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Biomedical subjects

J Wada

Publications and source records attributed to J Wada.

At least 127 records · Page 7Linked to original sources
PubMed1989

Accuracy of diagnosis on death certificates for underlying causes of death in a long-term autopsy-based population study in Hisayama, Japan; with special reference to cardiovascular diseases.

Major categorical diagnosis by International Classification of Diseases and type-specific diagnosis for cardiovascular diseases in death certificates were compared to the diagnosis made at autopsy in 864 consecutive autopsy cases aged 20 or over, among the Japanese residents in Hisayama town. Cerebral stroke was correctly diagnosed in 84%, malignant neoplasms in 78% and cardiac disease in 66%. Cerebral stroke and cardiac disease tended to be overdiagnosed, while malignant neoplasms were underdiagnosed. The validation of certified diagnosis was less reliable in the aged population, and in type-specific diagnosis of cardiovascular diseases. Cerebral hemorrhage with false negative or false positive diagnoses was usually classified into type unspecified stroke or different categories of cerebral stroke, while those misdiagnosed as cases of cerebral infarction frequently had no significant lesions in the autopsied brain. Finally, the relationship between the validation of diagnosis on the death certificates and the secular trend in cardiovascular disease in the Japanese vital statistics was discussed.

Adult↗
PubMed1989

Incidence and prognosis of subarachnoid hemorrhage in a Japanese rural community.

Twenty-six first episodes of subarachnoid hemorrhage occurred among 1,621 Hisayama residents aged greater than or equal to 40 years during the 22-year follow-up of a prospective study. Subarachnoid hemorrhage was confirmed by both clinical and autopsy findings. The average annual incidence (96.1/100,000 population) was 3-13 times higher than any previously reported and steeply increased with age in both sexes, being 2.3 times higher for women than for men after adjusting for age. Nine patients (35%) died less than or equal to 8 hours after the onset of subarachnoid hemorrhage. None was correctly diagnosed on the death certificates, and four of the nine (44%) were misdiagnosed as intracerebral hemorrhage. We found the survival rate of patients suffering subarachnoid hemorrhage to be much lower than previously reported because we detected a large number of sudden deaths due to subarachnoid hemorrhage through the high rate of autopsy in our cohort (81.4%).

Adult↗
PubMed1989

[Re-operation of pectus excavatum].

We performed surgical reconstruction on 1655 cases of deformed thoracic cage, we later operated again on 11 of these to repair postoperatively re-deformed anterior chest walls. Based on these experiences, we have concluded as follows. 1: Postoperative recurrence of funnel chest deforming is mainly due to insufficient resection of costal cartilages. In particular transection of the sternum at low levels during sternal turn-over procedure results in postoperative recurrence of depression in the upper anterior chest wall. 2: In young children who have undergone sternal turn-over procedure, the first and second costal bones and cartilages overgrow and protrude anteriorly, and in compensation their junctions to the sternum recess posteriorly. This results in a depression in the upper anterior chest wall. 3: We recommend sternal turn-over with overlapping of the sternum for repair of postoperative funnel chest deformity. Through this procedure, the extent of resection of costal cartilages can easily be determined and the depression of the anterior chest wall satisfactorily reconstructed. 4: In re-do surgery, we obtained pathological evidence confirming our clinical experience that our sternal turn-over technique does not interfere with blood circulation or development of the turned-over sternum even though the sternum is not connected to the rectus abdominus muscle pedicle, preserved internal mammary vessels, or anastomosis of the internal mammary vessels.

Adolescent↗
PubMed1989

[The supracardiac type of total anomalous pulmonary venous return in a ten-day-old neonate: report of a successfully treated case].

A case of a ten-day-old neonate weighing 3,867 g with the supracardiac type of total anomalous pulmonary venous return (TAPVR) is reported. The preoperative diagnosis was determined mainly by digital subtraction angiography. Surgical correction was carried out in this patient as an emergency operation. Under cardiopulmonary bypass on beating which required 3 hours and 7 minutes, anastomosis between the common pulmonary vein and the left atrium, ligation of both the anomalous vertical vein and the persistent ductus arteriosus, and closure of the atrial septal defects were successfully performed. Postoperatively cardiac failure was markedly improved, although 5 days were required for the weaning from the artificial respirator. The angiographic and hemodynamic examinations showed a complete repair of TAPVR. At present, 2 months after the operation, the patient shows an average development.

Female↗
PubMed1989

High tibial osteotomy with fixation by a blade plate for medial compartment osteoarthritis of the knee.

Surgical techniques were described on tibial osteotomy above the tuberosity, the fragments of which were fixed with a Koshino blade plate. Postoperative clinical results on 176 knees with medial compartment osteoarthritis of 138 patients with an average age of 62.1 years were excellent in 110 and good in 55 knees with an average of 5.5 years' follow-up. The best knee score was obtained in the knee with postoperative limb alignment of 6 to 15 degree valgus angulation (standing). The results were satisfactory, especially in postoperative management, which was much easier with the Koshino blade plate fixation than with other methods. The sinking of the osteotomy site was checked through observation of screw movement in the slot of the plate during postoperative management in 53 selected knees, and the averaged distance of sinking was 3.9 +/- 2.5 mm. The time of mechanical bone union judged by cessation of sinking averaged 12.9 +/- 6.2 weeks after osteotomy.

Aged↗
PubMed1988

The corpus callosum is larger with right-hemisphere cerebral speech dominance.

Variations in the size of the human corpus callosum were examined as a possible morphological substrate of functional asymmetries of the cerebral hemispheres, such as cerebral speech dominance. The midsagittal surface area of the corpus callosum, obtained by magnetic resonance imaging, was measured in 50 patients with epilepsy and 50 neurologically normal control subjects. The mean callosal area did not differ significantly between patients and control subjects, between left-handed and right-handed subjects, or between men and women. When measurements were compared among 44 patients, whose cerebral speech dominance had been determined by the intracarotid injection of sodium amytal, the area of the corpus callosum was significantly greater in patients with right-hemisphere cerebral speech dominance. The mean callosal area was greater by 109 to 159 square millimeters (18-28%) when compared to that of patients with either left-hemisphere speech dominance or bilateral speech representation. This difference in midsagittal surface area could represent as many as 37 to 54 million additional callosal axons in subjects with right-hemisphere cerebral speech dominance.

Adolescent↗
PubMed1988

Some correlates of intra- and interhemispheric speech organization after left focal brain injury.

Determinants of inter- and intrahemispheric organization following left focal injury were examined with data deriving from four different studies that used three different assessment methods (amobarbital, temporal lobectomy, dichotic listening). With regard to interhemispheric reorganization, the results revealed that the earlier the lesion onset, the higher the probability of a biomodal hemispheric reorganization (speech and hand). A unimodal reorganization (speech only) was tied to a later occurring lesion, but one before age six. Furthermore, interhemispheric speech reorganization was associated with an early lesion onset while intrahemispheric speech maintenance was linked to a later lesion onset. The results are discussed in terms of hemispheric plasticity and functional maturity.

Brain↗
PubMed1988

Prevalence and long-term prognosis of mild hypertensives and hypertensives in a Japanese community, Hisayama.

The prognosis and outcome for mild hypertensives (90 mmHg less than or equal to diastolic pressure less than or equal to 104 mmHg) and hypertensives (diastolic pressure greater than or equal to 105 mmHg) was prospectively studied in Hisayama, Japan, and compared between 1621 subjects aged 40 years or over, recruited in 1961, and 2053 subjects recruited in 1974. Each cohort was studied in a follow-up which lasted 10 years. The pharmacological treatment of hypertension proved effective among residents recruited in 1974: the survival rate had favorably improved, and the rates of mortality from cerebral stroke and morbidity from intracerebral stroke and morbidity from intracerebral hemorrhage declined significantly in mild hypertensives and hypertensives in the more recently recruited population. The management of mild hypertension was considered more likely to be effective in reducing stroke than in reducing coronary heart disease in the Japanese general population.

Adult↗
PubMed1988

Prognosis and outcome of elderly hypertensives in a Japanese community: results from a long-term prospective study.

A long-term prognosis and outcome study of elderly hypertensives (aged 60 years or over) was made based on the 20-year prospective population survey conducted in a Japanese rural community (Hisayama) and the results were compared with those for younger subjects (aged 40-59 years). The risk of cardiovascular mortality related to blood pressure level increased with the elevation of either systolic or diastolic pressure in both younger and elderly groups. Cardiovascular mortality increased markedly at a systolic pressure of greater than or equal to 160 mmHg, or a diastolic pressure of greater than or equal to 100 mmHg for those aged 40-59 years. There was no cut-off level for increased risk of cardiovascular mortality for either systolic or diastolic pressures for those aged 60 years or over. Stroke mortality was seven times higher in systolic, and 10 times higher in diastolic hypertensives than in normotensives (P less than 0.01) for the group aged 40-59 years. However, deaths due to stroke and heart disease were more frequently associated with borderline (relative risk 2.3 and 2.3, respectively; P less than 0.01), systolic (relative risk 3.2 and 3.7, respectively; P less than 0.01) and diastolic hypertension (relative risk 2.1 and 4.8, respectively; P less than 0.01), compared to normotension for those aged 60 years or over. Intracerebral hemorrhage and cerebral infarction occurred more frequently in diastolic hypertensives for both young (relative risk 9.8 and 4.8, respectively; P less than 0.01) and elderly subjects (relative risk 3.4 and 1.5, respectively; P less than 0.01) than in normotensives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Intracerebral hemorrhage in a Japanese community, Hisayama: incidence, changing pattern during long-term follow-up, and related factors.

The incidence of intracerebral hemorrhage over 13 years is compared between two Hisayama cohorts. Among men aged 40 years or older, the annual incidence declined significantly from 3.1/1,000 in the early cohort (1961-1970) to 1.2/1,000 in the recent cohort (1974-1983). Massive ganglionic hemorrhage decreased, while small or medium-sized intracerebral hemorrhage increased in the recent cohort on pathologic or computed tomographic examination. These trends could be due to the reduced prevalence of hypertension in the Hisayama population. The association of serum total cholesterol with intracerebral hemorrhage is discussed based on the results during a 22-year follow-up period.

Adult↗
PubMed1988

Pharmacokinetics of oral sulfa drugs and gastric emptying in the pig.

The plasma pharmacokinetics of sulfamonomethoxine (SMM) and sulfamethazine (SMZ) in the pig were examined after the oral and intravenous (i.v.) administration of the sodium salt solutions. Eight pigs from a commercial breed and 8 Goettingen minipigs were used. Both the Cmax and tmax of SMM and SMZ ranged widely. A flipflop phenomenon was found after the SMM solution but not after the oral SMZ. Duodenal cannulae were inserted in 5 pigs. The SMM solution and the SMM suspension were directly injected into the duodenum through the duodenal cannula. Both Cmax values were in a narrow range. Both tmax values were in a narrow range and were reached within 30 min. There was no flipflop phenomenon. Gastric emptying in the pig was examined using duodenal cannulated pigs. Phenol red solution and SMM suspension were administered orally. The time courses of gastric emptying of the two markers were nearly coincident and they approximated an exponential decrease. The times required for the 50% passage of the marker from the stomach ranged widely between 0.06-7.7 h, which may cause the variation in the Cmax and tmax of the sulfadrugs after oral administration. The kappa-GE (rate constant of the terminal phase of gastric emptying) also ranged widely. Nine kappa-GE values among 22 were smaller than the minimum value of the SMM kappa el values, which may cause the flipflop phenomenon of the oral SMM. In contrast, all of the kappa el values of SMZ were smaller than the minimum value of kappa-GE. And no flipflop phenomenon was found after the oral SMZ. Accordingly, the pharmacokinetics after the oral sulfonamides solution may be intimately influenced by the gastric emptying.

Administration, Oral↗
PubMed1987

Clinical evaluation of total-body hyperthermia combined with anticancer chemotherapy for far-advanced miscellaneous cancer in Japan.

One hundred sixty-eight patients with miscellaneous far-advanced cancer received a total of 444 extracorporeally induced total-body hyperthermia (TBHT) treatments in seven Japanese hospitals. Overall, a regression of malignancy was observed in 39 of 132 evaluable patients (29.5%) and the most favorable results were obtained for patients with lung cancer. Irrespective of whether the tumors were primary or secondary lesions or recurrences, favorable results were obtained in patients whose tumors were in the lung, liver, lymph nodes, and soft tissue. No relationship was found between an objective response to TBHT and histologic types of the tumors. There was no clear relationship between an objective tumor response and the nature of the simultaneous chemotherapy during hyperthermia. Antitumor effects were not evaluable in 36 patients (21.4%). Of these 36 patients, 33 died before evaluation could be made; 24 died of various complications and 9 died of cachexia without complication. The mortality increased in proportion to the reduction of the performance status of patients before TBHT. These results indicate that TBHT should be used as therapy for patients whose tumors are in the lung, liver, lymph node, and soft tissue and then only on patients in generally good condition.

Adult↗
PubMed1987

Performance on a free-recall verbal dichotic listening task and cerebral dominance determined by the carotid amytal test.

Epileptic patients whose speech dominance had been ascertained using the carotid amytal technique were given a verbal dichotic listening test. Patients with left hemisphere speech dominance, like normal controls, showed a REA. Patients with right hemisphere speech representation, as a group, tended not to show a bias toward either ear. Moreover, repeated administrations of the verbal dichotic listening test yielded similar results.

Adolescent↗