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Biomedical subjects

K Doi

Publications and source records attributed to K Doi.

At least 415 records · Page 23Linked to original sources
PubMed1996

[Statistical analysis of recovery from sudden deafness among treatment groups].

This study examined 131 patients with idiopathic sudden deafness in whom the averaged of five frequency hearing levels was greater than 60dB. Since combined pharmacotherapy has been used in the treatment of idiopathic sudden deafness, it is hard to make a quantitative analysis of single-drug efficacy. We used a single-drug treatment in turn to assess the drug efficacy within 30 days after the onset. There was no significant difference among patients treated within 6 days and not less than 7 days after the onset with steroid therapy, PGE1 therapy, and defibrinogenation therapy. Similarly, there was no significant difference among patients treated within 6 days and not less than 7 days after the onset with steroid and defibrinogenation combined therapy, steroid and PGE1 combined therapy, and steroid, defibrinogenation and Lasix-Vitamin combined therapy. In case of no steroid effect, treatment with defibrinogenation, PGE1 and Lasix-Vitamin therapy could achieve hearing improvement.

Adolescent↗
PubMed1996

[Three cases of Lermoyez's syndrome and its pathophysiology].

Two cases of bilateral Lermoyez's syndrome and one case of unilateral Lermoyez's syndrome are reported. The patients had recurrent episodes of vertigo with improvement of hearing or tinnitus, which is characteristic is Lermoyez's syndrome. In case 1, a 48-year-old female, dehydration with glycerol or furosemide induced nystagmus and improved bilateral hearing and the gain of the vestibulo-ocular reflex, while overhydration with drinking water impaired bilateral hearing with disappearance of nystagmus. These findings indicate that she had endolymphatic hydrops in both ears, suggesting that simultaneous changes in bilateral cochlear and vestibular function induce Lermoyez's syndrome. In case 3, a 52-year-old female, which we already reported, endolymphatic collapse in both ears may have changed bilateral inner ear function, resulting in Lermoyez's syndrome. On the other hand, patients 2, a 47-year-old male, experienced a vertigo attack with improvement of unilateral hearing after defibrinogenation therapy. In this case, slowly developing insufficiency of the inner ear blood supply may have caused the gradual hearing loss. It seemed that decreasing blood viscosity by defibrinogenation allowed blood to rush into the labyrinth, causing vertigo but at the same time improving hearing. We proposed that there are two types of Lermoyez's syndrome, bilateral (cases 1 and 3) and unilateral (case 2).

Endolymphatic Hydrops↗
PubMed1996

[Quick radioimmunoassay for plasma immunoreactive gastrin--application for localizing occult gastrinoma(s) during operation].

A rapid method for determining gastrin, quick gastrin, has been developed. Separation/washing procedure has been improved and can be completed within three minutes. It required only 48 minutes for the assay of 22 blood samples. Quick gastrin is a RIA that uses magnetic particles. On magnetic particles, a goat anti-rabbit IgG antibody is bound covalently. An anti-human gastrin rabbit antibody is bound to an anti-rabbit IgG antibody. Assay is started by adding the magnetic particles to a mixture of sample and 125I-gastrin. Following 30 minute incubation at 37 degrees C, the particles are sedimented in a magnetic field and washed. The gastrin content of the sample is then quantitated by counting radioactivity of the particles. Incomplete equilibration of antigen-antibody reaction is corrected using standard solution prepared from charcoal treated plasma. The immunoreactive gastrin values by quick gastrin correlated well with those by a commercial assay kit (Gammadab RIA kit; y = 1.01 x +4.3, r = 0.99). When compared to a reported conventional rapid assay, quick gastrin is easier and more accurate. Quick gastrin is sensitive enough to use for intra-operative determination of gastrin. We applied quick gastrin to the samples obtained from intra-operative secretin test in a gastrinoma patient. Twofold increases in gastrin after injection of secretin clearly indicated the existence of occult gastrinomas in her pancreas. When gastrin was assayed with the conventional rapid method, the increase in gastrin was less and did not reach the criteria for existence of gastrinoma.

Adult↗
PubMed1996

[Experience with 2 cases of traumatic diaphragmatic hernia occurred at the same time].

Two cases of traumatic diaphragmatic hernia (TDH) which occurred at the same traffic accident, are reported. The first case, a plain chest X-P was diagnostic of TDH. With thoracotomy and additional laparotomy, lacerated diaphragm was repaired. The second case, continual observation on plain chest X-P was useful to suspect TDH, and thoracoscopy was diagnostic. With thoracotomy diaphragm was repaired. Two patients recovered well. It has not been reported that two cases of TDH occurred at same trauma. For diagnosis of TDH, chest X-P is useful for suspicion, and thoracoscopy is useful for correct diagnosis. Surgical approach should be decided in consideration of phase, location, and complicated injuries.

Accidents, Traffic↗
PubMed1996

Clinical use of extracorporeal lung assist for a patient in status asthmaticus.

A 23-year-old man was transferred to our hospital in an unconscious state due to hypercapnea with massive subcutaneous emphysema secondary to status asthmaticus. Mechanical ventilation was ineffective for removal of carbon dioxide and oxygenation. After the initiation of extracorporeal lung assist the patient was able to effectively clear his secretions. This resulted in marked improvement in his pulmonary compliance. There were no hemorrhagic pulmonary or hematologic complications. This is the first patient in whom we have used venovenous bypass in the treatment of status asthmaticus.

Adult↗
PubMed1996

[Two successful cases of surgical treatment for left ventricular rupture following myocardial infarction: the usefulness of percutaneous cardiopulmonary support system (PCPS)].

Two successful cases of surgical treatment for left ventricular (LV) rupture following acute myocardial infarction (AMI) are reported. The first case was a 62-year-old man with circulatory collapse caused by a blow out type LV rupture. The second case was a 68-year-old woman with a oozing type LV rupture. In both cases PCPS was applied for cardiopulmonary resuscitation. After stabilizing their hemodynamics and recovering consciousness with PCPS, surgical repair for LV rupture was performed successfully. The first case was getting well, but suddenly circulatory collapse occurred and he died for acute pulmonary arterial thromboembolism on 10 days after operation. The second case woman is doing well without complication 1 year after operation. In conclusion, PCPS may be useful for LV rupture following AMI for the recovery and maintenance of hemodynamics, and also play as a bridge for surgical repair.

Aged↗
PubMed1996

[Antiplatelet therapy after open heart surgery].

This study evaluated the effects of an antiplatelet drug for the patients after open heart surgery. Dipyridamole (D), aspirin (A), ticlopidine (T) and sarpogrelate hydrochloride (S) were chosen as an antiplatelet drug. The 6 groups were devided into as G 1 with warfarin (W) and D, as G 2 with W alone, as G 3 with A and D, as G 4 with A alone, as G 5 with A and T, and as G 6 with A and S. The indices of anticoagulation and antiplatelet were as follows: TT, APTT, PT, D. Dimer, fibrinogen, TXB2, 6 kPGF1 alpha, beta TG, vWF and platelet aggregation with Grading Curve methods. The results showed that D.Dimer was beyond the normal range in G 1 and G 2. Thromboxane B 2 was increased markedly in G 1 and G 2 and showed under the normal range in G 3 and G 6. In all groups, 6 kPGF1 alpha showed low levels than normal. Activation of platelet causes the increased beta TG which was not suppressed with the antiplatelet drugs administered. The platelet aggregation was not suppressed in G 1 and G 2. Mild to moderate suppression was seen in G 3 and G 4 with no difference between the two group. Moderate to marked suppression was demonstrated in G 5 and G 6. This study demonstrated that dipyridamole had no effects as antiplatelet function. Aspirin showed antiplatelet effects and the combination of aspirin with the another antiplatelet drugs demonstrated the additional effects.

Adult↗
PubMed1995

Nerve regenerating effect of short-course administration of cyclosporine after fresh peripheral nerve allotransplantation in the rat: comparison of nerve regeneration using different forms of donor nerve allografts.

There is almost universal agreement that if cyclosporine (CsA), which is a potent immunosuppressant, is temporarily administered after surgery, regenerated axons will be maintained even after withdrawal of CsA following peripheral nerve allotransplantation. Thus, this experimental study was conducted to investigate whether a difference in donor nerve form, including thickness and length, influences nerve regeneration after withdrawal of immunosuppression with CsA. The findings suggest that as a result of immunosuppression with CsA, large-diameter nerve grafts are better able to induce nerve regeneration than small-diameter grafts, and after withdrawal of the immunosuppressant, thick nerve grafts are also better able to preserve regenerated axons against the rejection reaction than thin grafts. With regard to the length of the grafted nerve, short nerve allografts yield higher axon counts than long ones, the same as with autografts. The best way to induce nerve regeneration appears to be to transplant a short, thick nerve allograft, which is definitely capable of inducing many regenerated axons.

Animals↗
PubMed1995

One-stage treatment of infected bone defects of the tibia with skin loss by free vascularized osteocutaneous grafts.

Twenty-six patients who had an infected nonunion or segmental defect of the tibia with skin loss were treated in one stage with debridement and a free vascularized osteocutaneous fibula or iliac graft. Successful control of infection, closure of skin defects, and incorporation of bone union were achieved in all patients except one. In an average follow-up of 39 months, no recurrence of infection was seen. There were four stress fractures of the grafted fibula; these healed within 2 months with cast immobilization. Graft hypertrophy was common in the fibula grafts, but it took 1 1/2 years for hypertrophy of the graft to be strong enough to remove external supports without stress fracture or an additional cancellous bone graft. The use of a one-stage free vascularized osteocutaneous graft for the management of infected bone defects of the tibia with skin loss is effective because extensive debridement can remove all devitalized and infected tissue and can increase vascularity in the region of infection and osseous defect to enhance antibiotic delivery.

Adult↗
PubMed1995

Villous adenoma of the duodenum in a patient with familial adenomatosis coli.

A case of familial adenomatosis coli with villous adenoma of the third portion of the duodenum, which falls in the category of a Gardner's syndrome, is described. The patient, who had complained of an abdominal mass which had been diagnosed as a desmoid tumor after surgical resection, had numerous adenomatous polyps throughout the colon confirmed by colonoscopy with biopsy. Endoscopic examination of the upper gastrointestinal tract revealed fundic gland polyposis in the stomach and numerous small adenomas in the duodenum. In addition, there was a pedunculated polyp in the third portion of his duodenum, measuring 30 mm in diameter, the surface of which had a cauliflowerlike appearance. The polyp was removed with the electrocautery snare and was histologically diagnosed as villous adenoma. Our case report supports the concept that villous adenoma, which possesses a high malignant potential, may occur in the upper gastrointestinal tract in patients with familial adenomatosis coli, and careful examination of the upper gastrointestinal tract including the distal duodenum seems to be necessary in the follow-up patients with this disease.

Adenoma, Villous↗
PubMed1995

Computer-aided detection of clustered microcalcifications on digital mammograms.

A computer-aided diagnosis scheme to assist radiologists in detecting clustered microcalcifications from mammograms is being developed. Starting with a digital mammogram, the scheme consists of three steps. First, the image is filtered so that the signal-to-noise ratio of microcalcifications is increased by suppression of the normal background structure of the breast. Secondly, potential microcalcifications are extracted from the filtered image with a series of three different techniques: a global thresholding based on the grey-level histogram of the full filtered image, an erosion operator for eliminating very small signals, and a local adaptive grey-level thresholding. Thirdly, some false-positive signals are eliminated by means of a texture analysis technique, and a non-linear clustering algorithm is then used for grouping the remaining signals. With this method, the scheme can detect approximately 85% of true clusters, with an average of two false clusters detected per image.

Breast Diseases↗
PubMed1995

Detection of lung nodules in digital chest radiographs using artificial neural networks: a pilot study.

Radiologists can fail to detect up to 30% of pulmonary nodules in chest radiographs. A back-propagation neural network was used to detect lung nodules in digital chest radiographs to assist radiologists in the diagnosis of lung cancer. Regions of interest (ROIs) that contained nodules and normal tissues in the lung were selected from digitized chest radiographs by a previously developed computer-aided diagnosis (CAD) scheme. Different preprocessing techniques were used to produce input data to the neural network. The performance of the neural network was evaluated by receiver operating characteristic (ROC) analysis. We found that subsampling of original 64- x 64-pixel ROIs to smaller 8- x 8-pixel ROIs provides the optimal preprocessing for the neural network to distinguish ROIs containing nodules from false-positive ROIs containing normal regions. The neural network was able to detect obvious nodules very well with an Az value (area under ROC curve) of 0.93, but was unable to detect subtle nodules. However, with a training method that uses different orientations of the original ROIs, we were able to improve the performance of the neural network to detect subtle nodules. Artificial neural networks have the potential to serve as a useful classifier to help to eliminate the false-positive detections of the CAD scheme.

False Positive Reactions↗
PubMed1995

Immunosuppressive effect of 15-deoxyspergualin applied to peripheral nerve allotransplantation in the rat.

15-Deoxyspergualin (15-DSG), which has a unique immunosuppressive action, was applied to peripheral nerve allotransplantation. Its effects on graft survival were experimentally assessed using inbred rats. The sciatic nerve (20 mm) allotransplantation model was created in two different strains. An attempt was made to answer the following two questions: (1) can short-term immunosuppression alone produce sufficient immunological tolerance to maintain graft survival indefinitely? (2) can graft rejection be prevented by chronic intermittent low-dose 15-DSG administration (2.5 mg/kg/day), and to what extent does nerve regeneration occur? To evaluate the efficacy of 15-DSG, a comparison was made with autografts, allografts with no immunosuppression, and allografts immunosuppressed with cyclosporine (CsA), a strong immunosuppressant. The results indicate that short-term 15-DSG therapy is incapable of inducing immunotolerance of peripheral nerve allografts. Because nerve conduction in the rejected allografts was better preserved than in the CsA group, short-course 15-DSG therapy appeared to provide better results than CsA therapy for peripheral nerve allotransplantation.

Animals↗
PubMed1995

Insulin sensitivity, insulin secretion, and glucose effectiveness in obese subjects: a minimal model analysis.

The aim of the present study was to estimate insulin sensitivity (SI), insulin secretion, and glucose effectiveness in 14 obese subjects who were further divided into two groups: one with normal glucose tolerance and the other with impaired glucose tolerance (IGT). Glucose tolerance was determined by criteria of the World Health Organization. All subjects were Japanese. They underwent a modified frequently sampled intravenous glucose tolerance test: glucose (300 mg/kg body weight) was administered, and insulin (20 mU/kg body weight given over 5 minutes) was infused from 20 to 25 minutes after administration of glucose. SI and glucose effectiveness at basal insulin (SG) were estimated by Bergman's minimal model method. Body mass index (33.0 +/- 1.8 v 30.9 +/- 1.5 kg/m2, P > .05) and fasting insulin level (127.9 +/- 30.0 v 107.4 +/- 14.4 pmol/L, P > .05) were higher in obese IGT subjects than in normal obese subjects, but were not statistically significant. With regard to fasting glucose level, obese subjects with IGT (5.9 +/- 0.3 mmol/L) had significantly higher levels than those with normal glucose tolerance (5.1 +/- 0.2 mmol/L, P < .01). There was no significant difference in SI between the two groups (0.53 +/- 0.10 v 0.56 +/- 0.13 x 10(-4).min-1.pmol/L-1, P > .05). Pancreatic insulin secretion expressed as the integrated area of plasma insulin above the basal level during the first 19 minutes was significantly lower in obese subjects with IGT (3,366 +/- 1,495 pmol/L.min) than in those with normal glucose tolerance (16,400 +/- 4,509 pmol/L.min, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Expression and identification of the feline herpesvirus type 1 glycoprotein B (gp143/108).

The gene for feline herpesvirus type 1 (FHV-1) glycoprotein B (gB) has been cloned into an expression vector, pRVSVneo, containing the long terminal repeat of Rous sarcoma virus and polyadenylation signal of SV40. This expression vector containing FHV-1 gB gene, pRVSVgBneo, was transfected into Crandell feline kidney (CRFK) cells which are susceptible to FHV-1 infection. By indirect immunofluorescence analysis, the expressed gB was recognized with a panel of monoclonal antibodies (MAbs) against FHV-1 gp143/108. Immunoprecipitation analysis using a MAb 34H12 showed that molecular weights of the gB were 143 and 108 kDa under non-denaturing conditions that 108, 70, 64, and 58 kDa under denaturing conditions. The molecular weights were similar to those of the gB expressed in FHV-1-infected CRFK cells. In addition, when plasmid DNAs were injected into mice to obtain gB-monospecific serum, the pooled serum from mice inoculated with pRVSVgBneo, but not with pRVSVgDneo or pRVSVneo, recognized the FHV-1 gB polypeptides.

Animals↗
PubMed1995

Double free-muscle transfer to restore prehension following complete brachial plexus avulsion.

Restoration of finger flexion and extension as well as elbow flexion and extension with a double free-muscle and multiple nerve transfers following complete avulsion of the brachial plexus (nerve roots C5 to T1) is reported. The procedure combines (1) free-muscle transfer with reinnervation by the spinal accessory nerve to achieve elbow flexion and finger extension, (2) free-muscle transfer with reinnervation by the fifth and sixth intercostal nerves to restore finger flexion, (3) third and fourth intercostal motor nerve transfer to the triceps brachi to extend and stabilize the elbow, (4) nerve transfer of the supraclavicular nerve or nerve transfer of the sensory rami of the intercostal nerves to the median nerve to restore hand sensibility, and (5) glenohumeral arthrodesis. Seven of 10 patients recovered elbow function and finger flexion and extension. Five patients reported use of their hand in activities of daily living.

Adolescent↗