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Biomedical subjects

H Kashima

Publications and source records attributed to H Kashima.

72 records · Page 4Linked to original sources

Airflow in unilateral vocal cord paralysis before and after Teflon injection.

The effect of unilateral vocal cord paralysis and intracordal Teflon injection on maximum expiratory and inspiratory flows was studied in 15 consecutive patients. Ten patients had a ratio of forced expiratory flow to forced inspiratory flow at 50% vital capacity (Ve50/Vi50) more than one. Of the remaining five, four had low Ve50 consistent with underlying bronchial disease. Repeat studies were obtained in 10 patients two or more weeks after Teflon injection into a vocal cord for voice therapy. Maximum expiratory flow rates did not change (means 6.64 +/- 0.881/sec before and 6.47 +/- 1.101/s after injection). Inspiratory flow at 50% vital capacity improved in all six patients with a forced expiratory volume in one second (FEV1) greater than 75% of the forced vital capacity (FVC). In patients with an FEV1 less than 75% FVC, no consistent changes could be seen. We conclude that a high Ve50/Vi50 suggestive of variable extrathoracic airways obstruction is a frequent finding in the presence of unilateral vocal cord paralysis. Teflon injection does not cause a significant reduction in forced expiratory flows and improves inspiratory flows in subjects without evidence of underlying bronchial disease.

Airway Obstruction↗

Unusual manifestation of tuberculosis: TE fistula.

Fistulas between the tracheobronchial tree and the esophagus (TE fistula) caused by tuberculosis are rare; usually they are associated with readily apparent pulmonary and/or mediastinal infection, and require surgical management. The patient we describe presented with a TE fistula as the only manifestation of active tuberculosis. This case represents the first report of successful nonsurgical treatment of tuberculous TE fistulas.

Adult↗

Unidimensional scale for dementia.

A cognitive test comprising 27 subscales was administered to 262 demented patients and 92 normal subjects. Principal factor analysis followed by varimax and Harris-Kaiser rotation and Guttman's scalogram analysis was performed. The analysis yielded three factors, i.e. "recent memory", "immediate memory or attention" and "remote memory". The relationships between the three-dimensional distribution of the scores and the DSM-IIIR grade of dementia indicated the existence of a continuum of dementia severity. Scalogram analysis showed unidimensionality in the difficulty level of the subscales as well as in the severity of the cases. Thus, the simple summary score can be used as a good measure of the severity of dementia.

Aged↗

Demonstration of human papillomavirus capsid antigen in carcinoma in situ of the larynx.

We have undertaken a retrospective study to investigate the role of human papillomavirus (HPV) in the development of laryngeal carcinoma in situ (CIS). Sixty paraffin-embedded tissue specimens, collected from 20 patients with a history of laryngeal CIS, were examined for the presence of HPV capsid antigen. All but four individuals were men, with an average age at diagnosis of 64 years. An immunoperoxidase technique showed that 20 specimens from 14 patients contained detectable HPV capsid antigen. An independent evaluation for histopathologic features characteristic of HPV infection identified viral changes in the 14 patients as well as an additional two. No correlation was found between clinical course, as determined by histologic severity of vocal cord lesions, and presence of HPV. These results suggest that HPV should be considered an etiologic agent in the development of laryngeal CIS.

Adult↗

Stress analysis of metal-free polymer crowns using the three-dimensional finite element method.

PURPOSE: The purpose of this study was to evaluate the stress distribution under various loading conditions within posterior metal-free crowns made of new composite materials. MATERIALS AND METHODS: A three-dimensional finite element model representing a mandibular first molar was constructed. Variations of the model had crowns of two types of composite, a glass ceramic, and porcelain fused to metal. A load of 600 N, simulating the maximum bite force, was applied vertically to the crowns. Loads of 225 N, simulating masticatory force, were applied from three directions (vertically, at a 45-degree angle, and horizontally). RESULTS: The stress distributions in both types of composite crown were similar to that of the glass-ceramic crown. In the test simulating maximum bite force, the maximum tensile stresses on all crowns (17.9 to 18.3 MPa) concentrated around the loading points. In the masticatory force-stimulation test, the specimens experienced maximum tensile stresses of 20.3 to 26.6 MPa under a horizontal load and 10.9 to 11.0 MPa under a vertical load. When the load was applied horizontally, the maximum tensile stress was observed around the loading points on the surface in the case of composite and glass-ceramic crowns, and in the cervical area of the metal coping in the porcelain-fused-to-metal crowns. CONCLUSION: It would appear that the strength of occlusal contact points is important to the integrity of posterior metal-free crowns made of new composite materials and that bite forces applied from the horizontal direction are a critical factor determining success and failure.

Aluminum Silicates↗

Computed tomography of the neck.

Thorough familiarity with the anatomy of the neck depicted in axial sections is fundamental to the interpretation of computed tomography (CT) scans. Fifteen consecutive sections are selected at 1 cm-intervals beginning at the level of the nasopharynx and extending down to the level of the thoracic inlet. Each scan is referenced to a profile drawing of the neck. Each CT scan is reproduced in the line drawing, which is labeled for major organs and discrete structures appearing in that section. Twelve representative cases illustrate the usefulness of CT in the evaluation of neck masses by documenting tumor size, location and relationship to adjacent structures. Intravenous contrast improves recognition of vascular structures and distinguishes lymph nodes from blood vessels. The location and relative density of lesions facilitate their specific identification. Demineralization of bone and cartilage is accurately documented in the illustrative cases. Symmetry is the key to the interpretation of subtle pathologies.

Carotid Arteries↗

[Dementia and amyotrophy in Kufs disease. The adult type of neuronal ceroid lipofuscinosis].

A 26-year-old housewife, born of consanguineous parentage, began to have gait and speech disturbance. Her brother had died from suffocation because of dysphagia. At thirty-two, she developed difficulty in swallowing, clumsiness and incontinence. When she was thirty-six she had pseudobulbar palsy, vertical gaze paresis, hyperreflexia and muscular atrophy of the upper half of the body. CT scan showed cerebral atrophy. Her mental function progressively deteriorated and amyotrophic lateral sclerosis associated with dementia was suspected. She died at the age of thirty-seven. Diagnosis was made only by autopsy. There was no particular general pathologic finding excepting aspiration pneumonia. Microscopical examination revealed numerous distended neurons with accumulation of light brown pigments by Luxol fast blue/H & E stains, especially in hypothalamus, substantia nigra and nuclei of oculomotor nerves. To a lesser extent such neurons were noted ubiquitously. The stored material was mainly composed of lipofuscin and ceroid. Ultrastructurally they presented the various structures which have previously been reported, except for finger print profiles. The pigmentary deposits were shown to be immunoreactive with polyclonal antibody directed against amyloid beta-protein.

Adult↗

[Cytomegalovirus fetal infection. Porencephaly with polymicrogyria in a 15-year-old boy].

A boy, born after 41 weeks of gestation, presented with splenomegaly, microcephaly and chorioretinitis accompanied by immaturity signs. His mother was in good health but her previous pregnancy had been aborted owing to rubella. Laboratory data, including serological and virological evidence, confirmed the diagnosis of fetal cytomegalovirus infection. CT scan indicated a large cyst in the left temporal lobe and periventricular calcifications. At about 8 months of age, convulsions were noticed which were not controlled effectively by medication. There was spastic rigidity without significant psychomotor development. He died at the age of 15. Postmortem neuropathological examination revealed polymicrogyria predominant in the right cerebral hemisphere as well as a large cavity in the left temporal lobe communicating with the lateral ventricle. Widespread heterotopias and calcifications were observed notably in the periventricular white matter. No typical inclusion was found. By the method of Holzer and GFAP immunocytochemistry, no gliosis was noted in the cerebral cortex having the feature of polymicrogyria. This might support the theory that polymicrogyria is caused by neuronal migration failure.

Adolescent↗