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Biomedical subjects

H Niwa

Publications and source records attributed to H Niwa.

At least 127 records · Page 7Linked to original sources
PubMed1994

Clinical course of acute hepatitis C and changes in HCV markers.

Chronological measurements of various HCV markers were conducted to clarify the course and prognosis of acute hepatitis C. Among 49 patients with acute non-A, non-B hepatitis, 32 (65.3%) were diagnosed as having acute hepatitis C by these markers. Twenty-four (82.8%) of 29 patients with posttransfusion hepatitis were type C, while only eight (40.0%) of 20 patients with sporadic hepatitis were type C. Patients were also divided into those who returned to normal within one year based on changes in s-ALT levels and unresolved cases. Anti-HCV was present in 11 (44.4%) of 25 resolved cases and in 21 (87.1%) of 24 unresolved cases. Only one case was continuously positive for HCV-RNA although s-ALT levels returned to normal. In addition, quantitative determinations were conducted on those positive for anti-HCVs. Anti-second generation tested positive in all HCV-RNA-positive cases and positive rates were highest from the onset of hepatitis. In unresolved patients with continuous HCV infection, anti-core increased and titers at 12 months were 10 units or more in all cases. On the other hand, in eight of 10 resolved cases, titers declined gradually after initial seroconversion and titers were 10 units or less at 12 months. From these results, second generation anti-HCV was considered most useful in early diagnosis of acute hepatitis C and anti-core titer was considered most useful in predicting prognosis of acute hepatitis C.

Acute Disease↗
PubMed1994

Thymectomy and malignancy.

Three hundred ninety patients who underwent thymectomy for myasthenia gravis (MG) were followed up to investigate the development of associated malignancies. There were 102 patients with thymoma and 288 without thymoma. Malignant neoplasms were detected in ten patients, four of whom already had the tumor at the time MG was diagnosed. Thus, malignancy developed after thymectomy in six patients. Malignant fibrous histiocytoma (MFH) developed in three patients, as well as gastric cancer, gastric leiomyosarcoma, rectal cancer, liver cancer, lung cancer, breast cancer, and thymic carcinoid in one patient each. Nine of the ten malignancies developed in the thymoma group, and only one in the non-thymoma group. The predicted number of patients with malignancy was 2.63 in the thymoma group and 2.65 in the non-thymoma group. Our findings suggest that the presence of thymoma facilitates the occurrence of extrathymic malignancy, and that thymectomy never enhances the occurrence of malignancy but possibly inhibits it.

Adolescent↗
PubMed1994

Silent cerebral infarction associated with coronary artery disease.

To investigate the relationship of coronary artery disease and silent cerebral infarction, 50 patients who underwent coronary arteriography and cranial magnetic resonance imaging were studied. The patients were divided into three groups. The incidence of silent cerebral infarction (chiefly lacunar infarction) was significantly higher in patients with old myocardial infarction and in those with angina pectoris than in the control group (80, 78 and 29%, respectively, p < 0.05). Silent cerebral infarction is considered to be a risk factor for symptomatic cerebrovascular disease, so more attention should be focussed on the prevention of stroke in patients with coronary artery disease.

Aged↗
PubMed1994

[Forward masking of transiently evoked otoacoustic emissions].

To explore the mechanisms of cochlear regulation systems, two tone phenomena of transiently evoked otoacoustic emissions (EOAEs) were measured using a forward masking paradigm in normal human ears. EOAEs were elicited by probe tone (1 kHz, 25 dBnHL, 3 ms duration), with or without a preceding masker tone (841 Hz, 35-85 dBnHL, 10-300 ms duration, 5-160 ms interval). In the intensity study, EOAEs showed decrements in amplitude according to the masker intensity. To evaluate the effects of the stapedial reflex (SR), the forward masking in facial palsy cases without SR was also measured. For the higher intensity masker, SR effects were observed in normal cases. The duration study showed a little but almost constant decrement with lower intensities, below the SR threshold, and a 20 ms or more duration masker. The interval study showed the decrement even with low and middle (35/55 dBnHL) intensity masker when the intervals were short. As the intervals were shortened, the decrement in EOAEs amplitude became greater. These results suggest that not only the olivocochlear bundle but also other mechanisms, e.g. short-term adaptation and/or lateral inhibition, may affect the forward masking of EOAEs.

Adult↗
PubMed1994

[Clinical analysis of patients with chronic hepatitis C who discontinued interferon treatment because of side effects--our experiences and recent reports].

We prospectively studied side effects about 54 patients with chronic hepatitis C treated with 3 to 10 MIU a day of interferon (IFN) alpha, which was administrated for 16 to 24 weeks. Every day, all of them wrote down every symptoms, by themselves, during its treatment. Any symptoms occurred in all patients and each incidence of symptoms such as fever, fatigue, headache, anorexia, arthalgia, myalgia, chill, itching, insomnia, nausea, numbness of hand and foot, irritability, diarrhea, eye ball pain, vomiting, were all higher than those which have been reported by some papers in Japan. So, it was considered that the symptom self-wrighting method by patient was useful to evaluate the entity of side effects. Furthermore, we studied 26 patients, who discontinued IFN treatment because of side effects and analyzed the background factors. Each incidence of symptoms of these patients were not always compatible to those incidences. But by observation of those symptoms, we could know severe side effects earlier.

Adult↗
PubMed1994

[Double crush syndrome in patients with cervical spondylosis or ossification of posterior longitudinal ligament--a clinicophysiological study].

To clarify the clinical characteristics of double crush syndrome (DCS), we evaluated 207 patients with cervical spondylosis (CS) and 19 with ossification of posterior longitudinal ligament of the cervical spine (OPLL) clinicophysiologically. A diagnosis of DCS was based on the following criteria; 1) radiological evidence of CS or OPLL on X-ray films; 2) definite spinal cord compression on cervical magnetic resonance imaging (MRI); 3) neurological deficits in the upper extremities resulting from CS or OPLL; and 4) clinical and/or electrophysiological evidence of entrapment neuropathies in the upper extremities, namely carpal tunnel syndrome (CaTS), Guyon's tunnel syndrome (GTS), and/or cubital tunnel syndrome (CuTS). Pressure-provocative tests were used to confirm clinical entrapment neuropathies. Nerve conduction velocities were also examined. We found 28 patients with DCS (23 CS, 5 OPLL; 12.8% of all patients). There were 9 patients with clinical and electrophysiological DCS, 5 with clinical DCS, and 14 with electrophysiological DCS. Of the total number of patients with DCS, 21 proved to have CaTS, 4 had CuTS, 1 had GTS, 1 had both CaTS and CuTS, and 1 had both CaTS and GTS. Definite spinal cord compression was seen at C5/6 (23 patients), C4/5 (21), C3/4 (13) and C6/7 (10) on cervical MRI. In the majority of patients, neurological deficits of the upper extremities did not result from a single peripheral nerve lesion. It is well known that a discrepancy between neurological manifestation and neuro-imaging sometimes occurs in CS and OPLL, and circulatory disturbance in the spinal cord has been considered a possible pathogenetic mechanism of the disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Patterns of mediastinal and supraclavicular metastases in apical invasive lung cancer--importance of supraclavicular lymph node dissection].

Thirty-one patients with apical invasive lung cancer, who underwent surgical therapy were analyzed. In the patients with palpable nodal metastases in the supraclavicular region, the lymph nodes were dissected through a collar incision in supine position after thoracotomy. In the patients without palpable nodes, the supraclavicular nodes were dissected through the same wound and in the same position after the tumor was resected by the hook or anterior approach. N factor was N0 in eighteen patients, N1 in two patients, N2 in seven patients, and N3 in four patients. The ratio of supraclavicular metastasis was 33.3%. Patterns of mediastinal and supraclavicular metastases were classified into three types. Type I (supraclavicular type): metastasized directly to the supraclavicular nodes via the chest wall, Type II (mediastinal type): metastasized via a common route from hilum to mediastinum, Type III (mixed type): combination of Type I and Type II. Of the nine patients who had N2 or N3 disease uncovered by supraclavicular lymph node dissection, one patient was Type I, six were Type II, and two were Type III. Of the four patients with supraclavicular node metastasis, two had palpable nodes and two histological metastasis. The nodes were metastasized via the chest wall in three patients. Two patients with N3 disease are still alive without recurrence, one patient for eighty-six months and another for twenty months after the operation. Since supraclavicular lymph nodes are local and very near from involved structures of apical invasive lung cancer, dissection of these nodes will provide improved prognosis.

Adenocarcinoma↗
PubMed1994

Cell-mediated immune response in acute poststreptococcal glomerulonephritis.

To evaluate the role of cell-mediated immunity in acute poststreptococcal glomerulonephritis (APSGN), we identified the immune cell population infiltrating the glomeruli. Renal biopsies were obtained from 22 patients with APSGN, 16 with overt and 6 with asymptomatic disease, one to 30 days after onset. Samples of normal renal tissue were used as controls. Frozen sections were examined using monoclonal antibodies that recognize various leukocyte surface markers. Double staining for granulocytes and monocyte/macrophages (M phi) was performed using chloro-esterase staining and indirect immuno-alkaline-phosphatase staining with Leu M-5 sequentially. In overt APSGN, there was a substantial increase in the total number of granulocytes and M phi with a slight increase in T cells. Numbers correlated with time after onset, as more leukocytic infiltration was observed when the tissue was taken earlier. Furthermore, a significant positive linear correlation was seen between helper/inducer T cells and M phi (r = 0.86, p < 0.01). Helper T cells tended to be increased to a higher proportion during the early stage, while suppressor T cells remained constant throughout the course. Analysis with anti-proliferating cell nuclear antigen antibody revealed increased glomerular cell proliferation in the early phase of APSGN. In asymptomatic patients, the total number of leukocytes was less than in the overt patients, but the proportions of infiltrating cells were similar. These data suggest that M phi are important effector cells causing endothelial and mesangial cell proliferation in APSGN. M phi infiltration in the glomeruli appears to be mediated by complement-induced chemotaxis and probably be an antigen-specific event related to the delayed type hypersensitivity mediated by helper/inducer T cells.

Acute Disease↗
PubMed1994

[Hook approach for radical resection of invasive apical lung cancer].

The hook approach provides safe identification and a wide view of subclavian vessels and branchial plexus on both their extra-thoracic and intra-thoracic aspects by a long skin incision resembling a "hook" and by tilting the table and moving the arm. The hook approach permits dissection of fat pad including supraclavicular lymph nodes from the same wound. This approach is suitable for invasive apical lung cancers without involvement of sternum. A patient with invasive apical lung cancer who received combined resection of the subclavian artery, vertebral artery, lower trunk of brachial plexus, (C8, Th1), third and fourth thoracic vertebrae, and first 4 ribs is presented and details of the hook approach is described.

Humans↗
PubMed1994

[Extended aortic arch anastomosis for coarctation of the aorta and interruption of the aortic arch in early infancy].

We performed extended aortic arch anastomosis, which was so called EAA procedure, for Coarctation of the Aorta (CoA) with hypoplastic aortic arch (HAA) and interruption of the aortic arch (IAA) in 17 infants under three months of age. The proximal anastomosis site was extended into ascending aorta in order that we could make non-obstructive pathway of systemic flow. During anastomosis, we employed mild systemic hypothermia and topical cooling of head and lumber lesion. Satisfactory anastomoses were performed without any neurological and renal complications except one case. Postoperative Doppler echographic evaluation revealed that the mean peak flow velocities at anastomotic site were under 2.0 m/sec at 1 and 2 years after surgery. We concluded that EAA procedure was useful for CoA with HAA and IAA in early infancy.

Anastomosis, Surgical↗
PubMed1994

[Chronic empyema associated with large cell carcinoma of lung: case report with review of the literature].

A 71-year-old female was seen with a complaint of chest pain and cough, and a history of tuberculous pleurisy and artificial pneumothorax 40 years ago. The diagnosis of empyema with carcinoma was made by chest X-ray and CT scans. The examination of lung function showed a restrictive disorder. The value of the predicted postoperative FEV1 0.75 l encouraged to perform operation. A left pleuropneumonectomy and combined resections of the invasive portion of the pericardium and left atrium was performed. Histological examination revealed large cell carcinoma of lung (pT 4 N 1 M 0). The literatures are reviewed concerning the thoracic malignant tumor arising in chronic empyema cavity on Japanese cases.

Aged↗
PubMed1994

[Relief of pulmonary venous obstruction for asplenia syndrome associated with total anomalous pulmonary venous connection in neonates and infants].

Five patients of asplenia syndrome with pulmonary venous obstruction underwent TAPVC repair in the period of neonates (4 patients) and infant (1 patient). They also underwent associated procedures to reconstruct or adjust pulmonary blood flow (systemic-pulmonary shunts in 2, bilateral PDA banding in 1, pulmonary artery banding in 1) in accordance with individual anatomy of the pulmonary arteries. In four of them, they required subsequent surgical procedures for reduction of pulmonary blood flow because of intractable heart failure due to increase in pulmonary blood flow mostly at the early postoperative period. The increasing pulmonary blood flow was successfully controlled by early reduction procedures (1 patient: extrathoracically adjustable PA banding, 1 patient: tightening of shunt graft) in two patients. However, one patient died in the early postoperative period because of moribund preoperative condition. The remaining one patient underwent PA banding three month after the first operation, but died in late period due to heart failure. These results suggest that the adjustment of pulmonary blood flow is critically important for management of the patients of asplenia syndrome with TAPVC after the operation, and early decision of PA band re-adjustment (or other procedures to decrease pulmonary blood flow) is mandatory to improve the results.

Abnormalities, Multiple↗