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Biomedical subjects

Hajime Hirose

Publications and source records attributed to Hajime Hirose.

51 records · Page 3Linked to original sources
PubMed2003

Involuntary expiratory phonation as a dose-related consequence of L-dopa therapy in a patient with Parkinson's disease.

We report a case of involuntary phonation caused by abnormal vocal cord movements during expiration in a patient with Parkinson's disease. A 60-year-old woman had been treated for parkinsonism at the outpatient clinic of the Department of Neurology since August 1999. She began to groan involuntarily in the daytime in September 2001. She could not eat well while groaning. Stridor was not noted during sleep at night. Endoscopic examination of the larynx revealed insufficient abduction of the bilateral vocal cords, although the glottis was not so small as to cause stridor during inspiration. During expiration, however, the vocal cords adducted, resulting in the involuntary production of voice. Electromyography showed an increase in the activity of the thyroarytenoid and lateral cricoarytenoid muscles. This muscle activity was further enhanced during inspiration. The involuntary phonation disappeared when the patient's dose of L-dopa was decreased, although she had a decrease in her systemic mobility as well. When the dose of L-dopa was increased to the therapeutic level, involuntary phonation recurred, and her voluntary systemic activity improved. In the present case, it was considered that excessive dopaminergic denervation occurred in the nerve innervating the laryngeal adductors. Involuntary voice appeared to be produced by hypertonus of the laryngeal adductors because of a lowering in the threshold level for L-dopa, even though the drug was administered at the usual dose.

Antiparkinson Agents↗
PubMed2003

[Use of YAG laser combined with mucosal suturing for the treatment of polypoid vocal cord].

To improve low-pitched voices in cases with polypoid vocal cords, YAG laser irradiation combined with a mucosal suturing technique was attempted in 9 female cases with severe polypoid changes in their vocal cords. A YAG laser beam (5 to 10 W) was used to irradiate the upper surface of the polypoid vocal cord. The polypoid content of the cord was gradually coagulated, and the free edge of the cord appeared to slide up toward the burned area. The polypoid content was then removed and squeezed through an open wound made in the burned area using a conventional method. Bleeding was successfully controlled using the laser. After the excessive mucosal margin was trimmed and the contour of the vocal cord was adjusted, the wound was closed by 7-0 monofilament absorbable suture. Suturing was relatively easy because the mucosal edge was also coagulated. Postoperative evaluations of voice quality revealed an improvement in the GRBAS scale of voice quality as well as an elevation in voice pitch and an upwards shift in the voice range in all cases.

Adult↗
PubMed2002

1,25-dihydroxyvitamin D3 stimulates vascular endothelial growth factor release in aortic smooth muscle cells: role of p38 mitogen-activated protein kinase.

Vitamin D3 plays an important role in the regulation of mineral homeostasis, cell differentiation, and proliferation. However, the exact role of vitamin D3 in vascular smooth muscle cells remains unclear. In the present study, we investigated whether vitamin D3 induces vascular endothelial growth factor (VEGF) release in aortic smooth muscle A10 cells. 1,25-Dihydroxyvitamin D3 (1,25(OH)2VD3), an active form of vitamin D3, stimulated the VEGF release while 24,25-dihydroxyvitamin D3 (24,25(OH)2VD3), an inactive form of vitamin D3, had little effect on the release. The stimulatory effect of 1,25(OH)2VD3 was dose dependent in the range between 10 pM and 10 nM. 1,25(OH)2VD3 induced the phosphorylation of p38 mitogen-activated protein (MAP) kinase but 24,25(OH)2VD3 did not. PD169316 and SB203580, specific inhibitors of p38 MAP kinase, significantly reduced the 1,25(OH)2VD3-stimulated release of VEGF. On the contrary, SB202474, a negative control for p38 MAP kinase inhibitor, had little effect on the VEGF release. PD169316 attenuated the 1,25(OH)2VD3-induced phosphorylation of p38 MAP kinase. These results strongly suggest that 1,25(OH)2VD3 stimulates the release of VEGF in aortic smooth muscle cells via p38 MAP kinase activation.

24,25-Dihydroxyvitamin D 3↗
PubMed2002

Spontaneous intramyocardial hematoma presenting as a rapidly expanding mass followed by echocardiography.

A50-year-old man with an intramyocardial mass was referred to us. He had undergone resection of both a coronary arterial aneurysm of unknown origin and a postinfarction left ventricular (LV) aneurysm 5 years before. Peak creatine kinase was slightly over the upper normal range, and an electrocardiogram revealed neither a new Q-wave nor an additional ST-segment change. Repeated two-dimensional echocardiography indicated rapid expansion of a heterogeneous mass in the posterior wall of the LV. The mass was intraoperatively diagnosed as intramyocardial hematoma without connection to the LV cavity. Via posterolateral thoracotomy with partial cardiopulmonary bypass, the outer layer of the hematoma was completely resected, and xenopericardium was applied with a continuous suture to cover the space which the hematoma had occupied. The patient made an uneventful recovery.

Cardiomyopathies↗
PubMed2002

Mitral regurgitation without supravalvular aortic stenosis in Williams syndrome.

Isolated mitral regurgitation without supravalvular aortic stenosis is rarely identified in Williams syndrome. We describe the case of a 24-year-old man with isolated mitral regurgitation in Williams syndrome. Severe regurgitation due to prolapse of the anterior leaflet was noted in an echocardiogram and color Doppler, and a left ventriculogram showed grade IV regurgitation. No pressure gradient between the left ventricle and the ascending aorta was found. Mitral regurgitation had been noted since his birth, and pediatricians suspected Williams syndrome because of postnatal growth deficiency, mental deficiency, unusual personality, and unusual facial features in his childhood. The diagnosis was confirmed by demonstration of the hemizygous deletion of 7q11.23 in the karyotype by the fluorescent in situ hybridization technique after his admission to our department. The patient underwent mitral valve replacement, and microscopic examination of the excised valve revealed myxomatous degeneration.

Adult↗
PubMed2002

Dielectric spectrogram for evaluating ischemic microstructural changes of the liver in simple cold preservation.

PURPOSE: Monitoring ischemic liver injury is important in liver transplantation. We previously reported that dielectric properties were correlated with tissue adenosine triphosphate during liver preservation; however, it is unknown what the changes in dielectric properties are based on. Using rats, we studied the relationship between dielectric parameters and microstructural changes in liver tissues during preservation. METHODS: We serially measured the percent decrease in conductivity and the percent increase in relative permittivity in rat livers, and determined the areas of cellular and extracellular components using a charge-coupled device microscope and an NIH image. Thereafter, we evaluated the relationship between dielectric parameters and microstructural changes in the liver tissues. RESULTS: A positive linear and exponential correlation was found between the percent decrease in conductivity and the percent decrease in extracellular components ( P < 0.01). A positive linear and exponential correlation was also found between the percent increase in relative permittivity and the percent increase in cellular components ( P < 0.01). CONCLUSIONS: Our results suggest that the serial changes in tissue conductivity and the relative permittivity reflect changes in liver tissue microstructures during cold preservation.

Animals↗
PubMed2002

Nondissecting aneurysm of the thoracic aorta with arteritis in systemic lupus erythematosus.

A nondissecting aneurysm of the distal descending thoracic aorta, 55 mm in diameter, in a 35-year-old woman who was undergoing 24-year steroid therapy of systemic lupus erythematosus was successfully resected and replaced with a tube graft. The suture line of the aortic wall was reinforced with a polytetrafluoroethylene felt strip. Histologically, the media and adventitia contained numerous lymphoplasmacytic infiltrates that consisted of B and activated T cells mixed with plasmacytes. These findings would have been in accordance with active aortitis. Systemic lupus erythematosus was suggested as possibly associated with nondissecting thoracic aortic aneurysm, especially in patients undergoing chronic steroid therapy in which inflammation continued.

Adult↗
PubMed2002

Cephalometric and fiberoptic evaluation as a case-selection technique for obstructive sleep apnea syndrome (OSAS).

In order to obtain relatively simple and useful parameters to estimate the severity of obstructive sleep apnea syndrome (OSAS), cephalometric and fiberoptic studies were performed in 64 clinical cases previously diagnosed with either OSAS or snoring. Fourteen cephalometric parameters, 13 parameters derived from physical examination and 18 fiberoptic parameters were compared with the apnea index (AI), the apnea-hypopnea index and lowest SaO2 values. Statistically significant correlations were found between the Al and the shortest linear distance from the posterior line of the soft palate to the posterior pharyngeal wall measured along a line parallel to the supramentale-Gonion line (PAS-epipharynx distance), the distance from the mandibular plane to the most anterior and superior point on the body of the hyoid bone obtained from cephalometry (MP-H distance) and the degree of redundancy of mucosa in the arytenoid/aryepiglottic fold obtained from videoendoscopy. An increased Al was observed when the PAS-epipharynx distance was < 7 mm and there was 100% obstruction in Muller's maneuver at the palate level (supine), the MP-H distance was > 27.4 mm and the mucosa of the arytenoid/aryepiglottic fold was markedly redundant. As these three parameters are relatively easy to obtain on an outpatient basis, it is suggested that they could be used in an outpatient setting to provide a good prediction of the severity of OSAS.

Adult↗
PubMed2002

Speech rehabilitation after total laryngectomy.

The outcome of speech therapy for 65 laryngectomees at Kitasato University Hospital is reported and what needs to be done in order to establish a better system for laryngectomee rehabilitation in Japan is discussed. Of the 65 patients, 53 were trained for both esophageal and electrolarynx speech, 8 for electrolarynx speech only and 4 for esophageal speech only. Of the 57 patients who were trained for esophageal speech, 38 continued the training for a period of > 6 months. Of these 38, 36 (94.7%) could produce one-syllable sounds at the first session. For the production of 5-6 syllables, a median of 6 sessions was necessary for the total laryngectomee group and 10 sessions were necessary for the pharyngo-laryngo-esophagectomee group but the difference was not significant. The study showed that for the production of a single esophageal sound the training period in our hospital was much shorter than that reported in other Japanese studies. Of the 65 patients, 27 (41.5%) acquired practical esophageal speech and 59 (90.8%) acquired either esophageal or electrolarynx speech. Six (9.2%) could not acquire any alaryngeal speech and this percentage was lower than that reported in other studies from Japan (12.5-33%) and from other countries (8.5-40%).

Aged↗
PubMed2002

Autologous transplantation of fascia into the vocal fold as a treatment for recurrent nerve paralysis.

OBJECTIVES: To apply the technique of autologous transplantation of fascia graft into the vocal fold for glottal insufficiency due to recurrent nerve paralysis and to evaluate the results in eight patients who underwent the procedure. STUDY DESIGN: Technical modifications were made in transplantation of the temporal fascia into the paralyzed vocal fold. Eight patients underwent the surgery, and their phonatory function was examined preoperatively and postoperatively. METHODS: The following surgical techniques were applied to prevent the falling-off of the graft: 1) a roll-shaped fascia graft was prepared before the transplantation and 2) a pocket was made within the lamina propria mucosa using a newly devised special elevator. The maximum phonation time and airflow rate during sustained phonation (in four cases) were measured, and perceptual evaluation of voice quality was made using the GRBAS scale by speech pathologists before and after the surgery. RESULTS: All the cases showed no evidence of falling-off of the graft. Elongation of the maximum phonation time and improvement in voice quality were obtained in all cases postoperatively. CONCLUSION: The method proved to be useful for the treatment of glottal insufficiency due to recurrent nerve paralysis.

Aged↗
PubMed2002

[Swallowing function after near-total laryngectomy, cricohyoidoepiglottopexy (CHEP), and cricohyoidopexy (CHP)].

We studied postoperative swallowing in 4 patients undergoing CHEP and 1 undergoing CHP. Swallowing was obtained by intense swallowing rehabilitation since only 1/4 of the larynx remained after near-total laryngectomy. Our swallowing rehabilitation program is detailed in this paper. The improvement of swallowing is classified into 3 stages. In stage I, volus directly intrudes into the trachea. In stage II, volus stagnates between laryngeal inlet and tracheal stoma. In stage III, volus directly flows through the esophageal inlet. Stage III indicates that rehabilitation is almost completed. Stage I is shortest at 2 to 14 days and Stage II longest at 7 to 80 days. The MTF (Method, Time, Food) score described by Fujimoto et al was used to analyze swallowing. Three cases following CHEP showed high scores shortly after the introduction of rehabilitation and reached the maximum score at discharge (15 points = normal swallowing). At present, these 3 patients are satisfied with swallowing and enjoy a good quality of life. In 2 other cases (1 CHEP and 1 CHP), both had a wide laryngeal inlet and still have some difficulty with liquids. Further modification of the surgical technique is needed especially for CHP.

Aged↗
PubMedDate not supplied

Helper T-cell type 1 or type 2 function of xeno-MHC-restricted T-cell clones in a direct xenoantigen recognition.

There have been several reports that xeno-MHC-restricted T-cells have a cytotoxic function through a direct xenoantigen recognition, but yet no report that they have a helper function. Previously we showed that both xeno-MHC-restricted CD4(+) and CD8(+) T-cells recognized xenoantigens directly in a mouse anti-rat combination. In this study, we investigated whether or not xeno-MHC-restricted T-cells had a helper function. Mouse T-cell clones recognizing rat antigens directly were derived from T-cell lines using the limiting dilution method. Phenotype, cytotoxic activity and cytokine production of these clones were analyzed by flow cytometry, 51Cr release assay and ELISA, respectively. Rat-MHC class I-restricted mouse CD8(+) T-cell clones showed a specific cytotoxic activity against rat antigens. One CD4(+) clone produced IL-4 and IL-10, and the other CD4(+) clone produced not T-helper (Th) 2 cytokine but TNF-alpha. Our results suggested that xeno-MHC class I-restricted CD8(+) T-cells should have a cytotoxic function, and xeno-MHC class II-restricted CD4(+) T-cells should have either Th1 or Th2 function.

Animals↗
PubMedDate not supplied

Nonviral gene gun mediated transfer into the beating heart.

Several techniques for gene transfer into the heart have been developed, including direct injection of naked plasmid DNA into the myocardium and coronary infusion of various viral vectors. However, complications and side effects with those methods have been reported. In this study, to resolve these problems, the authors investigated the feasibility of nonviral gene transfer into the beating heart with the hand held gene gun. The genes pCAGGS/CTLA4-EGFP were coated around the surface of gold particles. Three sizes of gold particles (0.6, 1.0, and 1.6 microm in diameter) and three settings of helium gas pressure (200, 250, and 300 psi) were examined. Gene transfer into the rat beating heart was performed using the hand held gene gun. EGFP expressions were detected by fluorescence microscopy from day 1 to 3 weeks after bombardment. The most prominent expressions were detected with the combination of 1.0 microm gold particles and 300 psi helium gas pressure. In this study, the present authors showed that non-viral gene transfer into the beating heart was feasible with the hand held gene gun. This technique is effective for gene transfer into the heart and may be one of the most useful methods for gene therapy for many cardiovascular diseases in the future.

Animals↗