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Biomedical subjects

H Toyoshima

Publications and source records attributed to H Toyoshima.

At least 145 records · Page 8Linked to original sources

The role of initial minimum potentials on body surface maps in predicting the site of accessory pathways in patients with Wolff-Parkinson-White syndrome.

Forty-one patients (23 men and 18 women, ages 20 to 66 years) with Wolff-Parkinson-White syndrome were studied with isopotential body surface maps during sinus rhythm to find the most reliable index for predicting the sites of single accessory pathways. The sites predicted by surface maps were compared with those confirmed by multicatheter electrophysiologic study or in the course of surgical operation. Location of the initial minimum by a time criterion, 40 msec after onset of the QRS complex, was not reliable enough for prediction in patients with the small delta wave on their electrocardiograms, because ventricular activation via the normal conduction pathway significantly influenced the location of the minimum. Location of the minimum by an amplitude criterion, -0.15 mV or slightly deeper, was influenced minimally by fusion of ventricular activation, the patient's body size, or age and corresponded well to the site of the accessory pathway in 36 of 41 patients. Those minima appeared on circumscribed areas of the map in accordance with the anatomic subdivisions of the atrioventricular ring. Thus location of the minimum by the amplitude criterion was an excellent index for predicting the site of the accessory pathway, regardless of the degree of ventricular fusion. These amplitude-based map features suggest that nonstandard electrocardiograms recorded from selected positions on the body surface can be used as accurate predictors of the sites of accessory pathways.

Adult↗

Reduced serum carnosinase activity in hypothyroidism.

Carnosinase hydrolyses carnosine in muscle, and its deficiency is associated with extensive neuromuscular abnormalities. We measured serum carnosinase activity in patients with thyroid dysfunction which often involves neuromuscular systems. In hyperthyroidism, the carnosinase activity was not significantly different from that in normal subjects. In hypothyroidism, however, it was significantly lower than that in normal subjects. The activity examined in five patients with hypothyroidism returned to normal after replacement therapy. In hypothyroidism, the carnosinase activity showed significant correlation with concentration of serum thyroxine and negative correlation with serum creatine kinase activity. This finding may be of practical importance in the differential diagnosis of disorders causing carnosinase deficiency.

Clinical Enzyme Tests↗

[Surgery of incisional hernia and its prognosis--statistical analysis in 657 patients].

In order to study the problems of surgery for incisional hernia and its prognosis, 657 patients who had undergone surgery for incisional hernia between January 1974 and December 1983 in 27 hospitals were analyzed statistically by questionnaire survey. These patients consisted of 571 in whom surgery was performed for the first time and 86 in whom surgery was carried out for recurrent hernia. The ratio of male to female patients with initial surgery was 1:2.4, showing a higher frequency in females than in males. Initial surgery was most frequently carried out in the patients' 50s and 60s. The most common procedure which caused hernia was a median incision in 299 (51.6%), followed by an incision of the right hypogastrium for appendectomy in 211 (36.4%). There were many patients with systemic complications such as obesity, diabetes and asthma. The recurrence rate after radical surgery for incisional hernia was 9.1%. There was a tendency for the recurrence rate to be high in elderly patients and those who had had systemic complications (obesity, diabetes and asthma) preoperatively. The rate was very high, 33.3%, in patients with postoperative wound infection. The recurrence rate in patients with surgery for recurrent hernia was about three times as high as the 7.3% for patients with initial surgery. When the rate was determined by procedure, it was 2.4% for patients treated by a mesh prosthesis, 9.4% for those treated by celiorrhaphy and closure, and 16.7% for those treated by the overlap method. Mesh prosthesis was considered the best procedure, particularly for recurrent hernia.

Adult↗

Decreased activity of carnosinase in serum of patients with chronic liver disorders.

We measured the activity of carnosinase, a prominent hepatic peptidase, in sera from 69 patients with liver disorders. Mean values (and SDs) for those with liver cirrhosis (17 cases) and hepatoma (seven cases) were 0.51 (0.28) and 0.68 (0.21) mumol/mL per hour, respectively--clearly less than for normal adults: 4.19 (0.95) mumol/mL per hour. Samples from 17 cases of chronic hepatitis also showed moderately decreased activity, 1.41 (0.97) mumol/mL per hour. In contrast, 14 cases of acute hepatitis generally showed values falling within the normal limits: 3.41 (1.97) mumol/mL per hour. Our results for carnosinase correlated with those for cholinesterase (r = 0.70) and with the concentration of albumin in serum (r = 0.59), but not with the activity of either creatine kinase, aspartate aminotransferase, or alanine aminotransferase in serum. Carnosinase values differed more among groups of disorders than did the values for cholinesterase or albumin. Measurement of serum carnosinase activity may be of clinical value in assessing the severity of chronic liver-cell damage, but not in differentiating liver disease from nutritional, muscle, or endocrine disorders.

Adult↗

Role of macrophages in atherosclerosis. Sequential observations of cholesterol-induced rabbit aortic lesion by the immunoperoxidase technique using monoclonal antimacrophage antibody.

To elucidate the role of macrophages in atherosclerosis, sequential observations were carried out on cholesterol-induced aortic lesions of the rabbit with the immunoperoxidase technique by use of monoclonal antimacrophage antibody. Animals on cholesterol diets for 8 weeks or longer showed increased accumulations of lipid-filled macrophages in the intima. At a very early stage, when no grossly visible alterations were observed, macrophages were seen clinging to the endothelial surface with apparent penetration of the endothelium. A single line of three or four vacuolated macrophages were found in otherwise normal subendothelial spaces. In flat lesions consisting of a few layers of foam cells, lipid-laden macrophages were the cells that predominated. In advanced plaque lesions, negatively staining, most presumably, smooth muscle foam cells became noticeable and increased in number. At this stage, macrophage foam cells predominated in the superficial layer of the lesion, whereas negatively staining foam cells were prevalent in deeper areas. Macrophages were also spotted within areas of necrosis, and they were occasionally observed near the necrotic core of the atheroma. During 24 to 74 weeks after termination of the cholesterol diet, the number of cells with specific macrophage staining markedly diminished. The results support the concept that circulating monocytes are the prime source of foam cells in the initial phase of atherogenesis. It seems likely that the major role of macrophages in atherogenesis is to remove lipids from areas of lesion formation. The failure of macrophages to perform their scavenger role successfully may be a major factor in the accumulation of lipid-rich debris in advanced lesions. Relative paucity of macrophages may also be an important factor explaining why regression of atherosclerosis occurs rarely in the rabbits.

Animals↗

Renal amyloidosis with crescents.

An unusual case of renal amyloidosis associated with extensive crescents is reported. Light and electron microscopic examination revealed that deposits of amyloid were almost invariably involved in the locations in which proliferations of epithelial cells in the capsular spaces had merged with the glomerular tufts. Gaps or fractures of the capillary walls were present at such sites, in which amyloid fibrils were mingled with thrombic material containing fibrin. It is highly conceivable that the gaps apparently induced by amyloid deposition, with leakage of fibrin-fibrinogen into the capsular space, play a crucial role in the development of the extracapillary proliferation.

Aged↗

Fluorometric assay of human serum carnosinase activity in normal children, adults and patients with myopathy.

A sensitive, accurate method has been established for the assay of serum carnosinase by measuring the fluorescence emitted from the L-histidine liberated on treatment with o-phthaldialdehyde. Using this method the serum values for normal adults, infants and children were measured. The mean value was very low in infants of less than 1 year old but increased with age, being almost the same in children aged 6 years or more as in adults. In adult men, the mean activity was 1.85 mumol/mL/h and in adult women it was 2.07 mumol/mL/h. Low activity was observed in patients with muscular dystrophy.

Adult↗

[Pharmacokinetics and clinical studies of fosfomycin in bile duct infections].

Serum and bile levels of fosfomycin sodium (FOM-Na) were evaluated and the pharmacokinetic parameters were estimated in 10 patients with various forms of biliary drainage (PTCD or T-tube). Clinical trials of FOM-Na were also performed in another 11 patients with bile duct infections and the clinical efficacy was estimated. Mean serum level of FOM-Na after drip infusion of 2 g fosfomycin sodium was 145.43 micrograms/ml at 1 hour, meanwhile bile level was 31.49 micrograms/ml at 2 hours. Serum level of FOM-Na was interpreted by the pharmacokinetic analysis after the damping GAUSS-NEWTON method using the one-compartment open model and bile level of FOM-Na by the damping GAUSS-NEWTON method and deconvolution method. Mean Vd was 12.16 L/body and half-time of serum level was 1.75 hours. Lag-time of bile level was 0.9 hour, Tmax 2.01 hours. The clinical efficacy of FOM-Na was determined excellent without any adverse effect. FOM-Na was remarkably effective in 91% of the patients. Hence, the first choice of FOM-Na against bile duct infections could be recommended.

Aged↗