Biomedical subjects

H Yoshida

Publications and source records attributed to H Yoshida.

At least 811 records · Page 45Linked to original sources

PubMed1998

[A case report of mitral valve replacement using a parasternal incision (minimally invasive cardiac surgery) with pleuritis tuberculosa and after esophagus operation].

A 68-year-old man underwent mitral valve replacement because of mitral regurgitation (prolaps of anterior mitral leaflet) using parasternal incision (Delos M. Cosgrove, minimally invasive surgery). He had been treated as pulmonary tuberculosis previously and had undergone esophagus operation using stomach role reconstruction beneath the sternum four years before the mitral valve procedure. We could not select median-sternotomy as an approach due to stomach role beneath the sternum, nor left posterolateral thoracotomy because of the heavy left-side pleural adhesion. Cardio-pulmonary bypass cannulations were performed through the same incision, because severe atherosclerosis was found at the distal arteries of the abdominal aorta.

Aged↗

PubMed1998

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1996), III. Secular changes in susceptibility].

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 10 hospitals during June 1996 to May 1997, and the results were compared with those obtained during the same period in earlier years. 1. E. faecalis Among E. faecalis strains, those with high susceptibilities to ampicillin and minocycline appeared to have decreased in the latest study period. 2. S. aureus To almost antimicrobial agents, S. aureus isolated from uncomplicated UTIs showed low susceptibilities. But the MIC50s of those agents for S. aureus from complicated UTIs have changed better state. Particularly, the MIC50s of imipenem and clindamycin were 0.125 microgram/ml or below in the latest period for the first time in our history. 3. E. coli The susceptibilities to piperacillin and quinolones of E. coli isolated from uncomplicated UTIs were better than those isolated from complicated UTIs. 4. Klebsiella spp. The susceptibilities to almost antimicrobial agents of Klebsiella spp. have been better during the latest period, compared to those during period of 1995-1996, but to ofloxacin and ciprofloxacin have appeared to have been lower. 5. P. aeruginosa The susceptibilities to quinolones of P. aeruginosa have been better during the latest period compared those during periods of 1995-1996. But, the susceptibilities to cefozopran, carbapenems and monobactams of P. aeruginosa isolated from complicated UTIs appeared to have been lower. These susceptibility changes should be utilized in determining clinical treatments.

Anti-Bacterial Agents↗

PubMed1998

[Environmental factors possibly associated with onset of senile dementia].

Factors associated with senile dementia have not been clarified, and factors, especially those in the living environment which seem to have a close link to the dementia need to be analysed. We conducted a case-control study targeting patients within the jurisdiction of Nagahama Public Health Center in Shiga and Hikone city, who are diagnosed to have senile dementia of the Vascular type, senile dementia of the Alzheimer type, and senile dementia of the Mixed type, and compared them to age matched controls. The outcome of the study by Matched pair analysis (McNemar's test) before the onset of the senile dementia were as follows. 1 The factors related to senile dementia of the vascular type were: Previous histories (Matched Odds Ratio (MOR): 8.0 p < 0.05), disturbance of the lower limbs (MOR = 8.0 p < 0.05). Environmental factors were: strong preference for sweets (MOR = 8.0 p < 0.05 female), smoking (MOR = 3.7 p < 0.10), lower utilization of health care (MOR = 3.3 p < 0.10), such as periodic medical check (MOR = 0/6 p < 0.10), sleep (MOR = 0/5 p < 0.10), less commitment to hobbies (MOR = 2.6 p < 0.10), such as handicrafts (MOR = 0/5 p < 0.10) etc, less intercourse with relatives (MOR = 0/9 p < 0.01), not living together with children's family (MOR = 0.20 p < 0.05 female), and death (MOR = 8/0 p < 0.05) or hospitalization (MOR = 9.0 p < 0.05) of a family member. 2 The factors related to senile dementia of the Alzheimer type and the Mixed type were: some previous histories (MOR = 8.0 p < 0.05), less disturbance of gait (MOR = 0/5 p < 0.10). Environmental factors were: lower utilization of health care, such as periodic medical check (MOR = 0.18 p < 0.05), and lower participation in exercise (MOR = 0/5 p < 0.10) etc, less association with neighbors (MOR = 0.11 p < 0.05), less participation in community activities (MOR = 0.11 p < 0.05), not living together with children's family (MOR = 0/8 p < 0.05), relocation (MOR = 5/0 p < 0.10) and retirement (MOR = 5/0 p < 0.10).

Aged↗

PubMed1998

[Treatment of prostate cancer in patients aged 75 or older].

In view of the increasing incidence and mortality rate of prostate cancer in Japan, the management of elderly patients with prostate cancer is an important issue now. We therefore analyzed the clinicopathological features and long-term outcomes of 182 patients with prostate cancer, aged 75 or older, in order to establish the treatment strategy for this age group of patients. There were more patients with advanced disease (stage C-D) than those with localized disease (stage A2-B), and the patients with moderate to poorly differentiated tumors were more numerous than those with well-differentiated tumors. The overall survival curve of the patients with localized prostate cancer was in line with the age-matched expected survival curve, while that with advanced prostate cancer was far below the expected survival curve. These results demonstrated that advanced prostate cancer in elderly patients is as harmful as in younger patients, indicating the necessity for early detection and treatment of prostate cancer among the younger generation. On the other hand, localized prostate cancer in elderly patients should be treated less invasively to maintain their quality of life.

Aged↗

PubMed1998

Basic and clinical studies on the measurement of tau protein in cerebrospinal fluid as a biological marker for Alzheimer's disease and related disorders: multicenter study in Japan.

The development of a diagnostic marker for earlier and more accurate clinical diagnosis of Alzheimer's disease (AD) is essential to identify AD patients during life unequivocally. The purpose of this study was to investigate the basic performance and clinical significance of tau level measurement in the cerebrospinal fluid (CSF) using an enzyme-linked immunosorbent assay (ELISA) developed by Innogenetics. The ELISA system showed reliable reproducibility and good linearity. For clinical studies, the CSF samples from a variety of patients (n = 332) were examined. They were classified into the four groups: Alzheimer's disease (AD); neurodegenerative disease (ND); cerebrovascular diseases (VD); and a neurological control (NC) group. The CSF-tau levels for AD, ND, VD and NC were 426 +/- 234 pg/ml, 239 +/- 157 pg/ml, 216 +/- 136 pg/ml, and 188 +/- 103 pg/ml, respectively. The CSF-tau level of the AD group was significantly higher than that of the other groups (p < 0.001). The CSF-tau levels increased during follow-up. The measurement of the tau level in CSF is shown to be a useful marker to confirm a clinical diagnosis of AD.

Aged↗

PubMed1998

[Epidemiology of osteoporosis: incidence, prevalence, and prognosis].

Though the exact and cumulative incidence of osteoporosis has not been examined, using the criteria that osteoporosis is defined by a decrease of bone mineral density (BMD) below 70% from young adult mean (YAM), the prevalence of osteoporosis among the Japanese women can be estimated as to be more than either 30% (by spinal BMD) or 37% (by femoral BMD) in 60's, 37% or 64% in 70's, and 42% or 90% in 80's, respectively. The total number of osteoporosis among the women with age 50 and over can be also estimated as to be either about 5 million (by spinal BMD) or 8.5 million (by forearm BMD). National survey shows that the ratio of people receiving treatment for osteoporosis is 34.5 per 1,000 among the elderly with age 65 and over. In addition, both functional transition and survival rate of discharged patients with osteoporotic hip fracture are discussed as prognosis of osteoporosis.

Adult↗

PubMed1998

Active-MMP2 in cancer cell nests of oral cancer patients: correlation with lymph node metastasis.

We examined the gelatinolytic activity in human oral squamous-cell carcinoma tissues in order to evaluate the capability of intravasation and extravasation of cancer cells. By a microdissection-zymography, we demonstrated separately the gelatinolytic activities in cancer cell nests and stroma adjacent to the cancer cells. The gelatinolytic activities, such as pro-matrix metalloproteinase (MMP)9 and active-MMP2 in most of cancer cell nests were much higher than those of normal gingival epithelium. Moreover, the activities of active-MMP2 in cancer cell nests of metastatic cancers were significantly higher than those of non-metastatic cancers (p<0.05). These results suggest that active-MMP2 in cancer cells can be a predictive marker for metastasis formation in oral squamous-cell carcinoma patients.

Carcinoma, Squamous Cell↗

PubMed1998

[An experience of video-assisted thoracoscopic surgery for an intrapulmonary needle under CT-guided marking].

A 46-year-old female visited a near hospital, complaining of repeating skin eruption with spontaneous remission. A chest X-ray and CT examinations revealed a needle in the left S6, about 5 mm in length, which was suspected of causing the eruption. She was admitted to our hospital for operation. After CT-guided marking, video-assisted thoracoscopic surgery was performed. Because the needle was too small to be palpable, we decided to respect of it with the lung surrounding the marker and clamped the lung, followed by finding the needle finally. The analysis of the removed needle showed that it contained lead and tin besides iron, nickel and chromium, which are components of stainless steel. Although dermatological examination could not reveal the relation between the needle and the eruption, it has never recurred since the operation. It is thought that CT-guided marking is very useful for resection of an intrapulmonary needle and that a foreign body should be removed for the possibility of being harmful.

Endoscopy↗

PubMed1998

[Clinical study on chlormadinone acetate alone followed by combination with LH-RH analogue for prostatic cancer: effects on lipid metabolism].

Twenty-four previously untreated patients with a diagnosis of prostatic cancer were treated with chlormadinone acetate (CMA) alone (100 mg/day) for 4 weeks, and luteinizing hormone-releasing hormone analogue (LH-RHa) was added for the next 24 weeks. Marked decreases in blood LH, testosterone (T), prostate specific antigen (PSA), gamma-seminoprotein (gamma-Sm), and prostatic acid phosphatase (PAP) were observed after a single dose of CMA. T levels were significantly increased 3 days after the initial dose of LH-RHa, and did not return to the pretreatment level. There were no significant increases in any of the markers, nor were there any flare-up cases. Triglyceride levels, which were slightly elevated before the start of treatment, were significantly decreased 24 weeks after the completion of combined therapy. PSA was evaluated as partial response (PR) or better in 86.7% of the patients. Overall evaluation showed PR or better in 75.0% of the patients. These findings suggest that prior administration of CMA followed by combined administration with LH-RHa is useful in the treatment of prostatic cancer. No negative effects on lipid metabolism were observed at any time during the treatment period.

Aged↗

PubMed1998

[The evaluation of the pre-operative interviews using information sheets].

This investigation deals with patients of more than 15 years of age and family members of children younger than 12 years of age to evaluate the pre-operative interviews using information sheets. The information sheets describe the anesthetic management and complications in a simple style. Sixty% of the patients and 75% of the children's family felt anxiety about the anesthesia and/or the operation (P < 0.05). More than a half of the patients did not want to receive informations about the anesthetic management and the risk of anesthesia. On the other hand, 9% of children's family did not want to know informations about the risk (P < 0.05). More than 80% of patients read the information sheets after the pre-operative interviews and about a half of patients answered that their anxiety before the surgery decreased. In this investigation, the children's family wanted to have information about the anesthesia or the operation more than patients themselves. The pre-anesthetic interviews using information sheets is useful to give information about anesthesia and to relieve anxiety of the patients and the children's family.

Adolescent↗

PubMed1998

[Re-do surgery with minimally invasive cardiac surgery (MICS): mitral valve replacement 6 years after open mitral commissurotomy].

A 60-year-old man, who had undergone open mitral commissurotomy 6 years ago, underwent re-do surgery (mitral valve replacement) with minimally invasive cardiac surgery (MICS), using lower partial sternotomy to the height of the right side second intercostal space. Cannulation of the heart was carried out placing a cannula directly into the superior vena cava and a second cannula in the inferior vena cava via the right atrium. Arterial return was through the ascending aorta. Cardioplegia was administered directly into the ascending aorta with intermittent perfusion. Valve replacement was performed by opening directly right side left atrium.

Cardiac Surgical Procedures↗

PubMed1998

A mutation in plasma platelet-activating factor acetylhydrolase (Val279Phe) is a genetic risk factor for cerebral hemorrhage but not for hypertension.

Platelet-activating factor (PAF) acetylhydrolase is an enzyme that inactivates PAF. Deficiency of this enzyme is caused by a missense mutation in the gene. We previously found a higher prevalence of this mutation in patients with ischemic stroke. This fact suggests that the mutation might enhance the risk for stroke through its association with hypertension. We have addressed this hypothesis by analyzing the prevalence of the mutation in hypertension. We studied 138 patients with essential hypertension, 99 patients with brain hemorrhage, and 270 healthy controls. Genomic DNA was analyzed for the mutant allele by the polymerase-chain reaction. The prevalence of the mutation was 29.3% (27.4% heterozygotes and 1.9% homozygotes) in controls and 36.2% in hypertensives and the difference was not significant. The prevalence in patients with brain hemorrhage was significantly higher than the control: 32.6% heterozygotes and 6.1% homozygotes (p <0.05). PAF acetylhydrolase deficiency may be a genetic risk factor for vascular diseases.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗

PubMed1998

Physiological fluctuation of the human left ventricle sympathetic nervous system assessed by iodine-123-MIBG.

UNLABELLED: It has been proposed that sympathetic nervous system pathophysiology is involved in the development of cardiovascular disorders. Since cardiac adrenergic activity has been difficult to assess in humans, physiological changes in the sympathetic nervous system in the human left ventricle remain unclear. METHODS: To determine if age and gender influence the sympathetic nervous function of the left ventricle, 300 angiographically normal subjects (170 men, 130 women; age range 40-79 yr) had 123I-metaiodobenzylguanidine (MIBG) cardiac imaging. Regional quantitative analysis of MIBG uptake and washout rate was performed. RESULTS: Men and women had prominent age-related decreases in MIBG uptake in the inferior and lateral walls (r2 = 0.34, p <0.0001 for both). Both genders had a significant positive correlation between regional washout rate and age in each region. In contrast to men, women had strong positive correlations in all regions (r2 = 0.54, p <0.0001 in the anterior wall, r2 = 0.56, p <0.0001 in the lateral wall and r2 = 0.44, p <0.0001 in the inferior wall). According to the decade-by-decade analysis of washout rate, women had a significantly lower washout than men under 50 yr in every region and a significantly higher washout in the lateral wall than men over 70 yr. CONCLUSION: The sympathetic nervous system in the human left ventricle showed age- and gender-related regional changes. The findings suggested that men have high sympathetic nerve activity from a younger age, and women have a progressive increase in sympathetic nerve activity with aging. These changes may contribute to the age and gender differences in the incidence and development of cardiac disorders.

3-Iodobenzylguanidine↗

PubMed1998

[A case of transitional cell carcinoma and milk of calcium in a pyelocalyceal diverticulum].

A 66-year-old man presented with right flank pain and macroscopic hematuria. Abdominal radiographs and computed tomography revealed a right pyelocalyceal diverticulum with milk of calcium and a soft tissue mass inside it. Other examinations, including positive urine cytology and negative random bladder biopsies, suggested a malignant tumor of the pyelocalyceal diverticulum. The patient underwent right nephroureterectomy. Histopathological examination revealed grade 3 transitional cell carcinoma. This is the first case of transitional cell carcinoma and milk of calcium coexisting in the same pyelocalyceal diverticulum.

Aged↗

PubMed1998

Septic arthritis of a lumbar facet joint: report of a case with early MRI findings.

A 56-year-old man was hospitalized with a 2-day history of back pain and fever. A magnetic resonance (MR) scan taken on admission showed a facet joint effusion and soft-tissue abnormality posterior to the joint. Follow-up MR imaging confirmed the facet joint destruction and periarticular abscess. A biopsy specimen grew Staphylococcus aureus. MR imaging is helpful in detecting this rare infection in the earliest phase of the disease.

Abscess↗

PubMed1998

[Ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade: report a case].

The ruptured thoracic aortic aneurysm has had severely high mortality. A 71-year-old male who suddenly fainted away was admitted to our hospital. He was in shock on arrival. Computed tomography and echo cardiogram demonstrated ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade. Aortic arch replacement was performed using the selective cerebral perfusion under deep hypothermia. The recovery of his consciousness was delayed, and he had right hemiplegia postoperatively, but his state was improved gradually. Finally he complained only slight degree of aphasia, paralysis. An immediate and aggressive emergency operation is a only method to salvage the patient who has ruptured aneurysm of the thoracic aorta.

Aged↗

PubMed1998

[Thoracoabdominal aortic repair without using assisted bypass].

A 41-year-old man, who had undergone descending aortic repair following rupture of the DeBakey type III aortic dissection, underwent thoracoabdominal aneurysm repair 1 year after the first surgery. The operation was performed by partial-clamping and single crossclamping without using assisted bypass or shunt, in order to minimize bleeding ensuing the re-thoracotomy and dissection between lung and the graft.

Adult↗

PubMed1997

Remodeling of glycoconjugates on CD44 enhances cell adhesion to hyaluronate, tumor growth and metastasis in B16 melanoma cells expressing beta1,4-N-acetylglucosaminyltransferase III.

Beta1-4 N-acetylglucosaminyltransferase III (GnT-III) synthesizes bisecting N-acetylglucosamine structures on asparagine-linked oligosaccharides. Using B16-hm mouse melanoma cells stably expressing GnT-III activity as positive transfectants, the effect of bisecting N-acetylglucosamine on the function of CD44 was analyzed in association with adhesion to hyaluronate and tumor spread in mice. Transfection of GnT-III caused increased affinity of immunoprecipitated CD44 to erythro-agglutinating phytohemagglutinin, that preferentially recognizes bisecting N-acetylglucosamine, without affecting the surface CD44 amount, indicating an increase in bisecting N-acetylglucosamine residues on CD44 in positive transfectants. CD44-mediated adhesion to immobilized hyaluronate and the binding of fluorescence-labeled hyaluronate to the cell surface were increased in positive transfectants. The enhanced adhesion in positive transfectants was suppressed by the treatment with beta-N-acetylhexosaminidase, indicating that N-acetylglucosamine residues were responsible for the enhanced adhesion. Positive transfectants showed promoted CD44-mediated tumor growth and metastatic development in the spleen after subcutaneous inoculation into mice. These results indicate that glycosylation of CD44 due to GnT-III causes enhanced adhesion to hyaluronate, local tumor growth and metastatic growth in spleen, suggesting that the CD44-mediated adhesion and tumor spread can be modified through introduction of a glycosyltransferase gene.

Acetylglucosamine↗