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Biomedical subjects

J Hayashi

Publications and source records attributed to J Hayashi.

At least 235 records · Page 13Linked to original sources
PubMed1995

[A case of toxoplasmosis with dermatomyositis].

We report a case of dermatomyositis (DM) in a 15-year-old female with toxoplasmosis after ingestion of raw bovine liver. Facial erythema and cervical lymphadenopathy preceded myalgia and muscle weakness of the extremities. The diagnostic criteria of DM was fulfilled because of symmetrical and proximal dominant muscle weakness, elevation of myogenic enzyme (CPK, GOT, LDH, myoglobin, aldorase), myogenic pattern of electromyogram, skeletal muscle biopsy showing interstitial myositis with mild destruction of muscle fiber, and facial erythema. Immunological findings showed IgG anti-toxoplasma antibody to be 1340 IU/ml and IgM to be 7.0 (Cut off index 0.7), suggesting acute toxoplasmosis. Treatment with prednisolone for DM and acetylspiramycin for toxoplasmosis was successful. Toxoplasmosis should be considered as a possibility in patients with myositis.

Adolescent↗
PubMed1995

[An autopsy of an HIV infected patient with dilated cardiomyopathy (DCM)].

A case of a HIV infected 61-year-old bisexual male with dilated cardiomyopathy (DCM) is reported. The death was originally recorded as from undetermined causes, but on autopsy, his heart showed left ventricular dilatation macroscopically, variety in size and vacuolation of cardiomyocyte, partial deciduation of cardiac muscle and diffuse perivascular fibrosis microscopically. These findings were compatible with DCM which was compounded by excessive weight loss. The further data indicated that the etiology of DCM in this case was directly related to the HIV infection.

Cardiomyopathy, Dilated↗
PubMed1995

[Evaluation of three kinds of assays for the presence of antibody to hepatitis C virus (anti-HCV) and the association of them with HCV RNA].

In order to evaluate the feasibility for the detection of antibody to hepatitis C (anti-HCV), the first generation assay (c100-3 Ab) and two second generation assays (2nd EIA and 2nd PHA) were used to test 477 individuals who visited the medical hospital or clinics in Iki Island, Nagasaki Prefecture. HCV RNA, antibody titer by 2nd PHA and four kinds of antibody to epitope of HCV by RIBA II were also surveyed to determine their association with these three assays. Prevalence of anti-HCV was 26.6% by c100-3, 38.8% by 2nd PHA and 39.6% by 2nd EIA, indications that the 2nd generation assays are much more sensitive than c100-3. Prevalence of HCV RNA was 82.1% among 190, anti-HCV positive individuals; 100% among 52 individuals with liver disease, but only 75.4% in those without liver disease. HCV antibody titer, over 2(11) was higher among those who were positive for HCV RNA than those negative for HCV RNA. Four antibodies by RIBA II were all positive and reacted strongly when they were positive for HCV RNA, but only antibody to core antigen was observed among those negative for HCV RNA, suggesting that only antibody to core antigen remains in those with past HCV infection.

Adolescent↗
PubMed1995

[Evaluation of immunochromatography assay technique for detection of antibody to hepatitis B surface antigen (HBsAg)].

A new immunochromatography assay (Dainascreen Ausab Dainabot) has been recently introduced for the detection of the presence of antibody to HBsAg. To evaluate the feasibility of using the Dainascreen Ausab, we carried out comparison tests with this method and PHA. In the test of 439 sera from HB vaccinees, inhabitants in Iki Island, Nagasaki Pref., patients with autoimmune diseases and with acute hepatitis B, 154 (31.2%) were positive by Dainascreen Ausab, 145 (29.4%) were positive by PHA and 145 (29.4%) were positive by both Dainascreen Ausab and PHA. Nine (1.8%) were positive by only Dainascreen and there were none positive by only PHA. A good correlation was observed between the titer of the antibody by this method and IMx. The anti-HBs assay by this method was able to be completed within 15 minutes and the procedure was very simple. The results indicate that the sensitivity of Dainascreen is superior to PHA and that it is easy to use.

Chromatography, Thin Layer↗
PubMed1995

[Clinical analysis of 14 patients with anti-myeloperoxidase antibody positive rapid progressive glomerulonephritic syndrome].

We investigated the clinical features and outcome of 14 patients with anti-myeloperoxidase antibody (MPO-ANCA) positive rapidly progressive glomerulonephritic syndrome. Underlying diseases included microscopic polyarteritis in 6 patients, idiopathic crescentic glomerulonephritis with lung hemorrhage in 2 patients, idiopathic glomerulonephritis in 3 patients, rapidly progressive glomerulonephritic syndrome without renal biopsy in 1 patient, crescentic glomerulonephritis associated with Sjögren syndrome and progressive systemic sclerosis in 1 patient and crescentic glomerulonephritis associated with sarcoidosis in 1 patient. Five patients were male (mean age, 59.2 years) and 9 were female (mean age, 54.0 years). On admission, most patients had anemia, leukocytophilia, and marked elevation of C-reactive protein (CRP). Average hemoglobin, white blood cell count and CRP levels on admission were 8.1 mg/dl, 11,500/mm3 and 14.7 mg/dl, respectively. Average serum creatinine was 4.0 mg/dl. All patients were treated with steroids either with or without cyclophosphamide. As the patients recovered clinically, the MPO-ANCA titers declined. Although most patients responded well to immunosuppressive therapy, some died of serious complications (such as acute respiratory distress syndrome, fungal infection, and pneumocystis pneumonia). The prognosis of patients with severe renal failure was especially poor. We conclude that early diagnosis, treatment and intensive care during immunosuppressive therapy are very important in the management of MPO-ANCA-positive rapidly progressive glomerulonephritis.

Adolescent↗
PubMed1995

Transmission of hepatitis C virus by health care workers in a rural area of Japan.

OBJECTIVE: The prevailing route of hepatitis C virus (HCV) transmission in Japan is unclear, so we expected that a survey of routes of HCV infection in an endemic area might clarify the mode of transmission. METHODS: We screened 2049 inhabitants in an isolated rural village of Fukuoka, Japan using HCV markers. All serum samples were assayed for antibody to HCV (anti-HCV) (ELISA), and anti-HCV-positive samples were assayed for HCV RNA and genotype (polymerase chain reaction). RESULTS: The prevalence of anti-HCV was 19.7% and increased with advancing age, from zero in the under 19 yr of age group to 30.7% in the 60-69 yr of age group. HCV RNA was detected in 82.9% of the anti-HCV-positive inhabitants, and 88.3% of them had genotype II. Anti-HCV was detected in 17.8% of the children of HCV-carrier mothers, similar to the rate (15.4%) for all inhabitants in the 40-49 yr of age group, the same age group for the mean age of the anti-HCV-positive children. Anti-HCV was detected in 34.8% of husbands of female HCV carriers and in 22.2% of wives of male HCV carriers, similar to the rates (36.2% in males and 26.6% in females) for all inhabitants in 60-69 yr of age group, the same age group for the mean ages of carriers' spouses. The prevalence of anti-HCV was the highest in inhabitants of one of three distinct areas of this village where patients had often been injected with insufficiently sterilized syringes and needles for treatment in the same clinic. CONCLUSION: These observations suggest that medical intervention probably played a more important role in the spread of the HCV infection in the village studied than did familial transmission.

Adult↗
PubMed1995

Human T-lymphotropic virus type-I, and hepatitis A, B and C viruses in Nepal: a serological survey.

In 1987, 676 blood samples were collected from inhabitants of the Bhadrakali and Kotyang villages in Nepal. The samples were tested for the prevalence of antibody to hepatitis A virus (anti-HAV), hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), second-generation antibody to hepatitis C virus (anti-HCV) and antibody to human T-lymphotropic virus type-I (anti-HTLV-I). Anti-HAV was present in 99.3% of the people surveyed. The prevalence of anti-HAV reached 100% in the < 25 age group and was as high or only slightly lower in all other age groups. The prevalence of HBsAg was 0.3% and of anti-HBc 7.7%. Anti-HCV was found in 0.1% of the residents. No significant difference by gender or village was noted in the prevalence of anti-HAV, HBsAg, anti-HBc, or anti-HCV. No anti-HTLV-I-positive persons were identified. These data suggest that the prevalence of hepatitis B and C virus infections in Nepal is low in contrast to hepatitis A virus infection, and that human T-lymphotropic type-I infection may be absent in this population.

Adolescent↗
PubMed1995

[Cabrol's operation and the aortic arch replacement for Stanford type A dissecting aortic aneurysm].

Replacement of the aortic arch was performed simultaneously with Cabrol's operation utilizing modified selective cerebral perfusion (SCP) in a patient with a Stanford type A dissecting aortic aneurysm. Preoperative arteriography revealed that the dissection involved both common carotid arteries. For this reason, antegrade SCP was performed via the branches attached to the composite graft which were anastomosed to both of the common carotid arteries following clamping under deep hypothermia. The operation was successfully performed, and the patient's postoperative recovery was uneventful. This method of SCP is useful in the treatment of patients with prior difficulty or risk of cannulation.

Adult↗
PubMed1995

[Surgical treatment of 22 primary cardiac myxomas].

We report surgical treatment of 22 patients with primary cardiac myxomas, including 17 left atrial (LA), 3 right atrial (RA), 1 left ventricular and 1 right ventricular myxomas. Eighteen patients manifested congestive heart failure, and an embolic episode was observed in 5 patients preoperatively. Inflammatory laboratory findings were observed in 16 patients. One case of RA myxoma was complex cardiac myxoma. A transverse biatrial approach was useful for removal of large LA myxomas and when the attachment of the tumor was unconfirmed preoperatively. There were no hospital deaths. Stroke occurred in 1 and supraventricular arrhythmia in 3 patients in the early postoperative period. There were 2 late deaths unrelated to cardiac myxomas. No signs of recurrence have been observed.

Aged↗
PubMed1995

A preliminary study of retreatment of chronic hepatitis C with interferon.

Nine patients with chronic hepatitis C virus (HCV) infection and no complete response to the first treatment with natural interferon (IFN)-alpha, were prescribed a second treatment with IFN. Five patients (Group A) with unsustained levels serum alanine aminotransferase (ALT) after the first treatment were administrated the same species of IFN but in a higher dose. The remaining four patients (Group B), with no normalization of ALT throughout the observation period of the first treatment, were administrated IFN-beta. HCV RNA was eliminated in three patients of group A and in two of group B patients during 6 months follow up and ALT reverted to normal levels. These results suggest that retreatment with a higher dose of the same species of IFN-alpha can be effective in case of a relapse and that IFN-beta can be effective for those not responding to IFN-alpha.

Adult↗
PubMed1995

[Mechanism of the radiolucence around the implant after hip prosthetic replacement].

After hip prosthetic replacement, a progressive enlargement in the radiolucent area has often been observed around the implant, leading to loosening of the prosthesis. The purpose of this study was to investigate the mechanism of the radiolucent area formation. Radiolucent areas can be classified into either linear type or the erosive type, and these two types were compared histologically and biochemically. Interface membranes were obtained from patients at the time of surgery for revision of either cemented THA or cementless bipolar endprosthetic replacement. Histological specimens were stained by H.E., tartrate-resistant acid phosphate, and by the immunohistochemical reagents anti-macrophage antibody (CD 68), anti-T-lymphocyte (CD 3, CD 4, CD 8, CD 43), anti-interleukin-1 beta polyclonal antibody, anti-interleukin-6 polyclonal antibody, and anti-tumor necrosis factor-alpha polyclonal antibody. Biochemically, interleukin-1 beta, IL-6, IL-8, TNF-alpha were assayed by ELISA in the supernatant of homogenized samples and in organ culture media. Prostaglandin E2 was assayed by radioimmunoassay. The interfaces of the erosive type contained more debris (cement, high density polyethylene and metal), macrophages and multinucleated giant cells than the linear type. The interfaces of the linear type showed mainly fibrosis and necrosis. The levels of IL-6 and IL-8 in the homogenates and culture media from the erosive type were significantly higher than those from the linear type. We concluded that the bone resorption around the implant after hip prosthetic replacement occurred by two different pathways. One pathway involved the stimulation of macrophages by various debris and micromovement to form foreign body granulomas, which produced cytokines, prostaglandin E2 and metalloproteinase to resorb bone. The erosive type would arise from this pathway. The other possible mechanism involved a biomechanically unstable implant which caused bone necrosis probably by mechanical stress. The linear type may arise from this pathway.

Bone Resorption↗
PubMed1995

[Changes in the acetabular roof produced by Chiari pelvic osteotomy].

In order to clarify the changes seen in the new acetabular roof produced by Chiari pelvic osteotomy, we performed histological investigations post-operatively, as well as arthrography and arthroscopy before and after the operation. Plain X-rays showed an osseous step between the original surface and the new acetabular roof. Arthrography demonstrated no step between the original acetabular cartilage and the surface of the newly formed acetabular roof. At arthroscopy, the surface of the new acetabular roof could be seen to be covered by a soft white tissue. Histological specimens were taken from the new acetabular roof. Examination revealed that the superficial layer consisted of some oval shaped cells with an extracellular matrix slightly stained by safranin O, but not by anti-human type II collagen antibodies. In the deepest layer, there was cartilage tissue consisting of cartilage-like cells and an extracellular matrix which was stained by safranin O and by anti-type II collagen antibodies. However, the staining intensity of this cartilage tissue was less than that of hyaline cartilage, and the direction of collagen fibers could be clearly seen. These results suggested that the tissue covering the new acetabular roof had no ability to change into hyaline cartilage, despite the superficial layer creating a smooth surface. It was suggested that the bony modification of the new acetabular roof resulted from enchondral ossification of the deepest layer.

Acetabulum↗
PubMed1995

Direct visualization of atherosclerosis in small coronary arteries using the epifluorescence stereoscope.

OBJECTIVE: To visualize specifically at the beating heart surface atherosclerosis in small coronary arteries using the photosensitiser, mono-L-aspartyl chlorin e6 (NPe6). METHODS: Cholesterol-fed atherosclerotic rabbits were injected intravenously with 2.0 mg/kg of NPe6. Atherosclerosis was visualized by allowing NPe6 to accumulate in atheromatous plaques, and then used as a potent fluoroprobe to illuminate atherosclerotic coronary arteries upon excitation by light. An epifluorescence stereoscope system was used to visualize atherosclerosis in small coronary arteries. RESULTS: Although it was unable to specify the parts of the coronary arteries which had atherosclerotic changes under room light with the naked eye, several brightly illuminated branching small coronary arteries were observed clearly against the dark heart surface through the epifluorescence stereoscope, as an exciting mercury blue light beam was used to irradiate the beating heart. A fluorescence micrograph of the coronary artery, at which orange-red fluorescence was seen through the epifluorescence stereoscope, showed that the atheromatous plaques emitted orange-red fluorescence. CONCLUSIONS: The presence and extent of small coronary atherosclerosis were demonstrated in the beating heart. Such information may help assess the clinical significance of atherosclerosis in small coronary arteries.

Animals↗
PubMed1994

Functional and morphological abnormalities of mitochondria in human cells containing mitochondrial DNA with pathogenic point mutations in tRNA genes.

mtDNA with a point mutation in the tRNA(Ile) gene at nucleotide position 4269 found in a patient with fatal cardiomyopathy and mtDNA with a point mutation in the tRNA(Arg) gene at 10410 found in a patient with Alpers disease were transferred cytoplasmically to rho zero HeLa cells (HeLa cells lacking mtDNA) to determine whether these novel mtDNA mutations in the tRNA genes are responsible for the defects in mitochondrial respiration function observed in these diseases. Cybrid clones (clones of rho zero HeLa cells with mtDNA from the patients) were isolated, and respiratory function and morphology of the mitochondria of the cybrid clones containing wild-type mtDNA and mutant mtDNA predominantly were compared. The results showed that accumulation of mutant mtDNA at 4269 alone without defects in the nuclear genome was sufficient to produce a disease phenotype, while mutant mtDNA at 10410 was not related to pathogenesis and reflected one of the rare polymorphic sites of human mtDNA. Moreover, we found that mitochondria in living cells were significantly swollen only when they contained predominantly the pathogenic mutant mtDNA, suggesting that the functional abnormality of mitochondria induced by pathogenic mtDNA mutations in tRNA genes is always associated with their swollen structure.

Cardiomyopathies↗
PubMed1994

Nuclear but not mitochondrial genome involvement in human age-related mitochondrial dysfunction. Functional integrity of mitochondrial DNA from aged subjects.

The role of mtDNA and nuclear genome in human aging was examined by their intercellular transfer using skin fibroblasts and mtDNA-less HeLa cells (rho o-HeLa cells). We found in vivo age-related reductions in the activity of cytochrome c oxidase in human skin fibroblasts obtained from 16 donors of various ages (0-97 years). The abnormality in mitochondria of the aged donors was not attributable to either decrease in the copy number of mtDNA molecules or increase in the copy number of deletion mutant mtDNA molecules, but to significant decrease in overall polypeptide synthesis in the mitochondria. However, intercellular mtDNA transfer experiments showed that fibroblast mtDNA from elderly donors is functionally intact. By contrast, intercellular transfer of HeLa nuclei to fibroblasts from aged donors restored cytochrome c oxidase activity, suggesting that the age-related phenotype was nuclear recessive. However, during subsequent cultivation of these hybrids, the activity gradually reduced again, associated with gradual chromosome loss. These observations support the idea that accumulation of nuclear recessive somatic mutations, but not mtDNA mutations, is responsible for the in vivo age-related mitochondrial dysfunction observed in human skin fibroblasts.

Aged↗
PubMed1994

Combined warfarin and antiplatelet therapy after St. Jude Medical valve replacement for mitral valve disease.

OBJECTIVES: The clinical effect of combined warfarin and antiplatelet therapy on the incidence of stroke and postoperative complications after mitral (plus aortic) valve replacement was studied and compared with that observed with warfarin therapy alone. BACKGROUND: It has been reported that combined warfarin and antiplatelet therapy may be effective but may be associated with an increased hemorrhagic risk. Therefore, definite benefits of the treatment in patients with an implanted prosthetic valve have not been clearly documented. METHODS: Between January 1980 and December 1992, 195 patients with a St. Jude Medical valve at the mitral (plus aortic) position were assigned to receive treatment with either warfarin alone (125 patients) or warfarin plus antiplatelet agents (70 patients), such as dipyridamole (150 or 300 mg daily, 14 patients) or ticlopidine (200 or 400 mg daily, 56 patients). A minimal dose of aspirin (10 to 40 mg) was added (29 patients) if the maximal platelet aggregation rate by collagen was not reduced. The target thrombotest level was 10% to 20%. RESULTS: The two treatment groups were similar with regard to gender and age distribution. The number of patients with atrial fibrillation, left atrial thrombus, history of previous stroke, simultaneous aortic valve operation and previously performed valve procedures were comparable in the two groups. Actuarial survival rate at 10 years was 98.3 +/- 1.7% (mean +/- SD) in the warfarin plus antiplatelet group and 90.3 +/- 3.2% in the warfarin group (p < 0.05 at 1 and 9 to 12 years). The actuarial stroke-free rate at 10 years was 95.3 +/- 3.4% and 84.3 +/- 3.8%, respectively (p < 0.05 by the generalized Wilcoxon test). The actuarial complication-free rate at 10 years was 89.4 +/- 4.3% and 67.9 +/- 4.8%, respectively (p < 0.05 by the generalized Wilcoxon test). No hemorrhagic complications were seen in the warfarin plus antiplatelet group. CONCLUSIONS: The results strongly indicate the effectiveness and safety of combined warfarin plus antiplatelet treatment after St. Jude Medical valve replacement for mitral (plus aortic) valve disease.

Actuarial Analysis↗
PubMed1994

Detection of hepatitis C virus RNA in the ultrasonic dissector irrigating solution used in liver surgery.

Hepatitis C virus (HCV) RNA was detected in the irrigating solution aspirated by the ultrasonic dissector system used in liver surgery with a reverse transcription polymerase chain reaction technique and was then compared with HCV RNA in the serum to clarify the risk of viral transmission to hospital personnel. The positivity of HCV RNA in the aspirated irrigating solution was approximately equal in all patients whose serum was positive for HCV RNA. However, viral RNA was not detected in the aspirated irrigating solution of any patient who was seronegative for HCV RNA. These results indicate that it is necessary to be cautious regarding the transmission of HCV during liver surgery when using the ultrasonic dissector in HCV RNA seropositive patients, because the irrigating solution aspirated by this device appears to be highly infectious.

Aged↗