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Biomedical subjects

H Yoshimoto

Publications and source records attributed to H Yoshimoto.

At least 109 records · Page 6Linked to original sources
PubMed1988

Aneurysmal subarachnoid hemorrhage in Izumo City and Shimane Prefecture of Japan. Incidence.

During the 5-year period from 1980 to 1984, the incidence of subarachnoid hemorrhage due only to rupture of aneurysms was investigated in Izumo City, a small city with a population of 79,026. Additionally, to ascertain the relation of incidence to the size of the geographic area and/or population, a similar analysis was made on a larger area of Shimane Prefecture, including Izumo City, with a total population of 789,712. During this 5-year period, a total of 83 patients with aneurysmal subarachnoid hemorrhage were hospitalized in Izumo City, 548 patients in Shimane Prefecture. Ruptured aneurysms were confirmed in 77 cases (93%) in Izumo City and 466 cases (85%) in Shimane Prefecture. The crude annual incidences of aneurysmal subarachnoid hemorrhage for Izumo City and Shimane Prefecture were 21.0 and 13.9 per 100,000 population for all ages, and the age-adjusted annual incidences (adjusted to the 1980 population of Japan) were 18.3 and 11.0 per 100,000 for all ages, respectively. For both Izumo City and Shimane Prefecture, the age-specific annual incidences peaked at the ages of 50-69 years, and the highest incidence was 92.3 per 100,000 men from Izumo City in the eighth decade of life. The annual incidence of subarachnoid hemorrhage for Izumo City is the highest reported to date. If a wider area, such as Shimane Prefecture, were studied many patients in poor condition, particularly elderly patients, would be missed. To determine accurately the incidence of aneurysmal subarachnoid hemorrhage, it thus might be better to conduct the study in a small city such as Izumo City.

Adult↗
PubMed1988

Aneurysmal subarachnoid hemorrhage in Izumo City and Shimane Prefecture of Japan. Outcome.

The overall outcome of patients with aneurysmal subarachnoid hemorrhage was investigated in Izumo City and Shimane Prefecture. Of the patients from Izumo City, the clinical grade on admission was Grade I or II in 41% and Grade IV or V in 31%. Of those from Shimane Prefecture, 49% were graded as Grade I or II and 24% as Grade IV or V. The overall mortality rates 1 year after subarachnoid hemorrhage were 46% for Izumo City and 35% for Shimane Prefecture, while the surgical mortality rates were 18 and 15%, respectively. The mortality rates were particularly high among the elderly over the age of 70 years and among unoperated cases. The leading cause of death in these cases was the effect of aneurysm rupture itself, followed by rebleeding and vasospasm. The 5-year survival probabilities according to life table analysis were 50% for Izumo City and 59% for Shimane Prefecture, and a significant difference was observed in survival curves between Izumo City and Shimane Prefecture. It is concluded that the smaller the community studied, the less favorable the overall outcome, mainly because of poorer clinical conditions on admission.

Actuarial Analysis↗
PubMed1988

[Clinical study of hypertensive subcortical hemorrhage: surgical indication and long-term, functional prognosis].

There has been no report available for determining surgical indications in hypertensive subcortical hemorrhage based on functional prognosis. The authors then studied the clinical results of hypertensive subcortical hemorrhage for evaluating the surgical indication in relation to functional prognosis. Sixty-five patients with hypertensive subcortical hemorrhage diagnosed by CT scan who were hospitalized to Matsue Red Cross Hospital from January 1980 up to December 1986 were studied. The 44 male and 21 female patients ranged in age from 37 to 86 years, and 38 of them were operated on. The results were as follows: 1) Patients with grade I (Kanaya's neurological grading) or a volume of hematoma less than 30 ml should be treated with conservative therapy. Those with grade II and III or a volume of hematoma = 30 - 50ml should be treated in accordance with proper therapeutic method, taking into consideration the site of the hematoma. Patients with more than grade IVa or a volume of hematoma greater than 50ml would be in danger of losing their lives unless surgical therapy was performed. 2) The follow up study of the patients' long-term prognosis after discharge revealed the majority of the patients showed aggravation of the illness and/or death due to cerebral apoplexy-like attack and re-bleeding. It is necessary to follow up these cases with careful systemic control, including monitoring of blood pressure.

Brain↗
PubMed1987

Basilar bifurcation aneurysm associated with bilateral internal carotid occlusion.

A case of subarachnoid hemorrhage from ruptured aneurysm of the basilar bifurcation associated with occlusions of both internal carotid arteries at the neck is presented. Each internal carotid artery mainly received collateral flow at the cavernous portion from the internal maxillary artery through anastomotic artery of the foramen rotundum. Posterior circulation also supplied collateral blood flow via the right posterior communicating artery. This case report suggests that hemodynamic stress may be regarded as an important factor in the formation or development of cerebral aneurysm.

Aged↗
PubMed1987

The long-term fate of the gallbladder after endoscopic sphincterotomy. Complete follow-up study of 122 patients.

One hundred twenty-two patients with common bile duct stones and intact gallbladders underwent endoscopic sphincterotomy without cholecystectomy and were followed for 6 months to 9 years (mean 3 years). Nineteen patients died from unrelated causes. One hundred of 103 surviving patients (97 percent) were asymptomatic, whereas 3 had complaints. Acute cholecystitis did not occur in 91 patients without gallstones, whereas it did occur in 5 of 31 patients (16 percent) with gallstones (25 patients) or nonvisualization of the gallbladder (6 patients). Two patients in the former subgroup had formation of new gallstones. We conclude that cholecystectomy should be advocated whenever possible in patients with gallstones or nonvisualization of the gallbladder after endoscopic sphincterotomy due to the high incidence of acute cholecystitis in this subgroup and that operation is not necessary in patients without gallstones; however, one should be aware of possible formation of new stones in the gallbladder.

Aged↗
PubMed1987

[Growing aneurysm presenting with Weber's syndrome and obstructive hydrocephalus--a case report].

A case with two cerebral aneurysms, in which one at the origin of the left superior cerebellar artery (SCA) grew and presented with Weber's syndrome and obstructive hydrocephalus, is reported. The patient was a 69-year-old female, who had severe headache and vomited. On admission, neck stiffness was recognized. CT scan showed findings of subarachnoid hemorrhage. Angiograms demonstrated two saccular aneurysms at the right middle cerebral artery (MCA) bifurcation and at the origin of the left SCA. Craniotomy and neck clipping of the aneurysm at the right MCA was performed. After discharge, left oculomotor palsy appeared and gradually progressed. Severe headache and right hemiparesis suddenly occurred two years after the first attack. On the second admission, CT scan revealed high density on the brain surface and a well enhanced round lesion at the left ambient cistern. Left vertebral angiogram demonstrated increase in size of the aneurysm at the left SCA. The patient was discharged after conservative therapy. Drowsiness and urinary incontinence appeared, and she was admitted for the third time three years after the first admission. CT scan showed an enhancing mass lesion sized 25 X 30 mm beside the left midbrain and obstructive hydrocephalus. The aneurysm at the SCA no longer seen on the left vertebral angiogram. V-P shunt was performed. Both Weber's syndrome and obstructive hydrocephalus in this case indicate an aneurysmal natural history, in which aneurysm becomes gigantic and thrombosed spontaneously.

Aged↗
PubMed1987

Electrohydraulic lithotripsy of intrahepatic stones during choledochoscopy.

In two patients, electrohydraulic lithotripsy was used under direct vision during choledochoscopy to fragment intrahepatic calculi above bile duct strictures, which were difficult to remove by ordinary choledochoscopic methods. Choledochoscopy was performed after dilation of a percutaneous transhepatic tract in one patient and after intubation of the subcutaneous blind jejunal limb of a previous Roux-en-Y intrahepatic cholangiojejunostomy in the other. Both patients were treated without any complications. Electrohydraulic lithotripsy during choledochoscopy is a safe and effective method to fragment stones and facilitate their removal.

Adult↗
PubMed1986

Enhanced instability of IncFII basic replicon by the polA mutation.

IncFII plasmids consisting of a basic replicon and of an additional fragment(s) unrelated to plasmid maintenance were all less stable in polA1 than in its wild type. Reversion to UV-resistance recovered stability and vice versa. UV irradiation promoted instability in polA1 cells. Larger plasmids showed a greater instability and a fewer number of copies in a same host. Surprisingly, polA1 cells with Tn3 on the plasmid showed a higher ampicillin resistance than the wild type, apparently suggesting that the polA1 mutation increases the copy number. The size-dependency of instability was less marked in polA1 than in its parent. Comparison of the generation times has suggested a detrimental effect exerted by a basic replicon in polA1 hosts.

Ampicillin↗