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Biomedical subjects

H Moriyama

Publications and source records attributed to H Moriyama.

At least 163 records · Page 9Linked to original sources
PubMed1995

[Indications for endoscopic sinus surgery. A clinical study on patients with a poor post-operative course].

One hundred and fifty-three patients with chronic sinusitis underwent endoscopic endonasal sinus surgery. They were preoperatively evaluated on the basis of their complaints, the severity of nasal polyps, X-ray findings, and axial and/or coronal CT scans. Postoperative degree of improvement in their complaints and endoscopic findings in the nasal cavity and sinus cavities were assessed. Most patients, including those with severe maxillary sinusitis, had a good postoperative course. The percentage of improvement in their complaints was 99.3%. Even in the case of olfactory disturbance, which is the most difficult symptom to treat, the percentage of improvement was 81.0%. There were only 8 patients with complaints and pathological findings in their nose or sinuses after the operation, 4 with allergic rhinitis and/or asthma, 1 with severe inflammation of the olfactory cleft, 1 with thickening of the bone in the sinuses after a 25-year history of sinusitis without treatment, and 2 with narrowing of the antrostoma at the middle meatus after the operation.

Adolescent↗
PubMed1995

[Alteration of serum levels of endotoxin, polymorphonuclear leukocyte elastase, and the molecular markers of the coagulation and fibrinolytic system in the patients with esophageal cancer and lung cancer before and following operation].

The serum levels of endotoxin, polymorphonuclear leukocyte elastase (PMN-E), and the coagulation and fibrinolytic markers (D-dimer, TAT) were measured in the patients with esophageal cancer, lung cancer, and benign pulmonary tumors before and after the operation; on the day of operation, and the 1st, 3rd, and 7th postoperative day. The biological responses of the patients under surgical stress were evaluated. In the patients without complications, the endotoxin levels measured by the Toxicolor method and the PMN-E levels did show any significant increase in the early postoperative period, and they returned to the normal levels by the 7th postoperative day. On the contrary, in the patients with postoperative complications, they continued to increase throughout the study period. The endotoxin levels measured by the Endospacy test did not show any significant changes postoperatively. The D-dimer and TAT levels showed their highest values on the first postoperative day. The serum levels of endotoxin, PMN-E, and molecular markers of the coagulation and fibrinolytic system in the patients under surgical stress may be useful factors in predicting the postoperative outcome.

Aged↗
PubMed1995

[Tympanosclerosis--clinical and pathological investigation].

Fifty-nine cases of tympanosclerosis were investigated clinically and pathologically, and the following results were obtained: 1) The male to female ratio was about 1:1.8 2) Calcification in the tympanic membrane was most common in the upper quadrants of the pars tensa, and never seen in the pars flaccida. 3) Calcification in the middle ear cavity was most common around the malleus. 4) Chronic otitis media was the most common complication of tympanosclerosis. 5) Preoperative audiometry revealed a stiffness curve with elevated bone conduction thresholds. 6) 54% of the patient had chronic otitis media in the contralateral ear. 7) Microscopic examination revealed calcification in the submucosa of the middle ear. 8) Postoperative hearing was improved in 49 ears (79.7%). Because there was no difference in the average postoperative hearing gain after type I and type III tympanoplasty, type III tympanoplasty is recommended to remove sclerotic masses completely.

Adolescent↗
PubMed1995

[Staged bilateral upper lobectomy of pathologically different synchronous double primary cancer].

A case of double primary lung cancer was reported, one of which was peripheral type of adenocarcinoma of the right lung and the other was central type of squamous cell carcinoma of the left. A 66-year-old male was referred to our hospital on Nov. 2 1991, because a coin lesion at the right S1 was pointed out on chest X-ray. On bronchoscopy, a nodular tumor at the orifice of the left B3 was unexpectedly found. Biopsy of the left B3 tumor and washing cytology of the right B1 led to a diagnosis of left moderately differentiated squamous cell carcinoma (clinical T1N0 M0) and right adenocarcinoma (clinical T1N0M0). A right upper lobectomy was first performed with R2 lymph node dissection on Nov. 25 1991. Post-operatively, it was confirmed that the lesion was histologically poorly differentiated adenocarcinoma of the right S1, and the pathological stage was T2N0M0. Two weeks after the operation, chemotherapy of CDDP, VDS and MMC was given because of suspicion of rapid metastasis to the left hilar lymph nodes. Left upper lobectomy with R2 dissection was performed 7 weeks after the initial operation. Pathological findings showed squamous cell carcinoma originating from B3 with inflammatory lymphadenopathy and pathological evaluation was T1N0M0. He was discharged after an uneventful course of 3 weeks after the second operation. There are many reports that limited operations are recommended for each lesion in double primary lung cancer to reserve the pulmonary function. However, limited interventions cause frequently local metastasis, especially in peripheral type adenocarcinoma more than 3 cm in diameter and central type squamous cell carcinoma with lymph node metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1995

[Malignant mediastinal lesions with invasion to the superior vena cava].

Four patients underwent resection of mediastinal malignant tumors with invasion to the superior vena cava. Two patients had invasive thymoma, one seminoma, and one metastatic mediastinal lymph nodes of unknown origin. Prior to resection of the tumor, an ePTFE graft was anastomosed between the innominate vein and the right atrium to maintain the venous drainage from the brain and the upper extremities. In two patients, the superior vena cava was reconstructed by patch angioplasty after the tumor with a part of the vena cava was safely resected. One patient died of acute respiratory failure, but the other three are alive and well without any evidence of graft obstruction. This safe and useful method in order to prevent cerebral congestion during and after resection of the tumor.

Adult↗
PubMed1995

Evaluation of endoscopic sinus surgery for chronic sinusitis: post-operative erythromycin therapy.

We discuss the results of endoscopic endonasal sinus surgery for chronic pan-sinusitis characterized by nasal polyposis, especially the effects of post-operative long-term administration of low-dose erythromycin (EM) therapy. The subjects analysed in this retrospective study are surgical cases who had initially been operated for chronic pan-sinusitis. They are classified into one group who has received a post-operative long-term, low-dose EM regimen and into another group who has not received this treatment. The groups have been compared with respect to: (1) the degree of improvement in the post-operative subjective symptoms; (2) postoperative objective findings of the ethmoidal sinus and the ostium of the frontal sinus; and (3) the degree of improvement in the maxillary sinus lesion. Better improvement is achieved in subjective symptoms and objective findings in the EM group than in the non-EM group.

Adolescent↗
PubMed1995

Separation of nucleic acids by high-performance ion-exchange chromatography.

Separation of various nucleic acids was evaluated by high-performance ion-exchange chromatography on non-porous resin, TSKgel DNA-NPR. A 1 kb ladder DNA was studied as a model DNA on operational variables like flow rate, gradient time, temperature, sample load, etc.. As results, various DNA fragments were well separated within 15 min by 20 min linear gradient at a flow rate between 0.5 and 0.75 ml/min at room temperature while the resolutin was dependent on molecular weight of the sample. The relationship between sample load and its peak area was examined on polymerase chain reaction (PCR) product. The product was found to be quantitatively recovered even with nanogram loads. The detection limit was 3.8 ng at signal to noise level (S/N) of 3. This non-porous ion-exchanger also showed high resolution on separation of ther nucleic acids like transfer RNA, oligonucleotides (single-stranded) DNA.

Chromatography, High Pressure Liquid↗
PubMed1995

A mapping of histology and cell proliferation in human bladder cancer: an immunohistochemical study.

Transitional cell carcinoma of the urinary bladder is a multifocal disease and the whole bladder mucosa is more or less involved in the neoplastic process. A mapping study of 5 cystectomy specimens was performed, and cell proliferation was evaluated immunohistochemically using anti-proliferating cell nuclear antigen (PCNA) monoclonal antibody. A correlation between the pathological findings and the rates of PCNA-positive cells was observed in both the tumor and the surrounding mucosa in 4 of the 5 cases. The rates of PCNA-positive cells increased in areas with normal mucosa adjacent to those with dysplasia or transitional cell carcinoma, and in areas with normal mucosa or dysplasia adjacent to those with carcinoma in situ or transitional cell carcinoma in 2 cases. These features may indicate that a field change observed in the mapping study of a bladder with cancer is a manifestation of a stepwise progression of the mucosal disease.

Aged↗
PubMed1994

Chemical modification and site-directed mutagenesis of Tyr36 of 3-isopropylmalate dehydrogenase from Thermus thermophilus HB8.

3-Isopropylmalate dehydrogenase from an extreme thermophile, Thermus thermophilus HB8, was chemically modified with tetranitromethane which nitrated 1.5-2.0 Tyr residues per subunit. The nitration was biphasic and parallel to the loss of activity. The modified residue in the first phase was identified to be Tyr36, which is distantly located from the active site of the enzyme. The function of Tyr36 was investigated by site-specific replacement with Phe. The Michaelis constant for the substrate or co-enzyme was not altered by the replacement, whereas the catalytic constant decreased down to approximately 5%. X-ray analysis of the mutant enzyme revealed that Arg94 moved the largest distance among the active site residues, that is, the NH1 and NH2 of the guanidino group moved 1.11 and 1.32 A respectively. The results suggest that Arg94 is responsible for the enzyme catalysis.

3-Isopropylmalate Dehydrogenase↗
PubMed1994

Three-dimensional structures of chimeric enzymes between Bacillus subtilis and Thermus thermophilus 3-isopropylmalate dehydrogenases.

The 3-D structures of two chimeric enzymes (4M6T and 2T2M6T) between the Bacillus subtilis and Thermus thermophilus 3-isopropylmalate dehydrogenases were analysed by X-ray diffraction in order to investigate their different thermostabilities. The structure of 2T2M6T was determined by the difference Fourier method and that of 4M6T by rigid body refinement, as based on the structure of the T. thermophilus enzyme. These structures were refined stereochemically to an R-factor of 0.193 at 2.5 A resolution for 4M6T and to an R-factor of 0.195 at 2.2 A resolution for 2T2M6T. The 3-D structures of 4M6T and 2T2M6T were very close to the structure of the T. thermophilus enzyme, conspicuous differences being at the molecular surface. In particular, 2T2M6T having a larger reduction in thermostability was more closely related to the T. thermophilus enzyme. However, their correlations between C alpha-atom displacements and the root squares of the temperature factors were significantly different from each other.

3-Isopropylmalate Dehydrogenase↗
PubMed1994

The superior alveolar nerves: their topographical relationship and distribution to the maxillary sinus in human adults.

The superior alveolar nerves in human adults were investigated macroscopically using whole-mount silver impregnation, paying special attention to their topographical relationship and distribution to the mucous membrane of the maxillary sinus. In addition, the fiber composition of the alveolar nerves was analysed in order to estimate their contribution to teeth innervation. The posterior superior alveolar nerve (PSAN) ran through canaliculi in the lateral wall of the sinus (23 of 37 cases, 62.2%) or under the mucous membrane of the sinus (14 of 37 cases, 37.8%). Moreover, the PSAN gave off many fine twigs to make complex plexus under the mucous membrane of the sinus before joining the superior dental plexus. The plexus of the maxillary sinus was separated from the superior dental plexus by the bony wall of the sinus. After the above gross observations, the perimeter compositions of myelinated fibers of the plexus, PSAN and the anterior alveolar nerve were analysed in the same specimen. The plexus was composed of myelinated fibers of less than 27 microns in circumference perimeter (mean: 14.3 microns) and numerous unmyelinated fibers. The fiber composition suggested that few fibers in the plexus of the maxillary sinus contribute to the formation of the superior dental plexus. The superior dental plexus, innervating the upper teeth, was located in the thick alveolar process of the maxilla, and not on the maxillary sinus wall. The clinical importance of these results was discussed in relation to nerve injury during antrostomy of the maxillary sinus.

Aged↗
PubMed1994

Expression and localization of mRNA for epidermal growth factor and epidermal growth factor receptor in human cholesteatoma.

The roles of epidermal growth factor (EGF) and epidermal growth factor receptor (EGF-R) in the proliferation and progression of the epithelium of middle ear cholesteatoma were studied. An attempt was made to elucidate the site and degree of localization of the EGF mRNA and EGF-R mRNA in the epithelium of the cholesteatoma by means of the non-radioactive in situ hybridization method. Ten cholesteatoma specimens excised during operations and six normal skin specimens (control) collected from the external ear canal were used in this study. The signal of the EGF mRNA was slightly expressed in part of the basal cells in only one of the six control specimens, while the signal was strongly expressed along the basal cells of the cholesteatoma epithelium in five of the ten specimens. The signal of the EGF-R mRNA was observed along the basal cell layer in five of the six control specimens, while the signal was strongly expressed in all layers of the cholesteatoma epithelium in all ten specimens. The expression was especially marked in the basal cell layer. These findings suggest the possibilities that abnormal expression of the EGF-R mRNA in nearly entire epithelial layers of cholesteatoma is due to overexpression of EGF-R gene, and that there is a mechanism of epithelial basal cell proliferation through an autocrine regulatory system via EGF and EGF-R.

Base Sequence↗
PubMed1994

[Intracordal injection therapy using atelocollagen for unilateral laryngeal paralysis under local anesthesia].

Intracordal injection therapy is a surgical therapeutic modality for glottic incompetence caused by unilateral laryngeal paralysis. Atelocollagen, which has recently been attracting attention as a material for use in intracordal injection therapy that supplants silicon, was initially claimed and expected, by virtue of its salient biophysical properties, not to cause impaired wave-motion of the vocal mucosa when injected into the submucosa. Unfortunately, however, our attempt to use this material for the same purpose proved disappointingly unsuccessful, with vocal sounds produced thereafter being metallic, vocal folds becoming tense and consequently transforming the site into a muscular coat of vocal muscles. During the past 3 years, we at the Department of Otolaryngology of the Jikei University School of Medicine, have performed intracordal injection therapy with atelocollagen on 20 patients diagnosed as having unilateral laryngeal paralysis under local anesthesia using a flexible fiberscope and a stroboscope under a video monitoring system. Comparisons were made of the voice before and after injection in 6 patients receiving submucosal injection and 14 given intramuscular injection of the material. In some autopsied patients, histological findings of the treated vocal cords were scrutinized and problems regarding atelocollagen injection were investigated. Judging from pathological findings of the vocal cords after atelocollagen injection and the clinical results of this therapeutic procedure, it seems most appropriate to inject this plastic material into the vocal muscles. This will prevent atelocollagen diffusion and maintain unimpaired wave-motion of the vocal mucosa, thus resulting in an acceptable voice quality.

Adult↗