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Biomedical subjects

J Hayashi

Publications and source records attributed to J Hayashi.

At least 379 records · Page 21Linked to original sources
PubMed1989

[A successful biventricular assist for postoperative patient with severe heart failure and hepatorenal dysfunction after mitral and tricuspid valve surgery].

We report a case of successful biventricular assist for severe heart failure after open heart surgery. A 62-year-old man suffering from advanced valvular disease accompanied with hepatorenal dysfunction underwent mitral valve replacement and tricuspid annuloplasty on September 22, 1988. Because of inability of weaning from cardiopulmonary bypass, left heart assisted circulation using a roller pump with heparin-coated tubing system was inserted. Following the left heart assist, an right ventricular assist device (RVAD) was subsequently applied to intractable right ventricular failure. He was successfully weaned from an RVAD after 24 hours, and from left heart assisted circulation after 46 hours. At present, he is doing well without significant complications. Earlier application of biventricular assist might be effective for biventricular failure with hepatorenal dysfunction.

Cardiac Output, Low↗
PubMed1989

[Angioplasty of the left main coronary artery--report of a case with left main coronary stenosis and aortic valve stenosis].

A 58-year-old woman was admitted to our hospital suffering from repeated chest pain. Selective coronary angiography (CAG) showed severely stenotic lesion in the left main coronary artery. There was no additional lesion in the left anterior descending and circumflex arteries. Aortography showed severe calcification in the aortic valve. The aortic was incised and divided completely at the aortic root 1 cm distal to the aortic valve. The incision was then extended toward the opening of the left coronary artery. An atheromatous plague was found and resected at the ostium. A saphenous vein patch was used to enlarge the internal diameter of the artery. The aortic valve was replaced using #21 SJM prosthetic valve. The patient recovered the surgery well, and anginal attacks have disappeared. Postoperative coronary angiograms revealed no stenotic lesion in the left main coronary artery.

Aortic Valve Stenosis↗
PubMed1989

[Myocardial infarctectomy in the acute stage].

Seven patients with ventricular septal perforation or left ventricular free-wall rupture underwent myocardial resection in the acute stage of myocardial infarction. One of them received direct closure of the left ventricle, and the others replacement of myocardium with a Dacron prosthesis. One patient died of cardiac failure 5 days after surgery, and 4 in the late-stage between 2 months and 4 years. The following conclusions are obtained in our patients: 1. Echocardiography is very important for the diagnosis of cardiac free-wall rupture and determination of emergency surgery. 2. An intra-aortic balloon should be inserted in patients with VSP as soon as possible. If general state of the patients had been improved by the procedure, surgery might be withheld until the recovery, otherwise emergency surgery should be considered. 3. Myocardial replacement with a prosthesis seems to be useful when the left ventricular cavity is predicted to be small after resection of the myocardium. 4. The development of assisted circulation would improve a survival rate after the surgery. 5. Systemic managements are also important because the patients sometimes become fatal by non-cardiac complications even if they have survived from circulatory failure.

Aged↗
PubMed1989

Hepatitis B virus infection among mentally retarded patients in institutions, Okinawa, Japan.

To determine whether transmission of hepatitis B virus occurs among mentally retarded patients in six institutions, from 1986 to 1988, 373 patients (males 203, females 170, 18-53 years of age, mean age 29.9) were tested for hepatitis B markers. Seventy five of them had Down's syndrome. Overall prevalences were 9.1% for hepatitis B surface antigen (HBsAg), 39.7% for antibody to HBsAg (anti-HBs) and 48.0% for antibody to hepatitis B core antigen (anti-HBc). Prevalence of HBsAg was significantly higher in patients with Down's syndrome than in other mentally retarded patients. Five patients (three males and two females) in four institutions were infected with hepatitis B virus during the two years of observation. Four of these five patients were the other mentally retarded and became both anti-HBs and anti-HBc positive. The remaining one, who was 29 years old and Down's syndrome, became an HBsAg carrier. These observations indicate that hepatitis B virus transmission frequently occurs among mentally retarded patients in institutions and therefore vaccination of susceptible institutionalized patients is necessary. Vaccination to patients with Down's syndrome is particularly warranted, because they are uniquely predisposed to develop chronic hepatitis B infection following exposure.

Adolescent↗
PubMed1989

[Late clinical results of prosthetic valve replacement undergone more than ten years ago].

We evaluated late clinical results of 207 hospital survivors, who underwent prosthetic valve replacement from Dec. 1965 to May 1979 for acquired valvular heart diseases. The study group consisted of 134 patients with MVR (46 S-E non cloth covered (SENM), 56 S-E cloth covered (SECM), 16 Björk-Shiley (BSM), 16 Carpentier-Edwads (CEM)), 47 with AVR (21 S-E non cloth covered (SENA), 15 S-E cloth covered (SECA), 11 Björk-Shiley (BSA)) and 26 with combined aortic and mitral valve replacement using S-E non cloth and/or cloth covered ball valves. Actuarial analysis (Kaplan-Meier) revealed ten year survival rate was 85.1 +/- 5.6% in SENM, 77.1 +/- 5.8% in SECM, 85.7 +/- 9.4% in BSM, 77.8 +/- 11.4% in CEM, 79.2 +/- 9.3% in SENA, 71.8 +/- 12.0% in SECA, 90.9 +/- 8.7% in BSA and 53.1 +/- 10.4% in combined valve replacement group. Survival rate of combined valve replacement group was significantly lower than other groups (p < 0.05). Also, ten year reoperation free rate was 100% in BSM and BSA, 87.1 +/- 5.4% in SENM, 91.3 +/- 4.2% in SECM, 61.5 +/- 13.5% in CEM, 90.2 +/- 6.6% in SENA and 77.1 +/- 11.7% in SECA. Reoperation free rate of CEM group was significantly lower than other mitral groups (p < 0.05). Immature cardiac protection during anoxic arrest and unestablished anticoagulant therapy for implanted prosthetic valves in those days might increased mortality and morbidity in S-E groups.

Actuarial Analysis↗
PubMed1989

[Combined valvular and coronary artery surgery].

Combined valvular and coronary surgery were performed on 9 patients between 1973 and 1986. Valve replacements were consist of 5 AVR (including 1 translocated AVR and 1 Bentall operation), 2 MVR and 2 double valve replacement. Coronary surgery were of 6 aorto-coronary bypass using great saphenous veins, 1 innominate artery-coronary bypass using a Dacron prosthesis, 1 punch-out of coronary ostium and 1 dilatation of the left coronary ostium with a vein patch. Retrograde infusion of cardioplegic solution from the coronary sinus were done in patients with coronary ostial stenoses. One emergency case with acute cardiac failure died immediately after operation, and one with double valve and one with mitral valve replacement died of hepatic failure and multiple organ failure respectively within 1 year after surgery. Combined valvular and coronary surgery are necessary for patients with both diseases. Although the results of double valve replacement were not satisfactory, they would be improved using intra-aortic balloon pump and ventricular assist devices actively.

Adult↗
PubMed1988

Control of angiotensinogen production by H4 rat hepatoma cells in serum-free culture.

A serum-free, hormone and attachment factor supplemented culture for rat H4 hepatoma cells was established. In the defined medium (Dulbecco's Modified Eagle's + Ham's F12 + insulin, transferrin, fibronectin liver cell growth factor, and sodium selenite), H4 cells grew equally well as in 10% fetal bovine serum supplemented medium. H4 cells in either defined or serum-containing culture conditions produce transferrin but not albumin or alpha-fetoprotein. In this paper we have studied the effect of various hormones and pressor peptides on the production of angiotensinogen by H4 cells cultured in defined conditions. Only glucocorticoid hormone had a significant effect on the production of angiotensinogen, whereas other hormones previously reported to exert their effect on angiotensinogen production had little or no effect.

Angiotensin I↗
PubMed1988

A cloned rat thymic epithelial cell line established from serum-free selective culture.

A serum-free system has been developed for selective growth and long-term culture of rat thymic epithelial cells. The growth media is a modification of McKeehan's WAJC 404, plus insulin, cholera toxin, dexamethasone, and epidermal growth factor. Cultures have been continuously passaged and maintained for over 6 mo., and a cloned cell line, TEA3A1, has been established. These cells are epithelial, judging by morphology and ultrastructure, and are positive for A2B5 and thymosin alpha 1 markers for thymic endocrine cells.

Animals↗
PubMed1988

Hepatitis B virus DNA polymerase activity and hepatitis B e antigen (HBeAg)/anti-HBe status among type B chronic liver diseases.

To investigate the relationship between hepatitis B virus (HBV) replication and chronic liver disease, age-specific prevalences of HBeAg, anti-HBe, and HBV DNA polymerase (DNAP) activity were studied in 295 asymptomatic HBV carriers and 183 patients with B-type chronic liver diseases. DNAP activity decreased with age, and there was no difference in the overall prevalence of DNAP activity between the asymptomatic carriers (27.8%) and the chronic liver disease patients (27.3%). The prevalence of DNAP activity in the 40-and-over age group was significantly higher for the chronic liver disease patients (17.5%) than for the asymptomatic carriers (1.7%). The prevalence of HBeAg in the 40-and-over age group was also significantly higher for the chronic liver disease patients (33.8%) than for the asymptomatic carriers (2.6%). These data suggest that viral replication decreased with age and that viral replication occurring in older persons closely related to chronic liver disease.

Age Factors↗
PubMed1988

Comparison of results of recombinant and plasma-derived hepatitis B vaccines in Japanese nursery-school children.

Results obtained with a recombinant hepatitis B vaccine were compared with those obtained with a plasma-derived hepatitis B vaccine in separate studies conducted in nursery schools in which at least one child had hepatitis B e antigen associated with surface antigen. Recombinant vaccine (5 micrograms), made in Japan and prepared from antigen expressed in yeast, was given to 118 children (aged 0-5 years of age, mean age 2.9 years). Plasma-derived vaccine (10 micrograms) was given to 243 children. Side-reactions were not observed with either vaccine. Seroconversion rates for the recombinant vaccine group were 8.5% after 1 month, 98.3% after 9 months and 100% after 12 months. For the plasma-derived vaccine group, the rate after 1 month was 26.3% after 9 months 82.3%, and after 12 months 77.9%. Although in the recombinant vaccine group the immune response developed more slowly during the early phase, seroconversion rates were significantly higher than in the plasma-derived vaccine group after 6 months. Titres of antibodies also were significantly higher in the recombinant vaccine group after the third injection. None of the children in either group became infected with hepatitis B virus. These results confirm the high immunogenicity, safety and efficacy of the recombinant vaccine given to these nursery school children.

Carrier State↗
PubMed1988

Central attenuation of baroreflex by angiotensin II in normotensive and spontaneously hypertensive rats.

To determine whether angiotensin II (A II) can modify baroreflex centrally and contribute to the central resetting of baroreflex in spontaneously hypertensive rats (SHRs), the aortic depressor nerve (ADN) was electrically stimulated following intracerebroventricular (ICV) administration of A II and/or A II analog in urethane-anesthetized normotensive Wistar rats (WKYs) and SHRs. Electric stimulation of the ADN elicited frequency-dependent depressor, bradycardic, and sympatho-inhibitory responses. Angiotensin II, administered ICV, dose-dependently attenuated these responses induced by ADN stimulation in normotensive rats. We found, however, these attenuations could be abolished by ICV pretreatment with A II analog. Vasopressin (ICV) did not change any responses to ADN stimulation. The vasopressor and sympatho-inhibitory responses to ADN stimulation were significantly less in SHRs when compared with those in WKYs: In SHRs, A II analog completely cancelled the A II-attenuated responses to ADN stimulation. These findings suggest that A II can centrally attenuate baroreflex, which might be independent from vasopressin, and in the brain A II can contribute to the central resetting of baroreflex in SHRs.

Angiotensin II↗
PubMed1988

Central attenuation of baroreflex precedes the development of hypertension in DOCA-salt-treated rats.

To determine whether baroreflex is changed centrally before the development of hypertension in DOCA-salt treated rats, aortic depressor nerve was stimulated electrically 5 days after DOCA-salt treatment in urethane-anesthetized rats: compared with those of sham-operated control rats, blood pressure was not elevated in either awake or anesthetized rats. Aortic depressor nerve (ADN) stimulation elicited frequency-dependent vasodepressor, bradycardiac, and sympatho-inhibitory responses in both DOCA-salt-treated and control rats. However, the responses to ADN stimulation were significantly smaller in DOCA-salt-treated rats. These findings suggest that baroreflex is attenuated centrally before the development of hypertension and this attenuation may contribute to the pathogenesis of DOCA-salt hypertension.

Animals↗
PubMed1988

Increased extracellular concentration of norepinephrine in the hypothalamus by sinoaortic denervation.

To determine whether baroreflex can affect the norepinephrine system in the hypothalamus, the extracellular concentration of norepinephrine were measured by the brain dialysis technique in sinoaortic denervated rats (SAD). Twenty-four hours after sinoaortic denervation, systolic blood pressure and heart rate were significantly elevated, and norepinephrine concentration in perfusate of the posterior hypothalamus was significantly higher in SAD rats than in sham-operated rats. These results suggest that baroreflex could modify the activity of noradrenergic neuron projecting to the posterior hypothalamus.

Animals↗
PubMed1988

Changing pattern of intrafamilial transmission of hepatitis B virus in Okinawa, Japan.

To investigate the pattern of intrafamilial spread of hepatitis B virus, the authors conducted a seroepidemiologic survey of nursery school children aged 1-5 years as well as family studies of the hepatitis B surface antigen (HBsAg)-positive children found in the survey in 1980 and 1985 in the Yaeyama district of Okinawa, Japan. The data from these family studies were compared with data from the studies conducted in 1968-1980 in the same area. Although the prevalence of HBsAg was not different for 1980 (eight of 847 children, 0.9%) and 1985 (13 of 1,355 children, 1.0%), prevalence of antibody to hepatitis B core antigen was significantly higher in 1980 (3.3%) than in 1985 (1.7%). Families were divided into four groups by the HBsAg status of the parents. In 1968-1980, families in which both parents were HBsAg-negative were most prevalent (64 of 107 families, 59.8%), followed by families in which only the mother was HBsAg-positive (17 of 107 families, 15.9%). In 1980, families in which only the mother was HBsAg-positive were most prevalent (11 of 25 families, 44.0%) and became more prevalent in 1985 (nine of 12 families, 75%). These data suggest that in the area studied, hepatitis B virus infections among children have declined over a five-year period and that mother-to-child transmission may be a main route of intrafamilial transmission in recent years.

Carrier State↗
PubMed1988

An epidemiologic study of effects of alcohol in the liver in hepatitis B surface antigen carriers.

A total of 932 hepatitis B surface antigen (HBsAg) carriers and 1,704 HBsAg-negative inhabitants of the Yaeyama District of Okinawa, Japan, over age 20 years were investigated in 1982-1985 in order to elucidate whether an interaction between habitual alcohol intake and hepatitis B virus infection is capable of producing liver disease. All of the subjects were tested for biochemical liver functions and asked about their habitual intake of alcohol. HBsAg carriers were tested for hepatitis B e antigen (HBeAg) and antibody to HBeAg. Subjects were ranked into three categories by alcohol consumption: nondrinkers, light drinkers (1-59 g/day), and heavy drinkers (greater than or equal to 60 g/day). The prevalence of liver abnormalities in HBsAg carriers increased with alcohol consumption. The prevalence differed significantly between nondrinkers and light drinkers in HBsAg carriers (p less than 0.001), but not in HBsAg-negative inhabitants. Prevalence also differed significantly between nondrinkers and heavy drinkers irrespective of HBsAg positivity (p less than 0.001). The highest prevalence of liver abnormalities was observed in HBeAg-positive heavy drinkers (53.8%). In conclusion, this study confirms that alcohol consumption intensifies the development of liver disease caused by hepatitis B virus. Therefore, the authors see a need to educate HBsAg carriers about the risks of consuming alcohol.

Adult↗
PubMed1988

Prevalence of gallstone disease in a general population of Okinawa, Japan.

A total of 2,584 healthy residents in the Yaeyama District of Okinawa, Japan, were investigated in 1984 to determine the prevalence of gallstone disease and its associated factors. Diagnosis of gallstone disease was assessed by real-time ultrasonography. For participants over 20 years of age, obesity index and serum levels of total cholesterol and triglycerides were measured. Overall prevalence of gallstone disease was 3.2%. Prevalence increased with age from 0% under 19 years of age to 11.4% over 70 years of age and was higher in females (4.0%) than in males (2.5%). The results of the logistic regression analysis indicated that age and fatty liver were significant predictors of gallstone disease. The results of the automatic interaction detector analysis indicated that age and fatty liver were strong factors associated with gallstone disease and that prevalence was highest in females over age 50 with fatty liver.

Adolescent↗