensional coordinates of the center of tumors in axial, coronal and sagittal images for correlation. But, the target values did not differ by over 5.1 mm. Therefore we concluded that the distortion of the image had minimum effect on surgery. Thirteen surgical operations were performed for brain tumors. Among these surgical interventions biopsy alone was performed in 8 cases, and biopsy combined with brachytherapy was performed in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Brachytherapy↗
PubMed1989

[Extraordinary examinations in tuberculous prevalence areas and family contact examinations].

A survey was made on the actual state of performance of extraordinary examinations done in high tuberculosis prevalence areas and those of family contact examinations of the index cases of tuberculosis during the period between April 1986 and November 1987 in Chiba Prefecture. The results are as follows: (1) Forty-eight extraordinary examinations were performed by 19 public health centers. (2) By these extraordinary examinations, 22 additional tuberculous patients were detected and 143 persons were indicated INH prophylaxis. There were 2 cases of mass tuberculosis infection: from which 19 patients and 140 persons for chemoprophylaxis were detected. (3) Out of 18 extraordinary examinations done for contacts of cases from danger groups, one was done actually for unnecessary case. As to tuberculin tests, they were not performed in 2 groups, and in another case, the test subjects were inappropriate. (4) The examination rate of family members of index cases was as high as 95.4%, whereas the performance of tuberculin tests was not satisfactory, especially as regards to the younger populations. The total performance rate of the tests was 29.0%, and the rate in those below 19 years of age was 56.5%, and the rate in those below 29 was 42.9%. (5) There were 6 families with tuberculosis, which included 14 patients. It is considered that in extraordinary examinations, appropriate setting of subjects and tuberculin tests for younger persons are important; in family contacts examination, tuberculin tests for younger persons are indispensable.

Adolescent↗
PubMed1989

[A quality control of interpretation of rolled radiophotogramme used for mass screening of lung cancer in general habitants--cases difficult-to-diagnose and cases difficult-to-detect].

A mass screening for lung cancer was performed on 1,906,660 general habitants of Chiba Prefecture, using rolled radiophotogrammes (RP), a traditional mass screening method used for tuberculosis. Of those examined, 270 lung cancer cases were found. In order to evaluate the quality of RP interpretation, cases difficult-to-diagnose and cases difficult-to-detect were picked out from the detected lung cancer cases. Difficult-to-diagnose cases were defined as cases in which pulmonary tumor was not suspected in the screening. Among these cases, tuberculosis was the disease most frequently suspected. Thus, we reexamined the RP which were suspected as being tuberculosis or pulmonary tumor. There was no difference between the two diseases in terms of the location of pathological shadows. Isolated small nodular shadows and infiltrating shadows were seen as an indication of tuberculosis, while large nodular shadows were thought to indicate pulmonary tumor. In addition, by retrospectively examining the RP of the cases judged as normal in the screening of the previous year, tumor shadows could be found in 54.2% of the cases. These cases were considered to be difficult-to-detect cases of lung cancer. The tumor shadows of many cases were present in the hilar region in these re-examined X-ray films. It was difficult to recognize these shadows in the rolled X-ray films because small nodular shadows or infiltrating shadows overlapped with the opacities of normal structures. To overcome these problems of difficult-to-diagnose cases and difficult-to-detect cases, the following observations are important. (1) Care should be taken in order to obtain photogrammes with excellent quality.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1989

[Group infection of tuberculosis in a private extra-school tutoring institute].

1) Two students of different high-schools were found to have pulmonary tuberculosis by school medical examination. These two students learned in the same private extra-school tutoring institute when they were junior high-school students. Assuming this event as a group infection of tuberculosis in the extra-school tutoring institute, we performed an extraordinary examination on the teachers working there. 2) In the extraordinary examination, a patient who could be judged as the source of infection was found. 3) As a result of extraordinary examination on students learning in the institute, a bimodal distribution was noted in the size of tuberculin test, compared with the results of tuberculin test at the first grade of junior high-school, the reaction was amplified. Twenty four students were subjected to chemoprophylaxis. 4) One case of pleurisy occurred from a student recommended chemoprophylaxis by the ad hoc committee on epidemic of tuberculosis, and the recommendation was neglected by an attending physician.

Adolescent↗
PubMed1988

Disorder in reciprocal innervation upon initiation of voluntary movement in patients with Parkinson's disease.

Reciprocal innervation of the soleus motoneurones upon initiation of voluntary ankle dorsiflexion was investigated in eight patients with Parkinson's disease. H-reflex and visually guided step tracking methods were used for testing motoneurone excitability and for controlling the timing of movement initiation, respectively. While reciprocal inhibition appeared almost simultaneously with the agonist electromyographic (EMG) onset in normal subjects (Kagamihara and Tanaka 1985), facilitation appeared in the majority of patients under the same onset condition. It increased slowly, reaching a maximum at about 100 ms after the EMG onset. It then subsided slowly at around 200-300 ms, and was replaced thereafter by an inhibitory effect. No coactivation of the soleus muscle was detected electromyographically. The facilitation between the EMG onset and the onset of mechanical contraction was attributed to the direct effect of the descending command from the brain, suggesting a certain disorder in controlling the system for reciprocal innervation.

Adult↗
PubMed1988

Human placenta gangliosides.

Gangliosides extracted from human placenta were composed of four major components (G1-G4), which were purified by silica beads column chromatography. The structures of these gangliosides were analyzed by exoglycosidase treatments, 400 MHz proton magnetic resonance spectroscopy and gas chromatography-mass spectrometry and were concluded to be as follows: (Formula: see text). Gangliosides containing more than 10 sugar residues were observed in addition to the above four major components. But ganglio-series gangliosides were undetectable in the placenta.

Amino Sugars↗
PubMed1988

The use of the anteromedial thigh fasciocutaneous flap in the reconstruction of the lower abdomen and inguinal region; a report of two cases.

The use of the anteromedial thigh fasciocutaneous flap in the reconstruction of the lower abdomen and inguinal region is described. If there is a dominant vessel supplying the anteromedial thigh flap, it can be raised as an island or a free flap. When there are only slender vessels in this area, a random pattern fasciocutaneous flap can safely be created with a fasciosubcutaneous pedicle.

Abdomen↗
PubMed1988

Deficiency of a 42-kilodalton protein in tumor-derived fibroblastic cells in neurofibromatosis.

Cell proteins obtained from cultured normal appearing skin and neurofibromas of neurofibromatosis patients, and normal skin of normal donors were compared by SDS-PAGE and isoelectric focusing analysis. Essentially, identical protein patterns were obtained for the pellet fractions of all the strains. The lysate fraction binding patterns were also similar to each other, but a deficiency of a 42-kilodalton protein with pI 4.3 was observed in the four tumor-derived cell strains examined. These results raise the possibility that tumor-derived fibroblastic cells are of the same cell origin as skin fibroblasts, and that the deficiency of a 42-kilodalton protein could be related to the tumorigenicity in neurofibromatosis.

Electrophoresis, Gel, Two-Dimensional↗
PubMed1988

The significance of stapedial reflex test in facial nerve paralysis.

The stapedial reflex of 30 patients with peripheral facial nerve paralysis was compared with the results of facial paralysis scores. The stapedial reflex was measured with an oto-reflex analyser, RS-06A. The stimulation frequencies in the stapedial reflex test were 500, 1,000 and 2,000 Hz for both ipsilateral and contralateral stimulation. The stapedial reflex test at 500 Hz for contralateral stimulation seemed to be useful for evaluating the degree of facial paralysis. With 500 Hz or 1,000 Hz contralateral stimulation, the stapedial reflex test seemed to be useful for predicting the prognosis for facial nerve paralysis. In these stimulations, cases with a positive reflex within 2 weeks showed complete recovery within 12 weeks, and cases with positive reflex within 4 weeks showed recovery within 24 weeks.

Adolescent↗
PubMed1988

Characterization of abnormalities in the gamma-globin gene arrangements of Japanese newborns.

Cord blood samples from 889 healthy Japanese newborns from three districts of Honshu Island were studied with the purpose of characterizing the gamma-globin genes in the Japanese. The A gamma T gene frequency was 0.159 which is the same as that found elsewhere in Japan. The haplotype of the chromosome with the A gamma T gene was [-- ++ - + (+ or -) (+ or -)] at eight polymorphic sites. Data from analyses of DNA and the proportion of gamma chains in Hb F showed the existence of various kinds of gamma-globin gene arrangements; six genotypes were observed for individuals with high G gamma values and triple or quadruple gamma-globin gene arrangements, and seven genotypes for babies with low G gamma values and a single gamma-globin gene. The in vivo expression of the gamma-globin gene located at the third or fourth position in the multiple gene arrangement was found to be about 5% and 2.5% of the total, respectively. The haplotype for the chromosomes with a triple gamma-globin gene was [+ --(-)---- +], but that for the chromosomes with a single gamma-globin gene remains unclear. In addition, a new type of Bgl II polymorphism in the G gamma-globin gene was observed.

Fetal Blood↗