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H Tada

Publications and source records attributed to H Tada.

430 records · Page 24Linked to original sources
PubMedDate not supplied

Lip reconstruction of comparatively large defect including the commissure using remaining lip tissue: a modification of reconstructed method.

We present two reconstructed cases after malignant skin tumor of comparatively large defects of lip including the commissure using remaining lip tissue alone. After resecting a tumor including wedge-shaped full-thickness lip tissue, a full thickness oblique incision is made at the site 5 mm distant from the contralateral commissure. The rhomboid-shaped lower lip flap is created, transposed to the defect, and sutured with the defect margin, including the upper lip, to reconstruct the commissure. The cross lip flap is created at the contralateral side of the lower lip, 5 mm from the commissure, and the defect is closed with the crosslip flap. Although our method is applicable only to selected cases, we believe that it is useful in terms of maintaining symmetry of the lip and function of the commissure in the reconstruction of comparatively large defects including the commissure.

Aged↗
PubMedDate not supplied

A case of human adjuvant disease after augmentation rhinoplasty.

Human adjuvant disease (HAD) is an autoimmune syndrome which is caused by prolonged hypersensitization of injected foreign materials. Usually, this occurs after mammary augmentation with foreign materials. We report a rare case of HAD after rhinoplasty with silicone injection. Thirty years ago, the patient underwent augmentation rhinoplasty with silicone injection. We removed the silicone and grafted the area with fascia lata. After the operation, local and systemic symptoms improved.

Adult↗
PubMedDate not supplied

Correction of a posttraumatic nasal deformity using a hard palate mucosa graft.

We report corrected cases of posttraumatic nasal deformity using a hard palate mucosal graft as covering material of the inner-side defect. In all cases, the deformity was corrected satisfactorily. The nasal cavity was preserved, and because of the stiffness of the grafted mucosa, it did not collapse in the course of breathing. In all cases, the palate donor site healed in approximately 2 weeks, and after healing, none of the patients complained of irritation or ulceration. These results indicate that hard palate mucosa is also applicable in the correction of a traumatic deformity of the nose as an alternative to the auricular composite graft equally in the case of a nontraumatic deformity.

Adult↗
PubMedDate not supplied

Effective administration methods and dosages of interferon therapy for chronic hepatitis C.

The efficacy of interferon alfa (IFN-alpha) was evaluated in 127 hepatitis C virus-ribonucleic acid (HCV-RNA)-positive patients with chronic hepatitis C in relation to HCV-RNA levels and genotype. Patients were assigned to one of three groups. Patients in group A received IFN-alpha daily for 8 weeks (total dose, 336 million units [MU]); patients in group B received IFN-alpha daily for 4 weeks and then intermittently for 20 weeks (total dose, 348 MU); and patients in group C received IFN-alpha daily for 2 weeks and then intermittently for 22 weeks (total dose, 480 MU). Complete response rates in groups B and C were significantly higher than those in group A, regardless of the virus level or genotype. Complete response rates in groups B and C were similar, but in patients with a high virus level or HCV-RNA genotype II, the partial response rate in group C was significantly higher than that in group B. In conclusion, IFN-alpha was more effective after daily and then intermittent administration than after daily administration only, and a higher daily dose was necessary to be more effective in patients with high virus levels or HCV-RNA genotype II.

Adult↗
PubMedDate not supplied

High glucose levels enhance TGF-beta1-thrombospondin-1 pathway in cultured human mesangial cells via mechanisms dependent on glucose-induced PKC activation.

We have previously demonstrated that thrombospondin-1 (TSP-1) promotes activation of latent TGF-beta1 in cultured human mesangial cells (MCs) [Nephron 79 (1998) 38.]. This study was performed to clarify the relationship between protein kinase C (PKC) activity and activation of TGF-beta1 and TSP-1 production in cultured human MCs exposed to high glucose levels. MCs grown in 33 mmol/l glucose demonstrated a significant (P< .01) increase in activation of TGF-beta1 compared with those in 5 mmol/l glucose, which were evaluated by both an ELISA and a bioassay. High glucose-induced increase in active TGF-beta1 was completely inhibited by coincubation with 5 micromol/l GFX, a PKC inhibitor, and was mimicked by the addition of 0.1 micromol/l phorbol 12,13-dibutyrate (PDBu). On the other hand, increased TSP-1 production from MCs stimulated by 0.1 nmol/l recombinant TGF-beta1 and 0.1 micromol/l PDBu were significantly (P< .01) reduced by the addition of 10 nmol/l latency-associated peptide (LAP), a specific inhibitor of TGF-beta1 activity. The amount of TSP-1 secreted from MCs increased by a high ambient glucose. The glucose-induced increase in TSP-1 production was markedly attenuated by the treatment with GFX and LAP, while those agents did not affect TSP-1 production in low-glucose concentrations. Taken together, our results suggest that glucose-induced activation of TGF-beta1 is dependent on PKC activity, leading to a sequential increase in TSP-1 synthesis in cultured human MCs. Thus, we propose that high glucose conditions induce an increase in PKC-TGF-beta1 activity-TSP-1 pathway, and that glucose-induced increase in TSP-1 may synergistically facilitate TGF-beta1 activation in an autocrine manner in MCs.

Cells, Cultured↗
PubMedDate not supplied

Long-term effect of epalrestat, an aldose reductase inhibitor, on the development of incipient diabetic nephropathy in Type 2 diabetic patients.

The aim of the present study was to elucidate the long-term effect of epalrestat, an aldose reductase inhibitor (ARI), on renal function in patients with type 2 diabetes mellitus showing microalbuminuria. Patients were allocated to two groups (cases and controls) matched for age, BMI, and the extent of urinary albumin excretion (UAE). Thirty-five type 2 diabetic patients presenting microalbuminuria were included in this study: cases were treated with epalrestat (150 mg/day) for 5 years. No significant changes were found in blood pressure, HbA1c, and total cholesterol in either group during the observation period. In the control group, UAE increased significantly (P<.01) from 82+/-12 mg/g Cr at the baseline to 301+/-111 mg/g Cr at the end of the study, while UAE remained unchanged, 81+/-15 mg/g Cr at the baseline and 87+/-19 mg/g Cr at the end of the study, in the epalrestat-treated group. Reciprocal creatinine measured by an enzyme assay decreased significantly (P<.01) in both groups; however, the reduction rate in the epalrestat-treated group was significantly (P<.05) smaller than that in the control group. These results suggest the potential usefulness of ARIs in preventing the progression of incipient diabetic nephropathy in patients with type 2 diabetes mellitus.

Albuminuria↗
PubMedDate not supplied

Mid-term clinical results of Graf stabilization for lumbar degenerative pathologies. a minimum 2-year follow-up.

BACKGROUND CONTEXT: Spinal fusion has some adverse effects, such as nonunion and pain at the site of grafted bone, and fusion with rigid spinal instrumentation especially may have the possibility of increasing mechanical stress on the segments adjacent to the site of fusion. The theory of the Graf system is that it will decrease adjacent disc deterioration because of maintenance of regional lordosis with flexibility and restriction of the motion of unstable segments without rigid spinal fusion. PURPOSE: To assess the clinical and radiologic results of Graf stabilization for lumbar degenerative disorders with minimal or mild instability. STUDY DESIGN: This is a retrospective study examining the mid-term results of Graf stabilization. PATIENT SAMPLE: In total, 59 patients underwent Graf ligamentoplasty and adequate decompression from April 1993 to September 1997. The subjects were 30 men and 29 women, and the mean age at the time of surgery was 60.6 years, ranging from 23 to 82 years. The average follow-up period was 3 years and 5 months, ranging from 2 years to 5 years and 10 months. OUTCOME MEASURES: We evaluated the surgical results using a scoring system, a visual analog scale, and radiological measurements. METHODS: The results were assessed according to a clinical scoring system established by the Japanese Orthopaedic Association (JOA score) and ratings based on a visual analog scale. Through analysis of x-ray images, the sagittal alignment (regional lordosis) and the range of motion (ROM) of the stabilized segments were measured in all cases, and the percentage of segments slipping and posterior disc height were determined for 29 patients with degenerative spondylolisthesis. RESULTS: Clinical scores and low back pain ratings based on a visual analog scale were significantly improved at the time of final follow-up compared with the preoperative values. Regional alignment of the operative segments was maintained in lordosis at the time of final follow-up. Preoperative ROM was significantly reduced at the time of final follow-up. There were no statistical differences in percentage of slippage or percentage of posterior disc height between the final follow-up values and the preoperative values. CONCLUSIONS: Our clinical results indicate that the Graf system is a suitable treatment option for mild and early lumbar degenerative diseases with minimum flexion instability of less than 10 degrees.

Adult↗
PubMedDate not supplied

The effect of neutrophil depletion on reperfusion arrhythmias during intracoronary thrombolysis using the leukocyte removal filter.

To evaluate the effects of neutrophil depletion on reperfusion arrhythmias using a leukocyte removal filter (LRF), the authors examined several cardiovascular variables in three patients with myocardial infarction who underwent successful thrombolytic therapy with LRF compared with control patients without LRF. Coronary angiography performed within 4 hr of onset revealed total occlusion in the proximal segment of the left anterior descending (LAD) coronary artery, without collaterals, in all patients. Thrombolysis was performed by intracoronary administration of urokinase (10,000 IU/ml, 1,000,000 IU total) mixed with filtered autologous blood. LRF was composed of a nonwoven polyester fabric (1.8 microns, 4.6 g). Removal rates of leukocytes and platelets by LRF were 98-100% and 98%, respectively. Average duration of the ischemic episodes, maximum ST segment elevation, and integral of T segment depression did not differ in the two groups. However, the frequency of ventricular premature beats (VPB) during the first 30 min after reperfusion were significantly lower in the LRF treatment group (3.8%) compared with the control group (10.7%). Segmental shortening, measured by echocardiography one hour after recanalization, exhibited higher values in the LRF treated patients than control patients, without significant difference. Data suggested that LRF is effective in reducing reperfusion arrhythmias during intracoronary thrombolysis and activated neutrophils may play an important role in stunned myocardium.

Adult↗
PubMedDate not supplied

Is low density lipoprotein apheresis effective for coronary artery disease?

Low density lipoprotein (LDL) apheresis is one type of therapy currently being used for coronary artery disease; however, there has been no study to compare the effectiveness of this therapy with the effectiveness of other treatments, such as coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA). In this study, we evaluated the clinical results of these three therapies to compare their individual effectiveness for the treatment of coronary artery disease. Forty-four patients with two vessel disease (plasma cholesterol levels > 250 mg/dl) were divided into three groups (L, LDL apheresis; C, CABG; I, PTCA). After 2 years' observation, the coronary artery findings were evaluated by quantitative coronary angiography (QCA), frequency of cardiac events, changes in plasma lipids, and subjective symptoms, and the cost was examined. The symptoms of patients in Groups C and I showed significant improvement when compared with those of Group L. In Group L, the frequency of cardiac events was low (L, 0%; P, 44%; C, 14%), and lipid reduction was marked (L, 48%; P, 13%; C, 14%); however, the cost of this therapy is much more than the other therapies. There was no difference in the minimal luminal diameter evaluated by QCA in the three groups. LDL apheresis may be a good strategy for coronary disease, if its cost can be improved.

Coronary Disease↗
PubMedDate not supplied

Progressive jaundice due to lymphangiosis carcinomatosa of the liver: CT appearance.

In a case of progressive jaundice, contrast-enhanced CT demonstrated unevenly distributed areas of periportal low attenuation throughout the liver that were demonstrated to be dilated lymphatics with multiple carcinomatous thrombi at postmortem study. This CT appearance may be characteristic of lymphangiosis of the liver.

Adenocarcinoma↗
PubMedDate not supplied

Altered plasma levels of cytokines in patients with ischemic heart disease.

BACKGROUND: Cytokines play an important role in mediating inflammatory-proliferative responses, including atherosclerosis. Alterations in the plasma levels of cytokines in patients with ischemic heart disease (IHD) remain to be examined. OBJECTIVE: To examine the possible alterations in the plasma levels of cytokines in patients with IHD and in controls. METHODS: Thirty-one patients with IHD and 16 controls were studied. The cytokines measured in our study included interleukin-6, macrophage-colony-stimulating factor (MCSF), transforming growth factor-beta (TGF-beta), and seven other major cytokines. The measurements were performed by using an enzyme-linked immunosorbent assay method. RESULTS: The MCSF levels were significantly higher in patients with IHD than they were in controls (P < 0.01), whereas the TGF-beta levels were significantly lower in patients with IHD than they were in controls (P < 0.01). Moreover, the levels of MCSF and those of TGF-beta were correlated negatively (P < 0.05). The interleukin-6 levels tended to be higher in patients with unstable angina. The plasma levels of other cytokines were below the detection levels in most cases. CONCLUSIONS: Results from studies in vitro suggested that the process of atherosclerosis is accelerated and inhibited by MCSF and TGF-beta, respectively. The present results thus suggest that the alterations in the plasma levels of MCSF and TGF-beta may be involved in the pathogenesis of IHD in humans.

Aged↗
PubMedDate not supplied

Clinical effects of allopurinol on intractable epilepsy.

We studied the clinical efficacy of allopurinol as add-on therapy in 31 patients with intractable epilepsy. When administered for a short time, allopurinol was effective in 17 patients (55%); 8 were seizure-free, 8 had 75% decrease in seizure frequency, and 1 had greater than 50% decrease. Allopurinol was most effective in patients with localization-related epilepsy, especially in secondarily generalized tonic-clonic seizures. Allopurinol was not as effective in patients with Lennox syndrome or West syndrome, or in severe myoclonic epilepsy in infants. When allopurinol was administered greater than 1 year, its initial effectiveness continued in 8 of 14 patients who exhibited initial improvement. In 2 of the remaining 6 patients, the initial improvement disappeared during the course of treatment but control was regained by increasing the dosage of allopurinol. Mild side effects were observed in 4 patients (13%): drowsiness in 3 and abdominal pain in 1. Allopurinol may be a useful antiepileptic drug (AED), and a double-blind placebo-controlled trial should be performed.

Adolescent↗
PubMedDate not supplied

The spectrum of postpartum thyroid dysfunction: diagnosis, management, and long-term prognosis.

OBJECTIVE: To provide an overview of thyroid abnormalities that can occur after delivery. METHODS: We review the diagnosis and management of various types of postpartum thyroid dysfunction. RESULTS: A common problem during the postpartum period, thyroid dysfunction is found in approximately 5% of new mothers in the general population. Such thyroid dysfunction can manifest in various forms (hyperthyroid or hypothyroid, transient or persistent), each of which necessitates different treatment. The most common type of thyroid dysfunction is destructive thyrotoxicosis, which is due to the aggravation of autoimmune thyroiditis. It occurs at 1 to 3 months after delivery as sudden thyrotoxicosis and lasts for 1 to 3 months, after which transient hypothyroidism may ensue in some cases. Simply symptomatic treatment may be sufficient for such transient thyroid dysfunctions. Postpartum Graves' disease is found in approximately 11% of the cases of postpartum thyroid dysfunction. Graves' hyperthyroidism usually occurs at 3 to 6 months after parturition. In the treatment of postpartum Graves' disease, one may choose radioactive iodine, antithyroid drugs, or surgical therapy; however, transient Graves' hyperthyroidism, which often occurs in patients with postpartum Graves' disease, may require neither radioactive iodine therapy nor thyroidectomy. Mothers at high risk for development of postpartum thyroid dysfunction can be screened by testing for antimicrosomal antibodies. Although a strong correlation exists between the presence of antimicrosomal antibodies and postpartum thyroid dysfunction, the cost-effectiveness of screening for postpartum autoimmune thyroid syndrome remains controversial. CONCLUSION: For optimal management of the postpartum conditions of Graves' disease, destructive thyrotoxicosis, and hypothyroidism, the clinician should be aware of diagnostic techniques that will facilitate early intervention or will prompt careful surveillance.

Journal Article↗
PubMedDate not supplied

Effect of a leukocyte-platelet removal filter on ischemia induced reperfusion injury.

The effect of leukocyte and platelet depletion on reperfusion injury using a leukocyte-platelet removal filter (LRF) in intracoronary thrombolysis is reported. To better define the usefulness of LRF in evaluating the effectiveness of intracoronary thrombolysis with this device, several cardiovascular variables were examined in rabbits during ischemia followed by reperfusion. The rabbits underwent cytoapheresis with LRF (n = 5) and were compared with controls without LRF (n = 5). LRF was composed of a nonwoven polyester fabric (1.8 microns, 4.6 gm). Removal of leukocytes and platelets by LRF was 98% for both. A period of 30 min equilibration was allowed before any experimental intervention, at which time the diagonal artery was occluded for 20 min and then reperfused. All arrhythmias were defined and quantified in accordance with the Lambeth Convention. Regional wall thickening was examined by a pulsed Doppler dimension system. No significant differences were observed in hemodynamic variables between the two groups; however, rabbits treated with a LRF demonstrated greater regional wall thickening (LRF group: 17 +/- 0.9%, control group: 11 +/- 0.3%, p less than 0.01), as well as significant improvement in the frequency of ventricular arrhythmias (LRF group: 12.5%, control group: 47.2%, p less than 0.01). The data suggest that LRF may help prevent arrhythmias, and preserve left ventricular contraction, during and after intracoronary thrombolysis.

Animals↗