Search PubMed⌕ Search

Biomedical subjects

H Hirayama

Publications and source records attributed to H Hirayama.

At least 37 records · Page 2Linked to original sources
PubMed2000

Determination of left ventricular mass by echocardiography in normotensive diabetic patients.

Patients with Type 2 diabetes mellitus (DM) have excessive cardiovascular morbidity and mortality, even in the absence of hypertension. Left ventricular hypertrophy (LVH), which is an ominous prognostic sign and an independent risk factor for cardiac events, is often present in Type 2 DM patients. Forty-two Type 2 DM patients without hypertension, all of whom had been diagnosed more than 10 years ago, were examined in the present study. They had no evidence of renal dysfunction and had not received any anti-hypertensive drugs. Age-matched healthy normal subjects (n=47) were recruited as controls. All participants were classified according to the left ventricular mass index (LVMI) using M-mode echocardiography and their systolic function (fractional shortening) was examined. The systolic function was not significantly different between the Type 2 DM and control groups. LVH can be seen even in the normotensive Type 2 DM patients, with these patients still having a higher LVMI than the normal control subjects. Although the plasma insulin levels were not significantly increased in the Type 2 DM patients, the LVMI significantly correlated with plasma insulin levels. However, the LVMI did not significantly correlate with plasma fasting glucose and hemoglobin A1c in the Type 2 DM patients. These results suggest that LVH in Type 2 DM patients without hypertension may be associated with elevated plasma insulin levels.

Age Factors↗
PubMed2000

Comparison of vectorcardiographic and 12-lead electrocardiographic detections of abnormalities in repolarization properties due to preexcitation in patients with Wolff-Parkinson-White syndrome: proposal of a novel concept of a "remodeling gradient".

Repolarization abnormalities after radiofrequency ablation in patients with manifest Wolff-Parkinson-White syndrome (WPW) have been attributed to cardiac memory of pre-existing changes in repolarization properties. We compared spatial ventricular gradient (VG) from vectorcardiograms with QRST values of 12-lead ECG in 41 patients with WPW (group A, manifest WPW due to left-sided accessory pathway (n = 20); group B, manifest WPW due to right-sided accessory pathway (n = 12); group C, concealed WPW (n = 9)) before and after ablation. Group N (n = 607) served as control. In groups A and B, the abnormalities of spatial VG and QRST values of 12-lead ECG that existed before and 1 day after ablation significantly decreased 1 week after ablation. In group C, spatial VG and QRST values of 12-lead ECG showed no significant changes. The diagnostic ability of spatial VG is almost equivalent to that of the QRST value of ECG in detecting repolarization abnormalities in patients with WPW before and after ablation. We propose a new concept of a "remodeling gradient" directing from the preexcited area to the opposite side of the ventricle as a result of preexcitation-induced electrical remodeling.

Adolescent↗
PubMed1999

Evaluation of a screening program on reduction of gastric cancer mortality in Japan: preliminary results from a cohort study.

BACKGROUND: Systematic population-based screening for gastric cancer is widely spread in Japan. However, the case-control study method has been the main method used to evaluate the effectiveness of the screen ing to reduce gastric cancer mortality in Japan. METHODS: This article presents a population-based cohort study. A questionnaire about lifestyles and dietary habits was distributed to 36,990 residents in a city of Japan. The response rate to the questionnaire was 92.0%. After ineligible responders had been excluded, 24,134 subjects were classified into screened and un screened groups according to their self-reports of participation in the screening the previous year. We followed them up for 40 months and linked resident death records in the city. We compared mortality from gastric cancer and all other causes between the groups by us ing the Cox proportional hazard model. RESULTS: The follow-up period was 78,156.6 person-years from September 1992 to December 1995. The multivariate relative risks for gastric cancer death of the screened group in comparison with the unscreened group were 0.72 (95% CI 0.31-1.66) among males and 1.46 (95% CI 0.43-4.90) among females. CONCLUSION: Although our data are preliminary, we were unable to demonstrate a large contribution of the present screening program to decreasing gastric cancer mortality. Further follow-up is needed to in crease the precision.

Adult↗
PubMed1999

Shear bond strength of techniques for bonding esthetic veneers to metal.

STATEMENT OF PROBLEM: New composites with improved qualities have been introduced to the dental profession as alternatives to porcelain. There is concern about the strength and reliability of new metal-resin bonding systems when these composites are used as esthetic veneers over metal frameworks. PURPOSE: This in vitro study compared the shear bond strength of 2 metal-resin bonding techniques with the bond strength of conventional porcelain fused-to-metal (PFM). Effects of water storage and thermocycling were also evaluated. MATERIAL AND METHODS: Ninety disks, cast in a medium gold, high noble PFM alloy, were divided equally into 6 groups, and received 3 treatments for veneering: conventional feldspathic porcelain on 1 group, and a composite (Artglass) bonded to the metal, using 2 metal-resin bonding techniques. Specimens were tested in shear, half of them after a 24-hour dry storage at room temperature and the rest after 10-day storage in normal saline solution at 37 degrees C and thermocycling. Fractured specimens were evaluated under x10 magnification to determine the nature of failure. Statistical analysis was performed with 2-factor analysis of variance (ANOVA). RESULTS: Mean shear bond strength values before and after wet storage and thermocycling were 29.66 and 22.91 MPa for the PFM group; 21.43 and 17.92 MPa for the Siloc group; and 19.34 and 15.64 for the etched group, respectively. The PFM group exhibited significantly higher bond strength values compared with the other 2 groups (P<.001). All groups showed a significant decrease in bond strength values after wet storage and thermocycling (P<.001). CONCLUSION: Wet storage and thermocycling caused a significant decrease in shear bond strength of all specimens. Shear bond strength of conventional feldspathic PFM was significantly higher than that of the 2 metal-resin bonding techniques tested. The 2 latter techniques did not reveal any statistically significant differences.

Analysis of Variance↗
PubMed1999

Localization of precise origin of idiopathic ventricular tachycardia from the right ventricular outflow tract by a 12-lead ECG: a study of pace mapping using a multielectrode "basket" catheter.

Radiofrequency catheter ablation guided by pace-mapping techniques has proven effective in eliminating idiopathic ventricular tachycardia (VT) originating from the right ventricular outflow tract (RVOT). A method for rapidly identifying the origin of VT from 12-lead electrocardiogram (ECG) findings would be helpful for the catheter ablation procedure. The purpose of this study is to precisely localize the origin of idiopathic VT from the RVOT by a 12-lead ECG from a study of multipoint pace mapping. In one patient with premature ventricular complex (PVC) and 3 with VT, a "basket" catheter was deployed in the RVOT for bipolar pacing from 56 sites in the endocardium of RVOT. Under fluoroscopy the pacing sites were classified into the septum and free wall. We investigated the QRS morphology in leads, I, II, and III; the depth of the QS wave in leads aVR and aVL; and the height of the initial r wave in leads V1 and V2. Pacing was captured in 30-47 of 56 sites (54%-84%). As the pacing sites changed from the anterior to posterior of the septum, the QS notch (-) type in lead I shifted through rs to R, while a shift from R type to rR' or Rr' was noted in leads II and III. As the pacing sites changed from the anterior to posterior of the free wall, lead I showed a shift from the QS notch (+) type to R, while a shift from rR' to Rr' (or rR' unchanged) was found in leads II and III. The depth of the QS wave in leads aVR and aVL showed a tendency for aVR to be deeper than aVL toward the posterolateral attachment of both the septum and free wall, whereas aVL tended to be deeper than aVR toward the anterior attachment. The initial r waves in V1 and V2 became greater as the pacing site was positioned at a higher or more posterior location. These findings may provide more precise and clinically useful diagnostic information on the site of the origin of idiopathic VT originating from the RVOT by a 12-lead ECG.

Adult↗
PubMed1999

Outer membrane changes in a toluene-sensitive mutant of toluene-tolerant Pseudomonas putida IH-2000.

We isolated a toluene-sensitive mutant, named mutant No. 32, which showed unchanged antibiotic resistance levels, from toluene-tolerant Pseudomonas putida IH-2000 by transposon mutagenesis with Tn5. The gene disrupted by insertion of Tn5 was identified as cyoC, which is one of the subunits of cytochrome o. The membrane protein, phospholipid, and lipopolysaccharide (LPS) of IH-2000 and that of mutant No. 32 were examined and compared. Some of the outer membrane proteins showed a decrease in mutant No. 32. The fatty acid components of LPS were found to be dodecanoic acid, 2-hydroxydodecanoic acid, 3-hydroxydodecanoic acid, and 3-hydroxydecanoic acid in both IH-2000 and No. 32; however, the relative proportions of these components differed in the two strains. Furthermore, cell surface hydrophobicity was increased in No. 32. These data suggest that mutation of cyoC caused the decrease in outer membrane proteins and the changing fatty acid composition of LPS. These changes in the outer membrane would cause an increase in cell surface hydrophobicity, and mutant No. 32 is considered to be sensitive to toluene.

Cell Membrane↗
PubMed1999

Penetrating atherosclerotic ulcer at the proximal aorta complicated with cardiac tamponade and aortic valve regurgitation.

A 56-year-old man had a penetrating atherosclerotic ulcer originating in the proximal ascending aorta, which is an unusual case of penetrating aortic ulcer complicated with the aortic valve regurgitation and cardiac tamponade. This hemodynamically unstable patient was successfully treated by conservative management to control his blood pressure and was also monitored closely with follow-up imaging studies.

Aortic Diseases↗
PubMed1998

Isolation and characterization of toluene-sensitive mutants from Pseudomonas putida IH-2000.

Two toluene-sensitive mutants were generated from Pseudomonas putida IH-2000, the first known toluene-tolerant isolate, by Tn5 transposon mutagenesis. These mutants were unable to grow in the presence of toluene (log P(ow) 2.8) but they could grow in medium overlaid with organic solvents having a log P(ow) value higher than that of toluene such as p-xylene (log P(ow) 3.1), cyclohexane (log P(ow) 3.4) and n-hexane (log P(ow) 3.9). The Tn5 transposable element knocked out a cyoB-like gene in one mutant and a cyoC-like gene in the other mutant. Seven open reading frames were found in a 5.5-kb region containing the cyoB- and cyoC-like genes of strain IH-2000. ORFs 3.7 showed significant identity to the cyoABCDE gene products of Escherichia coli, but ORFs 1 and 2 showed no significant homology to any protein reported so far. The growth patterns of the Tn5 mutants with the inactivated cyo-like gene were similar to that of the wild-type strain in the absence of organic solvents, although the doubling times were slightly longer than that of the wild-type strain. Our findings indicate that cyo is an important gene for toluene tolerance, although its role is still unclear.

Amino Acid Sequence↗
PubMed1998

Isolation and transposon mutagenesis of a Pseudomonas putida KT2442 toluene-resistant variant: involvement of an efflux system in solvent resistance.

A toluene-resistant variant of Pseudomonas putida KT2442, strain TOL, was isolated after liquid cultivation under xylene followed by toluene for 1 month in each condition. Almost all the populations of the variant strain formed small but readily visible colonies under toluene within 24 h at 30 degrees C. The toluene-resistant strain also showed an increase in resistance to some unrelated antibiotics. Several toluene-sensitive Tn5 mutants have been isolated from the toluene-resistant strain and showed various levels of sensitivity. Most of these mutations did not cause significant changes in antibiotic resistance; however, one of the mutants (TOL-4) was highly susceptible to both organic solvents and various antibiotics, especially beta-lactams. Sequencing analysis revealed that the mutation in TOL-4 had been introduced into a gene that may encode a transporter protein of an efflux system. This efflux system is very similar to one of the multidrug efflux systems of Pseudomonas aeruginosa. These observations indicate that a multidrug efflux system plays a major role in the organic solvent resistance of P. putida TOL. However, several other genes may also be involved.

Adaptation, Physiological↗
PubMed1998

A new approach to fabricating the occlusal surfaces of removable prostheses.

A procedure is introduced to fabricate the occlusal surfaces of removable prostheses that oppose ceramic restorations or ceramic denture teeth. It involves the use of a heat-processed glass ceramic material in the form of onlays over the plastic denture teeth. This procedure provides for more wear compatibility, improved esthetics, and individualized occlusion.

Ceramics↗
PubMed1998

A new method for evaluation and dietary therapy of congenital: deficiencies of amino acid metabolic enzymes. Linear system analysis and optimization of feedback inputs for the metabolic pathways of lysine, methionine and isoleucine.

We intended to elucidate an integrated mathematical model of amino acid metabolism and we propose a system for optimization treatment of disturbed metabolic states caused by congenital enzyme deficiencies. Our analysis focused on the metabolic pathway starting at asparaginic acid proceeding to isoleucine, methionine and lysine. The rate of change in the concentration of the biochemical species was expressed as 21 linear rate equations. We obtained the rate constants and the magnitude of feedback from reported experimental data. Linear systems analysis revealed that the metabolic system under study was stable but uncontrollable. These properties were insensitive to changes in the magnitude of feedback. To show the effect of optimizing the feedback so that it minimizes the square of the concentration of the species and the control input, we analyzed the impulse response of the species, transient response and the singular value of the system for four cases; (1) at the physiological state without optimizing the feedback, (2) at the physiological state attained after optimizing the feedback, (3) at the pathophysiological state attained with enzyme deficiency states for lysine and methionine metabolism without optimizing the feedback, and (4) at the pathophysiological state attained after optimizing the feedback for enzyme deficiencies. In the enzyme deficient model, the impulse response oscillated and lasted longer than that in the physiological state. These changes appeared even in the species on other branched pathways. The singular value was elevated in the enzyme deficient state. By optimizing the feedback, all the impulse responses in the enzyme deficient state recovered to nearly those in the normal physiological state. Similarly, the transient response and the singular value in the enzyme deficient state recovered to nearly the normal physiological values. We elucidated the numerical value of the feedback gain for this optimization. The present analysis is useful for the evaluation of the integrated properties of amino acid metabolism and the optimization technique is potentially of use for determining a treatment course for congenital metabolic enzyme deficiencies.

Amino Acid Metabolism, Inborn Errors↗
PubMed1998

Extra-weak chemiluminescence produced by autoxidation of kampo extract preparations stored in heat-stressed conditions.

The purpose of this study was to evaluate the usefulness of extra-weak chemiluminescence (CL) measurement as a rapid method to estimate the stability of Kampo extract preparations. It was found that the Kampo drugs that emit little CL were stable, while those with higher CL were comparatively unstable with regard to the various stability markers, including change of coloration (browning), contents of specific ingredients, high molecular compounds, amino acids and sugars under various conditions of heat storage. Excellent correlation existed between the CL of Kampo drugs and the coloration (delta E* (ab)) and the other above-mentioned evaluation markers. From this investigation, it was deduced that the CL of Kampo drugs originates in the early stage of the Maillard reaction and reflects the stability of the preparations, and that CL is useful for estimating the stability of Kampo drugs.

Amino Acids↗
PubMed1997

Body-surface distribution of changes in activation-recovery intervals before and after catheter ablation in patients with Wolff-Parkinson-White syndrome: clinical evidence for ventricular 'electrical remodeling' with prolongation of action-potential duration over a preexcited area.

BACKGROUND: T-wave abnormalities after catheter ablation in patients with manifest Wolff-Parkinson-White (WPW) syndrome have been attributed to a continuation of repolarization abnormalities induced by preexcitation (cardiac memory). METHODS AND RESULTS: To clarify changes in repolarization properties, we analyzed the activation-recovery interval (ARI) obtained from body-surface maps and the relationship between the activation time (AT) and ARI in 30 patients with WPW syndrome (group A, 18 patients with manifest left-sided accessory pathway; group B, 7 patients with manifest right-sided accessory pathway; and group C, 5 patients with concealed left-sided accessory pathway) before, 1 day after, and 1 week after ablation. The ARI significantly decreased 1 week after ablation compared with before and 1 day after ablation over the preexcited area in groups A and B. Correlation coefficients between the AT and ARI showed a significantly (P<.01) stronger inverse relationship before (r=-.58) and 1 week after (r=-.64) ablation than 1 day after ablation (r=-.46) in groups A and B. In group C, the ARI and correlation coefficients between the AT and ARI showed no significant changes. CONCLUSIONS: These findings suggest a prolongation of the action-potential duration over the preexcited area before and just after ablation as ventricular "electrical remodeling," a decrease in the inverse relationship between the AT and action-potential duration 1 day after ablation, and a gradual recovery of the action-potential duration over the preexcited area and inverse relationship 1 week after ablation.

Action Potentials↗
PubMed1997

Incidence of cardiac sarcoidosis in Japanese patients with high-degree atrioventricular block.

In Japan the majority of sarcoidosis-related deaths are due to cardiac sarcoidosis. One of the most common electrocardiographic abnormalities in patients with this disease is atrioventricular block. This study surveyed the incidence of cardiac sarcoidosis in Japanese patients (40 men and 49 women; mean age, 69.1 years) with high-degree atrioventricular block who were admitted to the hospital to receive a permanent pacemaker. We excluded cases in which sarcoidosis had been diagnosed from the involvement of other organs. Patients with the characteristic signs of sarcoidosis underwent echocardiography, radionuclide imaging, and biopsy. Ten cases (11.2%) of cardiac sarcoidosis were diagnosed, most frequently in women aged 40 to 69 years (8 of 25, 32%). Thus the possibility of cardiac sarcoidosis should be carefully considered in middle-aged or elderly Japanese women who show high-degree atrioventricular block.

Aged↗
PubMed1997

Lack of association between variants of the angiotensinogen gene and the risk of coronary artery disease in middle-aged Japanese men.

The renin-angiotensin system is important in cardiovascular remodeling. Although a variant of the angiotensinogen gene is associated with an increased generation of angiotensinogen, it is unclear how this genetic variant might influence the activity of the renin-angiotensin system and thereby contribute to the predisposition to coronary artery disease (CAD). The relation between genetic polymorphisms in the gene-encoding angiotensinogen and the risk of CAD in middle-aged Japanese men was investigated. Two polymorphisms in exon 2 of the angiotensinogen gene, M235T and T174M, were analyzed in 327 patients with CAD and 352 matched control subjects. The genotype distribution of both polymorphisms did not differ between patients with CAD and control subjects. No combination of genotypes of the two polymorphisms was associated with CAD. Results indicate that the M235T and T174M variants of the angiotensinogen gene are not associated with CAD in Japanese men.

Angiotensinogen↗
PubMed1997

Lack of association of angiotensin converting enzyme gene polymorphism or serum enzyme activity with coronary artery disease in Japanese subjects.

The association of an insertion/deletion (I/D) polymorphism in the angiotensin converting enzyme (ACE) gene or the serum activity of ACE with coronary artery disease (CAD) was investigated in Japanese men and women. The ACE genotype of 947 CAD subjects who underwent coronary angiography and of 893 control subjects was determined by polymerase chain reaction analysis. No association of the DD genotype or the D allele with CAD was observed in men or women. In a low risk group (defined by a body mass index below the median value and the absence of a history of hypertension, diabetes mellitus, and hypercholesterolemia), there was also no association between the ACE gene polymorphism and CAD. No significant difference in serum ACE activity was detected between CAD subjects and controls of all genotypes or of the same genotype, whereas a significant association was apparent between serum ACE activity and ACE genotype for both CAD subjects and controls among both men and women. These results indicate that the ACE I/D polymorphism and genotype associated variation in serum ACE activity are not risk factors for CAD in Japanese men or women.

Adult↗
PubMed1997

An impedance matching of femoral-popliteal arterial grafts: a theoretical study.

We have proposed a mathematical method to investigate the matching conditions for an arterial graft in the femoral-popliteal region from a mechanical stand-point. Pulsatory blood flow, arterial wall motions, and conservation law are expressed by linear dynamical equations based on strict mechanical and constitutional considerations. To express the physiological blood flow in an actual arterial system, the tethering effects from the surrounding tissue and wall tensions were incorporated. The physiological parameters of arterial wall and tethering were utilized from reported experimental data. By complex analysis, mathematical expressions for the local impedance and reflection coefficient were obtained. They include not only blood properties such as viscosity and density, but also arterial properties including elastic modulus, radius, Poisson ratio, wall thickness, wall tension, frequency, and tethering effects from surrounding tissue. A matching condition was defined for minimizing the local impedance and reflection coefficient. The biophysical background was to reduce any mechanical mismatches, thus minimizing the disturbance of the flow velocity profile and shear stress distribution within the artery. Impedance matching in turn diminishes the negative factors for graft substitution represented by intimal hyperplasia and thrombosis. The calculated impedance and reflection coefficient inversed parabolically to functions of the resistance of the host artery, and there was one host arterial resistance that minimized the impedance and reflection coefficient. The present analysis revealed that for matching host artery with an elevated resistance, the dynamic elastic modulus of the wall of the graft that minimizes the impedance and reflection coefficient was increased. This indicates that for a host artery with a high resistance, an impedance matched stiff wall graft is preferable. For a large radius and a compliant host artery on the other hand, a large compliant graft should be linked. The present theoretical matching conditions will prevent anastomotic hyperplasia and thrombosis in graft substitution.

Blood Vessel Prosthesis↗