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Biomedical subjects

K Hirabayashi

Publications and source records attributed to K Hirabayashi.

At least 19 recordsLinked to original sources
PubMed1997

Prospective randomized comparative study of bipolar electrocoagulation versus heater probe for treatment of chronically bleeding internal hemorrhoids.

BACKGROUND: Our purpose was to compare the efficacy, complications, failure rates, and crossovers of heater and bipolar probe treatments of chronically bleeding internal hemorrhoids. METHODS: Eighty-one patients (31 female, 50 male) with mean age of 53 years had large (grade 2 to 3) internal hemorrhoids with bleeding for a mean of 12 years, had failed medical management, and were randomized in a prospective study of anoscopic treatments to heater versus bipolar probes. Failure was defined as a major complication or failure to reduce the size of all internal hemorrhoids with three or more treatments. RESULTS: With similar background variables and no difference in treatment times, rectal bleeding and other symptoms were controlled in a shorter time with the heater probe than with the bipolar probe (77 versus 121 days). Five complications (fissures, bleeding, or rectal spasm) occurred with the bipolar probe, and two occurred with the heater probe. The heater probe caused more pain during treatments but had significantly fewer failures and crossovers. CONCLUSIONS: For patients who had failed medical management of chronically bleeding internal hemorrhoids, the techniques and complications of heater and bipolar probes were similar, but pain was more common, failures and crossovers were less frequent, and the time to symptom relief was shorter with the heater probe than with the bipolar probe.

Chronic Disease↗
PubMed1997

Studies of bronchial asthma induced by chironomid midges (Diptera) around a hypereutrophic lake in Japan.

There have been few reports on hypersensitivity to chironomid midges in bronchial asthmatic patients around the area of hypereutrophic natural lakes, which have been notorious as an environmental hazard due to the massive occurrence of adult chironomids during several periods of the year. Our study investigated IgE antibodies to chironomid midges in bronchial asthmatic patients around the Lake Suwa area in comparison with those of the Matsumoto area (control area). A total of 123 adult patients with bronchial asthma were investigated by measurement of IgE antibodies with extracts of three chironomid midges (Chironomus yoshimatsui, C. plumosus, and Tokunagayusurika akamusi), mite, and silkworm. In addition, in the allergy testing, 12 common inhalant antigens were used. Of 123 adult patients with bronchial asthma, 65 (52.8%) produced positive allergy tests. Thirty-three (50.8%) were positive to mite, 28 (43.1%) to silkworm, 11 (16.9%) to C. yoshimatsui, eight (12.3%) to C. plumosus, and three (4.6%) to T. akamusi. We compared our results with the previous reports. The number of positive tests to silkworm in the Lake Suwa area was higher than in other areas. However, C. plumosus and T. akamusi showed a lower number of positive reactions. We considered the lower positive number of C. plumosus and T. akamusi tests in the Lake Suwa area to be related to the advanced age of patients in this area. The chironomids are an important cause of asthma, together with mite and silkworm, in the Lake Suwa area, but affect old asthmatic patients less than asthmatic children.

Administration, Inhalation↗
PubMed1997

[Brain stem encephalitis related with viral infection].

There is no definite classification of brainstem encephalitis, its etiology is not clear. Bickerstaff's brainstem encephalitis (BBE) was established by clinical diagnosis without etiology. Recently there are great progression to identify a virus by using immunological methods and PCR (polymerase chain reaction) methods. Sometimes the progression of MRI revealed subdiagnostic images of brainstem lesion. Nowadays we can investigate anti-ganglioside antibodies in some BBE patients but not all. High IgG anti-GQ1b antibody titers were present in some BBE sera samples but decreased with the clinical course of illness. A girl was suffered from BBE whose Cytomegarovirus-DNA was detected in the CSF by PCR. Serum anti-GQ1b antibody was positive. The neurological symptoms disappeared with decreasing of anti-GQ1b antibody. Immuno adsorption therapy is effective for BBE with anti-GQ1b antibody positive patients.

Adult↗
PubMed1997

[Current status of HIV infection in Yunnan Province of China].

In cooperation with the Chinese Academy of Preventive Medicine and Yunnan Province Provincial Office for AIDS Control and Prevention, we studied the current status of HIV infection intravenous drug users (IVDUs) and other high risk groups in Yunnan province of China. As of the end of 1995, 1,807 HIV cases were officially reported (Positive rate was 0.6%), of which 1,278 (77.9%) were IVDUs, and 24 were their spouses. The majority of cases were found among the Dai minority male farmers near Ruili which borders on Myammar, but HIV also appears to be spreading among the Han people. HIV antibody positive rates among commercial sex workers, pregnant women and blood donors were 0.2%, 0.07% and 0.04%, respectively. A system for surveillance of HIV has been developed, but preventive strategies to cope with HIV epidemic are not sufficient. As HIV/AIDS is now a global issue, (1) the integration and coordination of such preventive strategies in cooperation with community health workers, (2) general health education for condom use promotion and (3) care of psychological vulnerable person such as IVDUs, should be developed.

Acquired Immunodeficiency Syndrome↗
PubMed1997

[Combination chemotherapy with nedaplatin, bleomycin and ifosfamide for advanced cervical cancer of the uterus--a preliminary study for phase III clinical study].

A preliminary co-operative study by 7 institutes was conducted to determine the optimal dosage of the combination regimen with nedaplatin, bleomycin and ifosfamide, which is used in a phase III clinical study, to investigate its efficacy as neoadjuvant chemotherapy against advanced cervical cancer of the uterus. The drug administration consisted of 3 step; in the first step, nedaplatin and bleomycin were administered in a single dose at 80 mg/m2 and a 6-day dose at 7.5 mg/body/day, respectively, and this combination treatment was repeated every 4 weeks. After confirming the safety and efficacy of this combination regimen, the second-step treatment was started in which a 5-day dose of ifosfamide at 600 mg/m2/day was added to the combination regimen of the first step. In the third step, this three-drug combination regimen was used with the daily dose of ifosfamide increased up to 1,200 mg/m2. The drug administration was conducted in a total of 16 cases, consisting of 3 cases in the first step, 7 in the second step and 6 in the third step, which were all evaluable for tumor response and safety. Regarding tumor response, a 33.3% (1/3) of response rate was obtained in the first step, 71.4% (5/7) in the second step and 66.7% (4/6) in the third step. As for safety, bone marrow suppression indicated by grade 4 abnormal clinical laboratory test values was found in one case each in the second step (leukopenia and thrombocytopenia) and the third step (leukopenia). Thus, bone marrow suppression, mainly leukopenia and thro mbocytopenia, was regarded as the dose limiting factor of this three-drug combination regimen. The leucocyte and thrombocyte counts reached their nadirs at two weeks after administration with recovery in about two weeks. The other abnormal changes in clinical laboratory test values such as those indicating the effects on renal function were slight even in the third step. Nausea and vomiting, anorexia and fever were found in every step with high incidences. Alopecia was found in all cases of the third step. Based on the above results, the dosage of the third step (combination regimen with a single dose of nedaplatin at 80 mg/m2, 6-day dose of bleomycin at 7.5 mg/body/day and 5-day dose of ifosfamide at 1,200 mg/m2/day, repeated every 4 weeks) was considered to be the optimal dosage in the phase III clinical study for advanced cervical cancer of the uterus.

Adult↗
PubMed1997

[Miyoshi distal muscular dystrophy].

Miyoshi distal muscular dystrophy (MDMD) is a young-adult-onset, autosomal recessive inherited dystrophy initially affecting the plantar flexers. We analysed 12 MDMD families, five with consanguineous marriage, for chromosomal linkage using polymorphic microsatellite DNA markers to map MDMD gene. A significant lod score was obtained with the 2p13 locus D2S291 (Zmax = 15.3 at theta = 0). A gene for autosomal recessive limb-girdle muscular dystrophy 2B (LGMD2B) was also mapped 2p13. The onset was in the late teens with weakness and wasting of the pelvic girdle muscles. Now we cannot exclude the possibility that the cause of these diseases are allelic variants in the same gene. YAC contig of the region was constructed. Scleening for muscle genes in the MDMD region is under way.

Alleles↗
PubMed1997

Helicobacter pylori infection in early gastric adenocarcinoma: relationship between histologic subtypes and ulcer-formation.

Early stage of gastric cancers were divided into two subtypes; differentiated and undifferentiated adenocarcinomas, histologically. We examined the involvement of Helicobacter pylori (Hp) infection in the development and progression of cancer, and presence or absence of peptic ulcer (UL+/UL-). From the results, these findings obtained as follows; 1) Hp positive rate of UL+ group was significantly higher than that of UL-group. 2) Neither of gross features nor depth of the tumor did not correlate with Hp positive rates. 3) Hp positive rate of undifferentiated type carcinoma was significantly higher than that of differentiated type, contrarily to our expectation. These findings suggested that Hp infection might relate with ulcer formation in the cancerous lesion. The hypothesis which is "gastritis-intestinal metaplasia-differentiated type carcinoma sequence" was not supported by present study. Hence, Hp infection was suggested as an important factor of the gastric cancer development and progression, not only in differentiated type but also in undifferentiated type.

Adenocarcinoma↗
PubMed1996

Management of patients with an incomplete cervical spinal cord injury.

Forty-five patients with incomplete cervical spinal cord injuries were examined as to the mechanism of injury, neurological deficits in the initial stage and differences in treatment. Nineteen (42.2%) were treated non-surgically and 26 (57.8%) surgically. Their injuries could be divided into seven types of cervical spinal cord injury according to Usui's classification. Neurological changes were evaluated with Frankel's grading system. The neurological prognosis was relatively better in those with a unilateral cord injury type, but there was no statistical difference. Thirty-seven patients (82.2%) showed neurological improvement of at least one Frankel grade. There was no statistical difference between the surgical and non-surgical groups regarding neurological improvement, but all who underwent early surgery (within 4 weeks of being injured) improved. Surgical treatment was considered to be indicated for patients with cervical spinal canal narrowing, when satisfactory neurological improvement is not obtained by conservative treatment.

Accidental Falls↗
PubMed1996

Tumor necrosis factor-alpha stimulates the production of squamous cell carcinoma antigen in normal squamous cells.

Squamous cell carcinoma (SCC) antigen, a tumor marker of squamous cell carcinoma, is also increased in several nonmalignant skin lesions, e.g. pemphigus. The aim of the present investigation was to determine if tumor necrosis factor-alpha (TNF-alpha), one of the important environmental factors, stimulated the production of SCC antigen in the normal squamous cells. The exposure of normal human epidermal keratinocytes to TNF-alpha (100 IU/ml) for 72 h greatly increased the SCC antigen production. The stimulatory effect of TNF-alpha (1,000 IU/ml) on the production of SCC antigen was also observed in the normal squamous epithelium tissue. These results would be helpful for understanding the increase of SCC antigen in several nonmalignant skin disorders.

Antigens, Neoplasm↗
PubMed1996

Treatment protocol for fractures of the odontoid process.

Treatment results in 104 patients with odontoid fractures were reviewed. There were 2 type I, 62 type II, 32 type III fractures and eight epiphysiolyses in children <7 years old. Thirty-seven patients were managed nonoperatively using plaster casts, cervical braces, or halo devices. Sixty-seven patients were treated surgically including anterior screw fixation (ASF), posterior fusion (PF), and transoral anterior fusion (TAF). Plaster casts and cervical braces were effective for type I fractures and epiphysiolyses only. Halo devices provided successful results in stable type III fractures. ASF is the treatment of choice for most type II and unstable III fractures including some old cases. PF also provided successful union, although impaired cervical motion remained. It should be reserved for irreducible fractures, established nonunions, and as a salvage procedure. TAF should be limited to exceptional cases requiring anterior spinal cord decompression.

Adolescent↗
PubMed1996

[An early phase II study of gemcitabine hydrochloride (LY 188011). Gemcitabine Cooperative Study Group for Early Phase II].

An early phase II cooperative study of Gemcitabine Hydrochloride (abbreviated to "gemcitabine" herewith) was conducted in patients with a variety of solid tumors (i.e., lung cancer, gastric cancer, pancreatic cancer, colon/rectum cancer, cervical cancer, ovarian cancer and breast cancer) at 56 institutions. The aim of the first step (Step I) was to investigate the feasibility of gemcitabine in a variety of different solid tumors, including lung cancer regarding efficacy and safety. The aim of the second step (Step II) was as a result of step I (Responses were observed) to continue to investigate the efficacy and safety of gemcitabine in chemonaive patients with non-small cell lung cancer. As a Step I study, gemcitabine was administered once weekly at a dose of 800 mg/m2 for a consecutive 3-week period followed by a week of rest, in multiple courses. Among the 29 eligible patients with lung cancer, partial response (PR) was achieved in 3 patients (25.0%, 95% confidence interval: 5.5-57.2%) out of 12 chemonaive patients. Adverse reactions (grade 3 or higher) seen in 29 patients with lung cancer were neutropenia (27.6%), leukopenia (13.8%), decreased hemoglobin (13.8%), thrombocytopenia (10.3%), malaise (6.9%), anorexia (3.4%), nausea/vomiting (3.4%), diarrhea (3.4%), dyspnea (3.4%) and interstitial pneumonia (3.4%). In other types of solid tumors, PR was achieved in 2 (8.7%) out of 23 eligible patients with cervical cancer and in 1 (5.3%) of 19 eligible patients with ovarian cancer, while the use of analgesics became unnecessary in 1 patient with pancreatic cancer. Incidence as well as severity of main adverse reactions in these patients were comparable to those seen in patients with lung cancer. A Step II study, in which gemcitabine was administered once weekly at a dose of 1,000 mg/m2 to chemonaive patients with non-small cell lung cancer, was conducted, referring to the results of Step I and clinical studies conducted overseas. The results of the Step II study demonstrated PR in 5 (14.3%, 95% confidence interval: 4.8 - 30.3%) out of 35 eligible patients with non-small cell lung cancer and that the main adverse reactions were comparable to those seen in the Step I study, posing no tolerability problems in particular.

Adult↗
PubMed1995

Elevated levels of syndecan-1 expression confer potent serum-dependent growth in human 293T cells.

Syndecan-1 is the best studied integral membrane proteoglycan and functions to modulate epithelial cell attachment and physiology. Extracellularly, syndecan-1 binds both growth factors and extracellular matrix components, and intracellularly, its cytoplasmic portion interacts with cytoskeletal components. To investigate the possible role of syndecan-1 in epithelial cell transformation that is characterized by alteration in extracellular matrix interactions and cytoskeleton architecture, we established stable transfectants of syndecan-1 in a highly transformed human renal epithelial line expressing two viral oncogenes, adenovirus E1a and SV40 large T antigen (293T cell line). Expression of syndecan-1 core protein and appropriate posttranslational attachment of glycosaminoglycan chains was confirmed by enzymatic digestion and Western blot analysis. Overexpresser cells grew at a significantly faster rate than the vector-transfected control cells in serum-rich media but showed a proliferative disadvantage in serum-reduced media. In addition to this serum dependency, syndecan-1 overexpression caused a partial reversal of the transformed phenotype with the expressing clones becoming more anchorage dependent and less motile than the vector-transfected counterparts. Surprisingly, the overexpressers were more tumorigenic when injected s.c. into nude mice. These results indicate that syndecan-1 expression plays a role in the control of cell proliferation and suggest that serum-dependent growth may be the more reflective of tumorigenicity in nude mice.

Animals↗
PubMed1995

Multilevel cervical spondylosis. Laminoplasty versus anterior decompression.

Poor overall outcome and a high incidence of postoperative kyphosis and progressive myelopathy have driven surgeons away from decompressive laminectomy as a treatment for multilevel cervical spondylosis. Dr. Henry Bohlman advocates anterior decompression and fusion as the best approach to the pathophysiology of this disorder, while Dr. Kiyoshi Hirabayashi believes that laminoplasty represents an excellent strategy for patients with degenerative disease, as well as those with ossification of the posterior longitudinal ligament.

Cervical Vertebrae↗
PubMed1995

Chronic effect of oral mexiletine administration on left ventricular contractility in patients with congestive heart failure: a study based on mitral regurgitant flow velocity measured by continuous-wave Doppler echocardiography.

The long-term effect of mexiletine on left ventricular (LV) contractility in patients with congestive heart failure is not clear. The authors therefore measured LV contractility before and after continuous oral administration of mexiletine in patients with congestive heart failure accompanied by mitral regurgitation (MR) using Doppler echocardiography. The study population consisted of 8 patients with congestive heart failure (6 due to dilated cardiomyopathy and 2 due to old myocardial infarction) accompanied by significant functional MR who had more than 1000 ventricular premature contractions (VPCs) per day or Class IV Lown classification arrhythmias before mexiletine administration. The LV contractility was evaluated by calculating a Doppler-derived index, the rate of increase in LV pressure during the isovolumic contraction time (ICT delta P/delta t), which has been confirmed to be nearly equal to LV Max dP/dt. The increase in LV pressure (delta P) between 1 and 3 m/sec of the MR flow velocity as measured by continuous-wave Doppler echocardiography was calculated using the simplified Bernoulli's equation, and ICT delta P/delta t was derived by dividing delta P by the time required for this change. The left ventricular ejection fraction and the left ventricular and left atrial dimensions also were measured by echocardiography. These parameters were obtained before and after 2 to 4 weeks of daily oral administration of mexiletine 300 mg. Values of ICT delta P/delta t were 640 +/- 202 mm Hg/sec and 650 +/- 210 mm Hg/sec before and after mexiletine administration, respectively, showing no change.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗