Biomedical subjects

H Kagaya

Publications and source records attributed to H Kagaya.

At least 55 records · Page 3Linked to original sources

PubMed1996

Clinical use of percutaneous intramuscular electrodes for functional electrical stimulation.

OBJECTIVE: To evaluate the clinical use of the percutaneous intramuscular electrode in functional electrical stimulation (FES). DESIGN: Randomized and controlled study. SETTING: A referral center and institutional practice providing outpatient care. PATIENTS: Seventeen patients (12 men, 5 women) who had implanted percutaneous intramuscular electrodes for more than 1 year were examined. The average follow-up time after implantation of electrodes was 2.2 years (range, 1yr to 4yr 10mo). Overall, there were 327 electrodes (83 upper extremities and 244 lower extremities). INTERVENTION: The indwelling electrode was composed of helically coiled Teflon-coated rope stranded from 19 hard drawn wires of SUS 316L stainless steel (SES 114). MAIN OUTCOME MEASURES: The rates of breakage, movement, and infection, and the number of electrodes that needed reimplantation were evaluated. RESULTS: Only one electrode broke (0.3%) in the iliopsoas muscle at 12 weeks after implantation. Eight electrodes (2.4%) were removed because of loss of sufficient contraction force caused by movement of the electrodes. Movements occurred at 9 weeks in 6 electrodes and at 5 months in two. The failure rate of electrodes in the lower extremities was 3.7%. No failures occurred in the upper extremities. Ten electrodes (3.1%) required reimplantation. Although ten superficial infections (3.1%) were seen around the site of electrode insertion, no removals of electrode were needed. All electrodes in one patient were removed, however, because of generalized methicillin-resistant Staphylococcus aureus infection complicated with renal disease. Electrodes were reimplanted after improvement of the infection. CONCLUSIONS: The ultrafine percutaneous intramuscular electrode was considered practical for long-term FES use.

Adult↗

PubMed1996

An electrical knee lock system for functional electrical stimulation.

An electrical knee lock system that can be combined with functional electrical stimulation was designed for paraplegic patients. This knee system unlocks the knee electrically and allows knee flexion during the swing phase of the gait. When the knee is extended by electrical stimulation of the knee extensors, the knee is automatically locked by the weight of the locking bar, and the stimulation of the knee extensors is stopped. Since the knee extensors are stimulated for only a short period, muscle fatigue of the knee extensors seldom occurs. We applied this system to a T8 completely paraplegic patient. Standing-up, standing, walking, and sitting-down motions were all restored by our hybrid system. No electrical stimulation was necessary during standing, and the knee extensors were stimulated during only a small percentage of the 1-gait cycle.

Adult↗

PubMed1996

Clinical experience of functional electrical stimulation in complete paraplegia.

Percutaneous intramuscular electrodes and a portable multichannel system were used to restore the function of the paralyzed lower extremities in six patients with complete paraplegia. The total number of inserted electrodes was 168. All of the patients could stand, two could walk in parallel bars, and two could walk with a walker. The rate of breakage of electrodes was only 0.6% in our series. There were 10 (6.0%) superficial infections, and 10 (6.0%) movement of electrodes which required reimplantation. The results suggest that the ultrafine intramuscular electrode is practical for long term use with paraplegic patients. Although the system can be used for paraplegic patients during the activities of daily living, it will be necessary to develop a closed-loop controller to reduce the amount of stimulation to the extensor muscles and extend the endurance of upright activity to reduce fatigue.

Adolescent↗

PubMed1996

Changes in muscle force following therapeutic electrical stimulation in patients with complete paraplegia.

Changes in muscle force following therapeutic electrical stimulation (TES) in 5 patients with complete paraplegia were evaluated by computed tomography, Cybex II, a strain-gauge transducer, and manual muscle testing. The stimulation parameters included a frequency of 20 Hz, a pulse width of 0.2 ms, and an output voltage of -15 V. The cross-sectional areas of muscles, the muscle torques, and the muscle forces increased after TES, though the increased ratio differed in each muscle. The reasons why it differed are as follows: (1) The possibility of peripheral nerve injury; (2) The different patterns of nerve distribution in the muscles; (3) Implantation techniques; and (4) The possibility of breakage, movement, or changes in the impedance of electrodes. This study demonstrates that TES increases muscle force during electrical stimulation in paralyzed muscle, but that an initial TES-induced muscle force greater than a poor-minus level on manual muscle testing is necessary for practical use. TES treatment should be started as soon as possible after the onset of paralysis, in order to maintain muscle quality.

Adult↗

PubMed1996

Effects of lansoprazole plus amoxycillin on the cure of Helicobacter pylori infection in Japanese peptic ulcer patients.

AIM: The effect of lansoprazole plus amoxycillin on curing Helicobacter pylori infection and peptic ulcer recurrence was evaluated. METHOD: The study group was composed of 68 patients with gastric ulcers and 51 with duodenal ulcers, all were H. pylori-positive. The participants were assigned at random to the lansoprazole alone group (lansoprazole 30 mg o.m. for 6 or 8 weeks) or the lansoprazole plus amoxycillin group (lansoprazole alone regimen plus amoxycillin at 500 mg q.d.s. concomitantly for the first 2 weeks). Healed patients were not given maintenance treatment with acid secretion inhibitors. The cure rate for H. pylori infection and the ulcer recurrence rate after 1 year were investigated. RESULT: The cure rate for H. pylori infection was 4.2% in patients receiving lansoprazole alone and 38.5% in patients receiving lansoprazole plus amoxycillin (P < 0.01) for gastric ulcers, and 0% in patients receiving lansoprazole alone and 61.9% in patients receiving lansoprazole plus amoxycillin (P < 0.001) for duodenal ulcers. The recurrence rate was 42.3% in patients receiving lansoprazole alone and 28.6% in patients receiving lansoprazole plus amoxycillin for gastric ulcers, and 66.7% for patients receiving lansoprazole alone and 11.1% for patients receiving lansoprazole plus amoxycillin (P < 0.001) for duodenal ulcers. None of the patients with gastric or duodenal ulcers cured of H. pylori infection had a recurrence. CONCLUSION: Concomitant use of lansoprazole and amoxycillin increased the curative effects on H. pylori infection. However, the cure rates with this regimen remained inadequate.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1996

Split posterior tibial tendon transfer for varus deformity of hindfoot.

Sixteen patients (23 feet) who underwent split posterior tibial tendon transfers were evaluated. The patients were seen on a followup basis for a minimum of 1 year postoperatively. The causes were spastic cerebral palsy in 13 feet, spastic-athetoid cerebral palsy in 3 feet, hydrocephalus in 3 feet, and other diseases in 4 feet. The indication for surgery was varus deformity during the stance phase of gait and increased varus deformity during the swing phase of gait because of spasticity of the posterior tibial muscle. Heel cord lengthening was done on 17 feet. Preoperative and postoperative gaits were evaluated while the patients were walking. Axial radiographs of the calcaneus and the tibia were taken of all patients while they were weightbearing. There were 15 excellent, 6 good, and 2 poor results. The poor ratings were assigned to patients who had recurrence of varus deformity; there were no cases of overcorrection. Split posterior tibial tendon transfer was effective for treating spastic varus deformity of the hind part of the foot. This treatment also could be considered for a patient with spastic-athetoid cerebral palsy, if the deformity was determined to be caused by overactivity of the tibialis posterior muscle.

Adolescent↗

PubMed1996

[An operative case of bilateral coronary arteries fistulae to pulmonary artery associated with a giant saccular aneurysm].

We reported an operative case of bilateral coronary artery fistulae to pulmonary artery associated with a giant saccular aneurysm, the largest of which measured 30 x 30 mm. The patient was a 75 year old female who had anginal pain due to coronary steal phenomenon. A continuous murmur was detected. After establishing total cardiopulmonary bypass, two distal orifices of the fistula connected to the main pulmonary artery were closed with 5-0 polypropylene plegeted sutures. Aneurysmorrhaphy was then performed for giant saccular aneurysm. Postoperative course was uneventful.

Aged↗

PubMed1996

[A case report on concomitant graft replacement of the total aortic root and the transverse aortic arch for type A acute aortic dissection associated with annuloaortic ectasia].

A 49-year-old man with type A acute aortic dissection associated with annuloaortic ectasia (AAE) underwent the concomitant graft replacement of the total aortic root and the transverse aortic arch. This operation was performed with an aid of extracorporeal circulation, blood cardioplegia, selective cerebral perfusion and open distal anastomosis. The operative technique consisted of total aortic root replacement using a composite graft and total arch replacement using four vessel graft. This case suggests that type A acute aortic dissection associated with AAE involving aortic arch could be treated by concomitant graft replacement of the total aortic root and the transverse aortic arch.

Aortic Dissection↗

PubMed1996

[A case of total arch graft replacement for distal aortic arch aneurysm developed around the site of graft patch aortoplasty].

A 65-year-old male underwent graft patch aortoplasty for a sacciform aneurysm of the distal aortic arch. Three years later an aneurysm developed around the site of the graft patch aortoplasty, therefore total arch graft replacement was required. The operation was performed through median sternotomy and left supraclavicular incision. The ascending aorta was selected for the aortic perfusion site, avoiding thromboembolism. Selective cerebral perfusion (SCP) was employed to protect the brain. Open distal anastomosis with circulatory arrest offered the optimal operating field despite re-operation. Graft replacement or graft patch aortoplasty has been proposed for the treatment of sacciform aneurysm. However, there is a possibility of aneurysmal change around the site of resected aneurysm. Furthermore because of the development of surgical skill and extracorporeal circulation technique, total arch graft replacement should be considered for the surgical treatment of distal aortic arch aneurysm.

Aged↗

PubMed1995

Restoration and analysis of standing-up in complete paraplegia utilizing functional electrical stimulation.

OBJECTIVE: Restoration of stand-up motion in patients with complete paraplegia utilizing multichannel functional electrical stimulation, and analysis of the restored motion. DESIGN: Nonrandomized control trial. SETTING: General community, a referral center, institutional practice, and ambulatory care: PATIENTS: Twelve volunteer samples were used for the collection of normal data. Two complete paraplegics received treatment for the restoration of stand-up motion. MAIN OUTCOME MEASURES: The electromyogram, joint angle, and floor reaction force were investigated during standing-up with arms crossed in front of the chest, and hands-assisted standing-up using parallel bars. The maximum knee joint torque during standing-up without hands-assists was calculated using a three-segment link model. Standing-up motion in complete paraplegics was restored, and then analyzed using the three-dimensional floor reaction force and the hip, knee, and ankle angles. RESULTS: Main muscles used to stand up were the quadriceps, tibialis anterior, and paraspinal muscles. Hands-assists reduced the muscle activity and the vertical floor reaction force. Peak muscle activity was less during hands-assisted standing-up, except for the rectus femoris and the iliopsoas muscle. The maximum knee joint torque during standing-up was 1.6Nm/kg for both knees. Two complete paraplegics were able to stand up smoothly from a wheelchair based on stimulation data obtained from normal subjects. The characteristic pattern during standing-up was knee flexion preceding extension. CONCLUSION: Stand-up motion was restored utilizing electromyogram data and knee joint torque data from normal subjects.

Adult↗

PubMed1995

Clinical efficacy of lansoprazole in eradication of Helicobacter pylori.

A randomized, single-blind study was designed to assess the effect of lansoprazole alone and lansoprazole plus amoxicillin on the healing and eradication rates in Helicobacter pylori-associated peptic ulcer disease. Seventy-nine patients with gastric ulcers and 54 patients with duodenal ulcers were randomly assigned to two treatment groups. Group 1 received lansoprazole 30 mg daily for 8 weeks for gastric ulcers or 6 weeks for duodenal ulcers. Group 2 received the group 1 regimen plus amoxicillin 2 g daily for 2 weeks. Healing rates at 8 weeks for the gastric ulcer patients were 92 and 84% in groups 1 and 2, respectively (p = not significant). Healing rates at 6 weeks for duodenal ulcers were 96% in group 1 and 100% in group 2 (p = not significant). The eradication rates of H. pylori for gastric ulcer patients were 21 and 54% in groups 1 and 2, respectively (p < 0.05). The H. pylori eradication rates for duodenal ulcer patients were 5 and 73% in groups 1 and 2, respectively (p < 0.001). The H. pylori eradication rates in group 2 were significantly higher than in group 1. Lansoprazole was effective for eradicating H. pylori in this study.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1995

Immunohistochemical localization of transforming growth factor-beta receptors I and II in inflammatory bowel disease.

Transforming growth factor (TGF)-beta inhibits cell proliferation and stimulates cell differentiation. For the signal transduction of TGF-beta, receptors I and II are required. The present study discloses the immunohistochemical localization of TGF-beta receptors I and II in inflammatory bowel disease. In the normal colon and small intestinal tissue, TGF-beta receptors were expressed in the epithelial cells in the upper crypts. In inflammatory bowel disease, a disordered expression pattern of receptors I and II was observed in the epithelial cells. Fibroblasts in the area of early stage fibrosis were positive for both receptors, while fibroblasts in area of advanced fibrosis lacked immunoreactivity for both receptors. Our study suggests that TGF-beta receptors I and II are important for the initial step of fibrosis.

Animals↗

PubMed1995

Role of Helicobacter pylori in chronic gastritis: a prospective study.

We conducted a prospective study to evaluate the relationship between Helicobacter pylori infection and chronic gastritis in a Japanese population. H. pylori was found in 67% of patients positive for mononuclear cell (MN cell) infiltration and in 75.8% of patients positive for polymorphonuclear cell (PMN cell) infiltration, whereas H. pylori was found in 14.2% of patients without MN cell infiltration and in 33.2% of patients without PMN cell infiltration. The frequency of MN and PMN cell infiltration in H. pylori-positive patients was significantly higher than that in H. pylori-negative patients. The frequency of H. pylori infection did not differ in those with atrophic gastritis from those without, whereas the frequency of intestinal metaplasia became significantly higher in those with moderate and severe atrophy. There was no significant difference between serum pepsinogen I (PG I) levels in H. pylori-positive and -negative patients. However serum PG II levels were significantly increased in H. pylori-positive patients aged 40-69 years. The serum PG I-II ratio was significantly lower in H. pylori-positive patients aged 40-59 years. These results suggest that H. pylori infection in the gastric mucosa plays an important role in the pathogenesis of chronic and atrophic gastritis and in the development of intestinal metaplasia.

Adult↗

PubMed1994

[Therapeutic and functional electrical stimulation for paraplegics].

The first objective of this study was to compare the cross-sectional areas of muscles and muscle force before and after 6 months of therapeutic electrical stimulation (TES) by using computed tomography (CT), Cybex II, a strain-gauge, and manual muscle test (MMT) in 5 complete paraplegics. The stimulation parameters were a frequency of 20 Hz, a pulse width of 0.2 ms, and an output voltage of -15V. The cross-sectional areas of muscle, the CT numbers, and both the muscle torque and the muscle force increased after TES, but the initial muscle force need to have been greater than a poor-minus level on MMT in order to achieve practical benefits from TES. Therefore TES should be started as early as possible after the onset of paraplegia in order to maintain and improve muscle quality. The second objective of this study was to re-chart the electrical stimulation used for reconstructing the standing-up motion in paraplegics. Twelve healthy subjects were monitored during two different kinds of standing-up motion: 1) standing-up while the arms remained crossed in front of the chest, and 2) hands-assisted standing-up using parallel bars. The electromyogram, joint angle, and the vertical component of the floor reaction force were synchronized with time, and investigated. The main muscles for standing-up are the quadriceps, the tibialis anterior, and the paraspinal muscles. Comparing 1) and 2), the hands-assisted standing-up was performed with less muscle activity except for the rectus femoris and the iliopsoas muscle, and with less maximum vertical floor reaction force. A T6 paraplegic patient could stand-up smoothly from a wheel-chair using the parallel bars after electrical stimulation based on data from the hands-assisted standing-up study on healthy subjects. In comparison with healthy subjects, the knee joints initially flexed before extending, and the ankle joints were more dorsiflexed in the paraplegic patient. The maximum vertical floor reaction force was also less.

Adult↗

PubMed1993

[A case report of pseudocoarctation associated with aneurysm of the distal aortic arch].

A 42-year-old female was admitted to our hospital for abnormal shadow in the left superior mediastinum on chest X-ray. Her blood pressure was 120/70 mmHg in the left arm and 134/72 in the right. Aortography revealed pseudocoarctation of the aortic arch distal to the left carotid artery with two aneurysm, and showed elongation between the left carotid artery and the left subclavian artery. Aneurysmectomy and graft replacement using a woven Dacron graft were successfully performed under cardio-pulmonary bypass. In 1969, Gay et al reported a case of pseudocoarctation which led to a fatal rupture of the thoracic aorta, so we recommend surgical therapy in cases of pseudocoarctation associated with aneurysm formation.

Adult↗

PubMed1993

[A case report of unroofed coronary sinus with repeated congestive cardiac failure].

We reported a 64-year-old woman with frequent cardiac failure due to unroofed coronary sinus complicated with tricuspid regurgitation (TR). We performed direct suture closure of unroofed coronary sinus and tricuspid annuloplasty with a Carpentier ring (34 T). Immediately after the operation, large amount of pleural effusion accumulated owing to acute left ventricular failure. That cause consists in the scarcity of the left ventricular volume, which was depending on the much left-to-right shunt volume through the unroofed coronary sinus. But her general condition was recovered from acute left ventricular failure for administration of catecholamine, digitalization, and urinative. We think that the echocardiography is valuable to investigation of the existence of unroofed coronary sinus, especially complicated with TR.

Coronary Vessel Anomalies↗

PubMed1990

[A case of giant bullae of the lung with thrombosis in the inferior vena cava and the pulmonary artery].

A case of giant bullae of the lung is rarely accompanied with thrombosis in the inferior vena cava and the pulmonary artery, and because of the risk of pulmonary infarction, this case needed a surgical treatment. At this time, we removed the thrombus from the IVC as the first step of the operation, and two months later a bullectomy and the exploratory incision of the right main pulmonary artery were attempted as the second step of the operation. However, the thrombus in the pulmonary artery had spontaneously disappeared. The postoperative course was uneventful and there has been no evidence of recurrence with anticoagulant therapy.

Cysts↗

PubMed1990

[A case report of isolated congenital tricuspid regurgitation].

Reports of isolated congenital tricuspid regurgitation are very rare. A 20-year-old female with severe tricuspid regurgitation was reported. The patient was admitted to our hospital with complaints of easy fatigability and palpitation. Right ventriculogram showed severe tricuspid regurgitation. She was treated with tricuspid valve replacement with a 33 mm bioprosthetic valve. Seven surgical treated cases of isolated congenital tricuspid regurgitation including our case were collected from literature and reviewed.

Adult↗