Search PubMed⌕ Search

Biomedical subjects

H Kagaya

Publications and source records attributed to H Kagaya.

At least 37 records · Page 2Linked to original sources
PubMed1999

Detection of cerebroside sulfotransferase mRNA in human gastric mucosa and adenocarcinoma.

Sulfatide is a major acidic glycolipid in human gastric mucosa, and its sulfation is catalyzed by cerebroside sulfotransferase (CST). To investigate the expression of the CST gene in human gastric cancer, a reverse transcription PCR method was developed with the use of endoscopic bioptic specimens. By this method, we examined the CST mRNA expression in 11 cases of gastric cancer, and in all the cases we detected various levels of the expression both in cancer tissues and in uninvolved adjacent tissues. The present assay method was suggested to be useful in the detection of CST mRNA from a limited amount of bioptic samples.

Adenocarcinoma↗
PubMed1999

Gait analysis following varus osteotomy of the femur for hip osteoarthritis.

The purpose of this study was to evaluate differences in the gait patterns of healthy and osteoarthritic hips, and changes in these patterns after intertrochanteric varus osteotomy of the femur, in relation to the strength of the muscles around the hip joint. We measured the strength ratio of hip abductor muscles, temporal and distance factors, and pelvic movement, and carried out dynamic electromyography (EMG) in 24 women who underwent unilateral varus osteotomy of the femur for hip osteoarthritis (OA), 30 non-surgically-treated women with hip OA, and 54 healthy women. The stance phase time was shorter and the strength ratio of hip abductor muscles was lower in the operated patients than these values in the other two groups, changes in pelvic obliquity and tilt were smaller, and changes in the percent maximum voluntary contraction of the gluteus medius and tensor fascia latae muscles were greater than these values in the healthy subjects. This study showed the postoperative reappearance of the simulated conditions in the hip before varus osteotomy of the femur, providing evidence that the pelvis was horizontally maintained during walking due to the decreased stance phase time and increased performance of the hip abductor muscles achieved after this procedure.

Adult↗
PubMed1999

Hybrid functional electrical stimulation for energy-efficient restoration of standing-up motion.

OBJECTIVE: To find the most energy-efficient standing-up motion for quadriceps and to restore that motion in a person with complete paraplegia by using hybrid functional electrical stimulation. DESIGN: Nonrandomized control trial. SETTING: A referral center and institutional practice providing outpatient care. PARTICIPANTS: Twenty-nine volunteer samples were used to collect normal data. One patient with complete paraplegia received treatment for the restoration of standing-up motion. MAIN OUTCOME MEASUREMENTS: Joint angles and ground reaction forces were investigated during the standing-up motion with arms crossed in front of the chest with an ankle-foot orthosis set at various angles. The electromyogram (EMG) was performed during the standing-up motion with and without the orthosis. The energy costs of quadriceps during the standing-up motion were calculated using a mathematical model. Standing-up motion in a person with complete paraplegia was restored and then analyzed by measuring the vertical ground reaction force and the hip and knee angles. RESULTS: Quadriceps energy cost was lowest (p < .05) in subjects wearing the ankle-foot orthosis set at neutral with a flat sole line. In the integrated EMG the peak value of rectus femoris contraction was larger with the orthosis than without it (p < .05). A patient with complete paraplegia was able to stand up smoothly from a wheelchair based on stimulation patterns obtained from healthy subjects. CONCLUSIONS: Energy-efficient standing-up motion in a patient with complete paraplegia was restored when the patient used an ankle-foot orthosis set at neutral with a flat sole line.

Adult↗
PubMed1999

[Hereditary ataxias in Akita prefecture].

To provide a genetic survey of hereditary ataxia, we performed PCR screening of SCA1, SCA2, MJD1 (SCA 3), SCA6, DRPLA, with 71 patients in 61 families living in Akita prefecture (1,205,571 population in 1997) in Japan. Of 71 patients in 61 families, 18 MJD1, 14 SCA6, 5 DRPLA, 1 SCA1 and 1 SCA2 patients were detected. Eighty percent of autosomal dominant inherited spinocerebellar degeneration (AD-SCD) including 7 spoladic patients genetically diagnosed as AD-SCD was MJD1 (45.7%) and SCA6 (34.3%). These suggest the prevalence rate of hereditary ataxias in Akita prefecture; 1.5 and 1.2/100,000 of MJD1 and SCA6, respectively. Only one patient of SCA1 was detected, which was frequently reported in Hokkaido and Tohoku area in Japan.

Genetic Testing↗
PubMed1999

Eradication of Helicobacter pylori using 30 mg or 60 mg lansoprazole combined with amoxicillin and metronidazole: one and two weeks of a new triple therapy.

A new triple therapy using a proton pump inhibitor and two antibiotics shows high efficiency against Helicobacter pylori infection. The aim of this study was to determine the optimal dose and duration of lansoprazole (LA) administration in combination with amoxicillin (AMPC) and metronidazole (MNZ). A total of 91 patients were enrolled in this study. They were divided into four groups: group A, 2 weeks of 30mg LA once daily, 500mg AMPC tid, and 250mg MNZ tid; group B, 2 weeks of 30mg LA bid, 500mg AMPC tid, and 250mg MNZ tid; group C, 1 week of 30mg LA once daily, 500mg AMPC tid, and 250mg MNZ tid; group D, 1 week of 30mg LA bid, 500mg AMPC tid, and 250mg MNZ tid. H. pylori status was determined by the rapid urease test, culture, histology, and 13C-urea breath test before and at least 4 weeks after the end of therapy. The cure rates in a per-protocol analysis and the incidence of adverse events in the evaluated patients were, respectively, 89.5% and 21.1% in group A, 100% and 20.0% in group B, 96.8% and 12.9% in group C, and 92.3% and 26.9% in group D. Most of the adverse events were tolerated. All four regimens in this study showed the same cure rates, and they were effective and well tolerated. One week of triple therapy using once-daily administration of 30mg LA is a good alternative.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Electrophysiologic evaluation of denervated muscles in incomplete paraplegia using macro electromyography.

OBJECTIVE: To evaluate denervated muscles in persons with incomplete paraplegia due to thoracolumbar spinal injury (TLSI) using macro electromyography in determining indications for functional electrical stimulation (FES). DESIGN: A randomized clinical trial and a criterion standard. SETTING: A department of orthopedic surgery in a university hospital. PATIENTS AND OTHER PARTICIPANTS: Eighteen patients with incomplete paraplegia, including 11 with TSLI, and 50 healthy adults. INTERVENTION: Area and amplitude of macro motor unit potential (macro MUP) were measured at the tibialis anterior, the vastus lateralis, and the vastus medialis. The normal limits of macro MUP parameters were defined based on values from healthy subjects. Abnormal denervated muscles were detected by macro EMG and conventional EMG in paralytic patients. The correlation between macro MUP parameter values and muscle forces of the tibialis anterior and quadriceps femoris induced by electrical stimulation was analyzed. MAIN OUTCOME MEASURES: The number of abnormal muscles, parameter values, and muscle force induced by electrical stimulation. RESULTS: Abnormal muscles were found only in the TLSI patients and 13 abnormal muscles were detected by macro EMG only. The abnormal muscles defined by macro EMG showed insufficient contraction induced by electrical stimulation. The increase of parameter value negatively correlated with the muscle force (tibialis anterior area r=-.797, amplitude r=-.866; quadriceps area r=-.866, amplitude r=-.893; p < .001). CONCLUSIONS: These results suggest that macro EMG is useful in detecting denervated muscles, in determining indications for FES, and in predicting FES effects before implantation of electrodes.

Adolescent↗
PubMed1998

Reliability of closed double helix electrode for functional electrical stimulation.

The reliability of a closed double helix electrode in the lower limbs was studied. This electrode is an implanted intramuscular electrode and is used for a totally implantable functional electrical stimulation system. Eighty electrodes were evaluated retrospectively with a mean period of 15 months. The total implant time was 1222 electrode months. The cumulative proportion surviving was 0.934 at 6 months, 0.855 at 1 year, 0.765 at 2 years, and 0.730 after 30 months. Fifteen of 80 electrodes failed, seven showed increasing electrode impedance, and eight had undesirable changes in recruitment. Of the failed electrodes, 2/3 failed during the first 10 months. The reliability was 0.91 at 6 months and 0.80 at 1 year after implantation in all muscle groups. The closed double helix electrode displayed an increased reliability when compared with the open double helix electrode at 6 months, and an equivalent reliability as compared with the electrodes developed by Handa and colleagues at 6 months and 1 year, using the chi squared test for independence. This study suggests that the closed double helix electrode has an acceptable reliability and can be used as a part of a totally implantable functional electrical stimulation system.

Electric Stimulation Therapy↗
PubMed1998

Effects of rebamipide in combination with lansoprazole and amoxicillin on Helicobacter pylori-infected gastric ulcer patients.

The aim of this study was to compare the additive effect of rebamipide with that of teprenone in combination with dual therapy on H. pylori eradication. A total of 102 H. pylori-positive gastric ulcer patients were assigned at random to two groups; in addition to dual therapy (amoxicillin 500 mg thrice daily and lansoprazole 30 mg every morning for two weeks), one group received rebamipide 100 mg thrice daily for eight weeks, while the other group received teprenone 50 mg thrice daily for eight weeks. H. pylori diagnosis after treatment was made by [13C]UBT. The ulcer healing rate was 85.7% in the rebamipide group and 79.5% in the teprenone group (P = NS). The eradication rate was 68.4% (95% CI = 54-83%) in the rebamipide group and 47.7% (95% CI = 32-61%) in the teprenone group (P = 0.043) by per-protocol analysis. These findings suggest that the efficacy of dual therapy may be increased by the administration of rebamipide.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Ten minute 13C-urea breath test for the diagnosis of Helicobacter pylori infection.

We investigated the utility of a 10-min 13C-urea breath test (13C-UBT) using 100mg of 13C-urea; this is a simple and rapid method for the detection of Helicobacter pylori infection. One hundred and fifty-one patients in whom the identification of H. pylori was established by rapid urease test, culture, and histology of six biopsy specimens underwent 254 13C-UBT examinations before and/or after eradication treatment. In the 133 patients who did not receive eradication treatment, the calculated sensitivity of the 10-min 13C-UBT was 99.4% and specificity 100% when the cut-off point was set at 3.5/1000, using a mass spectrometer. In the 121 patients who received eradication treatment, this cut-off point gave a sensitivity of 86.7%, a specificity of 99.1%, and a positive predictive value of 92.9%, with a negative predictive value of 98.1%. There were no significant differences between the diagnosis of H. pylori infection at 1 month and more than 3 months after the endpoint of eradication treatment. The 10-min 13C-UBT is suitable for the diagnosis of H. pylori infection before and after eradication treatment.

Breath Tests↗
PubMed1997

[A case of tricuspid valve endocarditis in a non-addicted adult person without underlying cardiac disease].

A very rare case of tricuspid valve endocarditis which developed in a healthy adult was observed. An 18-year-old man with no history of heart disease nor use of stimulant drugs was diagnosed as having cardiac tumor, introduced to this hospital and admitted. Before the operation, symptoms characteristic to infective endocarditis such as high fever and embolism were not observed, but the tumor was detected in the right ventricle by echocardiography. The patient underwent cardiotomy. The thrombus was removed and annuloplasty was performed by Kay's method, and good results were obtained. Pathologically the disease was diagnosed as infective endocarditis accompanied by thrombus. The postoperative course has been good. When the injury of the valve is slight, the surgical method preserving patient's own valve such as excision of localized vegetation and annuloplasty appears to be useful.

Adolescent↗
PubMed1997

[A case of localized pleural mesothelioma].

Localized pleural mesothelioma is reported. A 62-year-old male had been observed as a patient with old tuberculosis of the left lung for a few decades. For detailed examination of fever of unknown cause and abnormal shadow on the chest X-ray, the patient was introduced to our hospital. By percutaneous cytodiagnosis, the illness was diagnosed as pleural mesothelioma, and the patient underwent surgery. Since adhesion of the tumor to the lower lobe of the lung was extremely tight, the tumor and the left lower lobe were resected as a mass. The tumor was about 15 cm in diameter, weighed 1,300 g and a slight pleural effusion was observed. The tumor was diagnosed as malignant localized pleural mesothelioma pathologically. Localized pleural mesothelioma should be subjected to surgery in the early stage, in principle. Even in cases difficult to diagnose, operation should not be delayed by repeating easy-going needle-biopsy or a long-term treatment with antitubercular drugs. The postoperative course of this case has been good, and no recurrence nor metastasis has been detected.

Humans↗
PubMed1997

[Abdominal aortic surgery in Stanford type B chronic dissecting aortic aneurysm].

Three cases of a chronic type B dissecting aneurysm which required abdominal aortic reconstruction are presented. Constriction of the iliac artery due to dissection was found in case 1, in case 2 the left subclavian artery originated from a giant false lumen, and arteriosclerosis obliterans was observed in case 3. The left renal artery originated from a false lumen in all cases. Each patient underwent preliminary graft replacement of the abdominal aorta because using the femoral artery for extracorporeal circulation had a higher risk factor. The distal arch and descending aorta were then replaced with woven dacron graft. In a chronic type B dissecting aneurysm, the surgical procedure is sometimes complex because of the narrowing of the true lumen and the enlargement of the false lumen or arteries originating from the false lumen to major organs. It is necessary to consider preliminary abdominal reconstruction in cases of 1) dilatation of abdominal aneurysm, 2) obstruction, stenosis or thrombus below the abdominal aorta, or 3) presence of a giant false lumen.

Aged↗
PubMed1997

[A case of successful surgical treatment of recurrent Stanford type A thrombosed aortic dissection].

A 70-year-old female was hospitalized with a complaint of anterior chest pain. Enhanced CT scan demonstrated acute type A aortic dissection with the clotted false lumen. Aortography showed ulcer-like projection in the ascending aorta. The patient received the conservative medical treatment and had been followed up medically at outpatient clinic. One year later, she was admitted with the general malaise, chest discomfort and the enlargement of the mediastinum on the chest X-ray. Aortography revealed recrudescent enlarged false lumen. Graft replacement of the ascending aorta was successfully performed. Careful medical follow up should be necessary for the thrombosed Stanford type A aortic dissections.

Aged↗
PubMed1997

[Simultaneous surgical treatment for distal aortic arch aneurysm associated with innominate artery aneurysm and coronary artery disease].

The patient was 69-year-old male who admitted to our hospital in November 1995 with the complaint of abnormal shadow on chest C-ray. CT scan and aortogram revealed aneurysms of the distal aortic arch and innominate artery. Seventy-five percent stenosis of the right coronary artery was also found in coronary angiogram. The total arch replacement and reconstruction of the innominate artery and CABG to right coronary artery were performed with the aid of cold blood cardioplegia and selective cerebral perfusion and open distal anastomosis. Ascending aorta was used for arterial cannulation to avoid the thromboembolism due to retrograde perfusion from the femoral artery. Satisfactory postoperative course was obtained except transient left hemiplegia and post operative three-dimensional CT scan demonstrated the successful reconstruction. The patient was doing well 8 months postoperatively.

Aged↗
PubMed1997

[Concomitant composite graft replacement of the aortic root and the aortic arch for type A aortic dissection].

Successful surgical treatment of type A aortic dissection with annuloaortic ectasia (AAE) and severely destroyed aortic root was reported. Between April 1991 and April 1996, 26 patients with type A aortic dissection underwent the surgical treatment in our institute. Among those cases, 4 cases (15%) needed the total aortic root replacement with composite graft. Two cases had Marfan syndrome and AAE and aortic regurgitation. Other two cases had severely destroyed aortic root because of the extension and advancement of the dissection to the aortic root. One was the case of disrupted right coronary ostia. And another was the case of frank rupture and massive bleeding from the aortic root during the operation. Cases of AAE were treated successfully by the routine composite graft that was made before the operation. However, the reconstruction of the aortic root for the cases who had destroyed aortic root with normal relation and size of the aortic root was cumbersome because of non displaced coronary artery ostia and the relatively narrow aortic root. For these cases, composite graft was fixed just below the aortic valve annulus by the sutures enforced with Teflon felt strip from the outside of the aorta and it made the reimplantation of the coronary ostia easier. As for the technique of the reimplantation of the coronary ostia, Carrel patch technique was used because good coaptation and fixation of the suture line around the coronary ostia could be obtained with this technique which prevent the complication such as the pseudoaneurysm or the periostial aneurysm formation around the coronary artery in the long term period. Concomitant procedures were aortic arch replacement in all cases, total arch replacement with four vessels graft in 3 cases and hemiarch replacement in 1 case. Each operations were performed with the aid of selective cerebral perfusion and open distal anastomosis.

Aged↗
PubMed1997

[Clinical evaluation of heparin concentration and activated clotting time monitoring (HEPCON HMS) system].

The HEPCON HMS system provides both activated clotting time (ACT) and accurate whole blood heparin concentration measurements. We evaluated the impact of heparin and protamine administration using this system on the incidence and treatment of bleeding after performing a cardiopulmonary bypass. Patients were randomly divided into two groups. Heparin and protamine administration during extracorporeal circulation was determined by classical ACT management in Group A (n = 15) and by HEPCON HMS system in Group H (n = 19). There were no statistical differences in the coagulation factor, the postoperative chest tube drainage or the blood products used between the two groups. Patients in Group H received a higher dosage of heparin and a lower dosage of protamine compared with Group A. By facilitating the maintenance of a therapeutic heparin concentration and by determining an appropriate protamine dosage, the HEPCON HMS system may be useful in managing extracorporeal circulation.

Blood Coagulation Tests↗
PubMed1996

An MRI analysis of brain-stem and cerebellar lesions and olivary hypertrophy.

We describe the relations between primary brain stem or cerebellar infarct or haemorrhage and secondary inferior olivary pseudo-hypertrophy (OPH). We identified 17 patients (43.6%) among 39 with brain stem or cerebellar vascular disease who had MRI follow-up more than 3 months after their ictus, with OPH. The primary lesions in the 22 cases without OPH were 11 haemorrhages, including 8 medial cerebellar and 3 brain stem lesions, and 11 infarcts: 4 brain stem lesions without accompanying cerebellar involvement, 2 cerebellar infarcts with brain stem extension, and 5 cerebellar lesions without a brain stem infarct. The causative lesion in the 17 patients with OPH included 5 brain stem and 7 cerebellar haemorrhages and 5 brain stem infarcts; no cerebellar infarcts without brain stem involvement were found to cause OPH. Primary involvement of the tegmentum of the brain stem was closely related to secondary OPH, but we could not characterise MRI differences in the cerebellar lesions between the patients with or without OPH.

Adult↗