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Biomedical subjects

E Hayashi

Publications and source records attributed to E Hayashi.

At least 55 records · Page 3Linked to original sources

Quality control of human IVF/ICSI program using endotoxin measurement and sperm survival test.

Quality control is essential for maintenance and improvement of a successful human in vitro fertilization and embryo transfer (IVF/ET)/intracytoplasmic sperm injection(ICSI) program. Quality control of medium, serum and equipments were performed using endotoxin measurement and human sperm survival test. It was proved by high pregnancy rate that the method of quality control at present study was essential for the development of the program.

Embryo Transfer↗

Pseudoaneurysm of the cystic artery associated with upper gastrointestinal bleeding.

Pseudoaneurysm of the cystic artery is a cause of hemobilia, and is extremely rare, with only eight cases having been reported in the world literature. We report a case of pseudoaneurysm of the cystic artery in a 72-year-old Japanese man. The patient experienced epigastric pain and melena, and was found to have jaundice and liver dysfunction. Repeated gastroendoscopy did not reveal the cause of the alimentary tract bleeding; however, color-Doppler ultrasonography detected an aneurysm of the cystic artery in the gallbladder. Selective hepatic arteriography demonstrated that the posterior branch of the cystic artery was markedly dilated and that an aneurysm had formed in the midst of the artery. We diagnosed hemobilia due to the pseudoaneurysm of the cystic artery, and associated gastrointestinal bleeding. Cholecystectomy was performed immediately. Pathologically, the gallbladder showed acute calculous cholecystitis. This case emphasizes the importance of including hemobilia in the differential diagnosis whenever gastrointestinal bleeding is associated with signs of biliary disorder; color-Doppler imaging is a favorable modality for the diagnosis of pseudoaneurysm of the cystic artery.

Aged↗

A case of silent 21-hydroxylase deficiency with persistent adrenal insufficiency after removal of an adrenal incidentaloma.

A case of an adrenal incidentaloma in a 57-year-old man with silent 21-hydroxylase deficiency is reported. Abdominal computed tomography revealed a right adrenal tumour of 6cm in diameter. There was no evidence of adrenal hormone excess. However, after surgical removal of the adrenal tumour, the patient developed acute adrenal insufficiency. Adrenocortical function has remained low ever since surgery. Pathological examination of the tumour revealed a cortical adenoma. On the basis of increased plasma renin activity and serum 17 alpha-hydroxyprogesterone concentration and decreased 21-hydroxylase activity of the adenoma tissue, the patient was diagnosed as having systemic 21-hydroxylase deficiency. There are two possible mechanisms for the persistent adrenal insufficiency; first the residual left adrenal gland may have been originally hypo-functioning for some reason and, second, the left gland may have lost the ability to regenerate following prolonged suppression by the adenoma. In cases of adrenal incidentalomas with 21-hydroxylase deficiency, the indications for surgical removal should be carefully considered.

Adenoma↗

DNA fragmentation of oocytes in aged mice.

To investigate whether female fertility decreases with age due to poor oocyte quality, we examined the presence of DNA fragmentation in ovulated oocytes from young, mature and aged mice. Oocytes from three age groups of female mice (7-8, 20-24 and 40-48 weeks) were retrieved from the oviducts 15 h after human chorionic gonadotrophin (HCG) injection. Oocytes from each mouse were incubated in a CO2 incubator for 0-60 h in human tubal fluid (HTF). After incubation, each oocyte was stained with the terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL) method. The rate of DNA fragmentation (interpreted as apoptotic changes) was significantly higher for oocytes from aged mice, and the fertilization rate was significantly lower, compared with oocytes from young and mature mice. Our results suggest that DNA fragmentation of oocytes might be one of the reasons for poor oocyte quality and lower fertility in the aged group.

Aging↗

[Liver diseases and essential trace elements].

The significance of the biochemical and nutritional roles of trace elements is widely recognized, since metals are found as constituent components of many metalloproteins and metalloenzymes. Some trace elements such as copper act as cofactors against hepatic fibrosis in chronic liver diseases, particularly in the biosynthesis of collagen. As the disease progress from chronic hepatitis to liver cirrhosis, serum calcium, magnesium, phosphorus and zinc concentrations decrease, while the copper concentration increases. In the patients with hepatocellular carcinoma, serum concentrations of trace elements are similar to those of liver cirrhosis. In the patients with acute hepatitis, serum calcium, magnesium and zinc concentrations decrease, while phosphorus, iron and copper concentrations decrease. These trace element abnormalities may reflect such pathological conditions as liver dysfunction, cholestasis, hepatic fibrosis or liver regeneration.

Humans↗

[Trial of home infusion therapy for near-terminal stage patients with lung cancer].

To improve the quality of life in patients with malignant diseases at the near-terminal stage, we established a system for home infusion therapy (HIT) in Osaka Prefectural Habikino Hospital in 1994. Thirty-three patients were taken care of at home using the HIT system from January, 1995 to May, 1996. Their average age was 70 years old. The duration of HIT varied from 1 to 105 days (mean:25.5 days). Twenty-four cases received parenteral nutrition. The others received agents for brain edema (4 cases), morphine hydrochloride (2 cases), and anti-fungal agents (3 case). Additionally, 63% of these patients required home oxygen therapy (HOT) with HIT. Questionnaires to their families revealed that they were afraid of the progress of the disease in patients and their physical burden became heavier after the start of HIT. However, they were quite satisfied with the results of HIT.

Adolescent↗

Simultaneous production of G- and M-CSF by an oral cancer cell line and the synergistic effects on associated leucocytosis.

We established a novel cell line, TSU, from a oral cancer patient with marked leucocytosis. The culture supernatant of TSU cells promoted granulocytic colony formation by mouse bone marrow cells, indicating that TSU produced granulocyte-colony stimulating factor (G-CSF). The concentration of G-CSF was 2.45 micrograms/mg protein, measured by enzyme-linked immunosorbent assay (ELISA). The maximum number of colonies induced by TSU culture supernatant was more than that achieved with recombinant human G-CSF (rhG-CSF) and the size of the colonies induced by TSU supernatant was obviously larger than those achieved with rhG-CSF. The activity of TSU supernatant was completely inhibited by antihuman G-CSF and macrophage-colony stimulating factor (M-CSF) antibodies, but was only partially inhibited by antihuman G- or M-CSF antibody alone. These results indicate that not only G-CSF but also M-CSF, both of which could be produced by TSU cells, are involved in causing leucocytosis; the results suggest that the synergistic production of G- and M-CSF could play an important role in the leucocytosis associated with oral cancer.

Colony-Forming Units Assay↗

Evaluation of serum concentration of parathyroid hormone-related protein and its implication in hypercalcemia in squamous cell carcinoma of the head and neck.

Hypercalcemia is a common and serious complication associated with squamous cell carcinoma (SCC) and is considered to be caused by a tumor-derived factor, parathyroid hormone-related protein (PTHrP). However, the correlation between serum levels of calcium and PTHrP and the kinetics of PTHrP in SCC of the head and neck is unknown, because the behavior of the circulating form of PTHrP in patients has not been determined. In the present study, the PTHrP concentrations in serum samples from 54 patients (37 with SCC and 17 with benign tumors) were measured by a recently developed radioimmunoassay directed toward the C-terminal region of PTHrP, and the laboratory data including those calcium levels in corresponding samples were reviewed retrospectively. Results showed hypercalcemia in four patients with advanced cancer and in whom elevation of the serum PTHrP concentration was observed simultaneously. The regression analysis also revealed the linear relationship of the calcium level to the PTHrP concentration, but not to the concentration of phosphorus or creatinine, suggesting that monitoring of serum PTHrP level is useful for prediction of hypercalcemia associated with head and neck cancer.

Adult↗

Familial hyperparathyroidism associated with jaw fibroma: case report and literature review.

A 53-year-old female suffering from renal stones and hypercalcaemia was diagnosed as having primary hyperparathyroidism caused by hyperplasia of the parathyroid glands. She underwent total parathyroidectomy and implantation of parathyroid tissue. After one year, she underwent surgery for a jaw tumour. The pathological findings indicated it to be a cementifying fibroma. Jackson et al. (1990) reported the familial association of hyperparathyroidism with jaw tumours, and they suggested that this condition represents a new clinical syndrome. We believe that our case belongs to this syndrome.

Female↗

[Marked dilatation of the bilateral common carotid artery: a case report].

We reported a rare case of marked dilatation of the bilateral common carotid artery (CCA) associated with stenosis of the left middle cerebral artery (MCA). A 64-year-old female was admitted with right hemiparesis and dysarthria. She was hospitalized 2 years ago for cholecystitis. For 5 years, she has been under medical treatment for hypertension, diabetes mellitus, hyperlipidemia, cardiac failure associated with hypertrophic cardiomyopathy, and atrial fibrillation. Brain CT scan showed infarction of the left corona radiata. Angiography revealed marked dilatation of the bilateral CCA and the internal carotid artery (ICA), moderate dilatation of the innominate artery and the right subclavian artery, kinking of the right CCA, diverticular outpouching of the left ICA, and stenosis of the right external carotid artery and the left MCA. Breast CT scan revealed moderate dilatation and marked calcification of the ascending aorta and the aortic arch. Laboratory examination did not show any sign of inflammation, rheumatoid factor (RA), antistreptolysis-O (ASLO) and antinucleotic antibody. Based on the clinical course, radiological findings and laboratory data, possible diagnosis of the dilatation of the bilateral CCA was discussed with particular emphasis on arteriosclerotic aneurysm and aortitis syndrome.

Aortic Arch Syndromes↗

Model analysis of time duration in a medication order entry system with attention to do-medication orders.

To investigate the relative time length needed for a medication computer order entry in comparison with the handwritten prescription system, we made a model, focusing our attention on the "do-medication order entry function." In the model analysis, we conducted a statistical analysis using the Nagoya University Hospital Information System. From the results and our model, if the time needed to make one (drug) item medication order entry is less than 1.9-3.0 times the time needed for handwriting one item prescription, computer order entry is faster on average.

Algorithms↗

[A case of bilateral emphysematous pyelonephritis associated with diabetes mellitus and liver cirrhosis].

A 32-year-old woman was hospitalized with the chief complaints of high fever and right flank pain. The patient had received treatment for diabetes mellitus and liver cirrhosis. The patient's laboratory data indicated pyuria, renal dysfunction and hyperglycemia. E. coli was detected in the blood, urine and pus. Plain abdominal X-ray revealed gas shadows at the right renal region. Abdominal CT scanning also showed gas shadows in the renal parenchyma of both sides. A diagnosis of bilateral emphysematous pyelonephritis was made. Chemotherapy and retroperitoneal drainage was performed. After therapy, the patient's laboratory data was improved and the abnormal gas shadows disappeared. We reviewed 77 cases of emphysematous pyelonephritis, including our case, from the Japanese literature.

Adult↗

Evaluation of the order entry system by end users--a step to the new hospital information system.

Nagoya University Hospital has developed a new, comprehensive computerized hospital administration system since April 1992. In the present study, a user's evaluation questionnaire survey on the order entry system revealed that the improvements at the human interface level were appreciated by some respondents, but not all users felt the human interface provided, adequately meets their needs. Another presumed advantage of the micro-mainframe-link architecture is fast response, but in our study respondents considered the response time too long. Most users felt that transmission of orders was fast, accurate and clear, and that fast retrieval of the results of laboratory tests was good. Our system with this kind of architecture has thus proved satisfactory except for the slow response time. This study will be useful to reengineer our hospital information system in the next phase.

Evaluation Studies as Topic↗

Clinical evaluation of plasma des-gamma-carboxy prothrombin as a marker protein of hepatocellular carcinoma in patients with tumors of various sizes.

We measured des-gamma-carboxyprothrombin (DCP) (prothrombin induced by vitamin K absence or antagonist-II, abbreviated as PIVKA-II) by a newly developed enzyme immunoassay using an anti-DCP monoclonal antibody in 665 human subjects, of which 112 were patients with hepatocellular carcinoma (HCC). PIVKA-II was elevated to more than 0.1 AU/ml in 54 of the 112 patients (48.2%) with HCC, while it was positive only in 7.1% of those with liver cirrhosis and 3.1% of those with chronic hepatitis. Three patients with elevated PIVKA-II greater than 0.1 AU/ml who had been diagnosed as having liver cirrhosis by ultrasonography and computed tomography at the start of this study developed a diffuse type of HCC three or six months later, which was detected by angiography. No obvious correlation was observed between plasma PIVKA-II concentration and serum alpha-fetoprotein (AFP) level in HCC patients. Of the 112 HCC patients, 40.2% showed an increase in AFP to above 200 ng/ml. In the remaining patients, 32.8% had a PIVKA-II concentration greater than 0.1 AU/ml. In these patients with a negative or low serum AFP concentration, PIVKA-II proved to be a valuable tumor marker for laboratory diagnosis of HCC. Among them, 59.8% tested positive for PIVKA-II and/or AFP. Thus, combination assay with PIVKA-II and AFP seems useful for increasing the accuracy of laboratory diagnosis of HCC. None of patients with a solitary tumor smaller than 2 cm had elevated PIVKA-II. In patients with larger-sized and multiple HCC, positive results of elevated PIVKA-II were more frequent than those of increased AFP.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers↗

Depression of plasma gelsolin level during acute liver injury.

Human plasma contains two actin-binding proteins, plasma gelsolin and vitamin D-binding protein. These proteins are considered to play an important role in the disposition of actin derived from injured tissue. To evaluate this actin-scavenger system, gelsolin concentrations were measured in serial plasma samples obtained from patients with acute liver injury using an enzyme-linked immunosorbent assay. Plasma gelsolin levels in 43 healthy persons were 226 +/- 52 micrograms/mL. They were markedly reduced to 80 +/- 40 micrograms/mL in 14 patients with an early stage of acute hepatitis and returned to normal levels of 232 +/- 38 micrograms/mL as the disease resolved. Moreover, they showed a significant negative correlation with serum aminotransferase and bilirubin levels. In 7 patients with hepatocellular carcinoma, plasma gelsolin levels rapidly decreased from 182 +/- 42 to 87 +/- 41 micrograms/mL after transcatheter arterial embolization therapy. Because plasma gelsolin is not a hepatic protein, the decreased levels are considered to depend exclusively on the extent of actin leakage from the injured liver.

Actins↗

Fetal and neonatal excretion of free and conjugated ritodrine.

The ability of the human fetus and neonate to conjugate and excrete ritodrine, a beta 2-sympathomimetic drug, was investigated. Free and conjugated ritodrine concentrations in the plasma, amniotic fluid and urine were measured in 11 mother-infant pairs, to whom intravenous ritodrine had been administered before elective cesarean section at term. Ritodrine was determined by HPLC with electrochemical detection. At delivery, conjugated ritodrine values were significantly higher than those for the free form in maternal and fetal plasma. There were significant positive correlations between the concentrations in the maternal and umbilical vein plasma for both free and conjugated ritodrine. In the amniotic fluid, the total ritodrine concentrations were much higher than those in the fetal plasma, the conjugated form accounting for 90.2% of the total. Furthermore, the percentages of conjugated ritodrine in the amniotic fluid and neonatal urine were significantly higher than the percentage in the maternal urine on the day of birth. In the neonatal urine, the concentrations of free and conjugated ritodrine decreased rapidly after birth as did those in the maternal urine, on day 3 postpartum being less than 2% of the values on the day of parturition. These results indicate that the fetus at term is capable of forming conjugated metabolites of ritodrine and of excreting free and conjugated ritodrine in its urine.

Amniotic Fluid↗

Interferon therapy for non-A, non-B hepatitis: a pilot study and review of the literature.

We treated four cases of acute unresolving non-A, non-B hepatitis, and eleven cases of chronic non-A, non-B hepatitis with recombinant interferon alpha-2a for up to one year. The dose of interferon was initially 3 million units daily, and was gradually decreased to 1 million units three times weekly. The overall response rate was 80 percent (twelve out of fifteen cases) at the end of treatment. Relapse occurred after the cessation of treatment in seven of the eight cases of chronic disease responding to interferon therapy. In contrast, three of the four cases of acute unresolving hepatitis became (sero)negative for antibody to hepatitis C virus, and in three completely normal serum aminotransferase levels persisted for more than one year after therapy. It is urged that early recognition of non-A, non-B hepatitis should be striven for, because interferon therapy may lead to an improved prognosis of the disease, particularly in cases of possible transitional phase from acute to chronic disease.

Acute Disease↗