Biomedical subjects

K Makimoto

Publications and source records attributed to K Makimoto.

At least 37 records · Page 2Linked to original sources

PubMed1996

Influence of hypotension on cochlear blood flow in polycythemic condition.

We examined the influence of hypotension by infusion of acebutolol hydrochloride (AH), a cardioselective beta-receptor antagonist, on cochlear blood flow in guinea pigs with various hematocrit values. AH infusion lowered the mean blood pressure to almost the same degree in all animals, regardless of the hematocrit level. The degree of the concomitant decrease of CBF varied with the hematocrit, being greater in animals with a higher hematocrit. In those with the highest hematocrit CBF did not return to the initial level. From these values we calculated the O2 transport capacity after AH infusion and found it to be lower than in animals without AH infusion. The difference was greater at higher hematocrits. These findings suggest that the microcirculation of the inner ear is responsive to transient decreases of perfusion pressure at high hematocrits.

Acebutolol↗

PubMed1996

[Clinical studies on autologous blood transfusion].

To study the present status of blood transfusion in head and neck surgery, we investigated recent cases of intraoperative transfusion in our department. In addition, we present our autologous blood transfusion cases, presently involved in an ongoing clinical trial for patients with head and neck cancer in our department which began in 1989. 1. Investigation of intraoperative blood transfusion cases There were 37 cases of intraoperative blood transfusion among 677 cases who underwent surgery under general anesthesia during the period from May, 1991 to December, 1993. We divided these 37 cases into three groups according to the amount of intraoperative blood loss: less than 600ml (10 cases), more than 600ml and less than 1200ml (11 cases), and more than 1200ml (16 cases). Average amounts of intraoperative blood transfusion in each group were 195ml, 475ml and 780ml, respectively. As we noted that most of these 37 cases received a blood transfusion of less than 800ml, the majority needing intraoperative blood transfusion during head and neck surgery are potential candidates for autologous blood transfusion. Therefore, we have promoted autologous blood transfusion for intraoperative blood transfusion in head and neck surgery. Thus, the patients undergoing intraoperative autologous blood transfusion increased to seven annually as of 1994. 2. Clinical studies on autologous blood transfusion Among 677 cases of head and neck surgery conducted during a six year period (1989-1994), we experienced ten cases of autologous blood transfusion. For the prevention of anemia due to repeated blood withdrawal, we administered an iron preparation. Patients who preoperatively showed a low value of Hb (less than 11g/ dl) received intravenous drip infusion of erythropoietin. Since some patients selected for autologous blood transfusion, who also received neo-adjuvant chemotherapy and preoperative radiotherapy, exhibited a generally chronic anemia status, an iron preparation and erythropoietin should be preoperatively administered in combination.

Adolescent↗

PubMed1995

Tracheo-esophageal shunt speech: report of an unusual case.

A rare case of laryngectomee who acquired TE shunt speech is reported. Our patient was a 64-year-old woman with laryngeal cancer (glottic type T3N0M0). She underwent laryngectomy in 1990, and a Komorn tracheo-esophageal shunt operation was performed simultaneously. A voice prosthesis (BIVONA) was inserted into the shunt, but the voice valve was not used. She acquired shunt speech soon after the operation, and there was no need to close the tracheostoma during phonation. Fiberoptic, X-ray and aerodynamic findings of the shunt and esophagus were as follows: (i) The one-way valve of the voice prosthesis was open during inspiration and closed during phonation. (ii) Swallowing of air, as seen in esophageal speech, was not observed. (iii) The neoglottis was in the upper part of the esophagus. It was concluded that the air for the vibration of the neoglottis entered the esophagus through the T-E shunt during inspiration.

Female↗

PubMed1995

Mortality in psychiatric patients, with a specific focus on cancer mortality associated with schizophrenia.

BACKGROUND: Higher mortality rates among psychiatric patients compared with the general population have been widely reported. On the other hand, lower cancer mortality for schizophrenics has been occasionally pointed out. Few studies from Japan have investigated mortality among psychiatric patients, and this study is the first large-scale follow-up in this country. METHODS: A total of 4980 patients admitted to a national mental hospital from 1948 through 1982 were followed up until 31 August 1985. The standardized mortality ratios (SMR) were calculated in comparison to the general population, using the person-years method. RESULTS: The SMR for total deaths and those for malignancy were as follows for males/females respectively: 2.55/3.02 and 0.84/1.37 for schizophrenia, 1.76/2.37 and 1.44/2.10 for depression, 2.45/3.04 and 1.18/1.82 for mania, 1.81/1.90 and 0.27/1.07 for neurosis, 5.55/4.33 and 1.85/3.34 for alcohol/drug abuse, and 3.65/3.57 and 1.01/0.72 for organic brain syndrome. CONCLUSIONS: The SMR for total deaths were significantly elevated in schizophrenia, depression, mania, neurosis, alcohol/drug abuse, and organic brain syndrome, respectively. The SMR for malignancy were not elevated nor lowered significantly in any of these disease categories. The SMR for stomach cancer in male schizophrenics was significantly lower (0.27; P < 0.05).

Cause of Death↗

PubMed1995

Effect of lidocaine injection of EOAE in patients with tinnitus.

In the present study, evoked otoacoustic emissions (EOAEs) were measured in 30 patients with tinnitus before and after intravenous lidocaine injection (1 mg/kg). For EOAE recordings, 1 kHz tone burst stimuli were used. Intravenous lidocaine injection resulted in suppression of tinnitus in 22 (73%) ears, and changes of EOAE amplitude (increase or decrease) in 18 (60%) ears. Of the 18 ears with EOAE amplitude changes, tinnitus disappeared or decreased in 17 (94%) ears. In 12 ears without changes of EOAE amplitude, tinnitus was suppressed in only 5 (42%). Changes in latency were not detected in any of the ears. These results indicate that there is a relationship between the effect of lidocaine in tinnitus suppression and changes in cochlear micromechanics caused by lidocaine.

Acoustic Stimulation↗

PubMed1994

Blood viscosity and plasma viscosity in patients with sudden deafness.

Blood viscosity and plasma viscosity were measured in 51 patients with sudden deafness (SD) and 70 controls with normal hearing. Blood viscosity and plasma viscosity in patients with SD at their first medical examination were significantly higher than in the control group. The difference in viscosimetry results between the two groups was greater at higher shear rates. The data obtained in viscosimetry and pure-tone audiometry were analyzed after dividing the patients into a high viscosity group and a normal viscosity group. The correlation between average hearing level in pure-tone audiogram and blood viscosity or plasma viscosity was positive. The values of the O2-transport capacity of the blood demonstrated a negative correlation with average hearing level in patients with SD before treatment. During the course of treatment, blood viscosity and plasma viscosity decreased with the improvement of hearing impairment. When the distribution of average hearing level was 40 to 79 dB, a few of the patients with "recovery" or "good improvement" and most of patients with "fair improvement" or "no change" belonged to the low viscosity group. And, most of the patients with flat type hearing impairment and a few patients with high tone type hearing impairment belonged to the high viscosity group. These results suggest that many patients with SD have increased blood viscosity and plasma viscosity, and that this increase may play a significant role in the etiology of SD. There are also some differences in etiologic factors concerning type of hearing impairment and prognosis. In conclusion, the present study points to the importance of measuring blood viscosity and plasma viscosity in patients with SD, since blood and/or plasma viscosity may be involved in its etiology and prognosis.

Adult↗

PubMed1993

[Human herpesvirus-6 antibodies in idiopathic facial nerve palsy and sudden deafness].

Human herpesvirus-6 (HHV-6) is the causative agent for exanthem subitum. This study investigated the relationship between idiopathic facial nerve palsy (Bell's palsy), sudden deafness and HHV-6 infection. Both Bell's palsy and sudden deafness are syndromes which causes are unknown. Both of them are suspected viral infection as causative agents. Paired sera from 22 patients of Bell's palsy and 39 patients of sudden deafness were examined for reactivity to HHV-6 by the indirect immunofluorescence test. On a case of Bell's palsy and two cases of sudden deafness each of the HHV-6 antibody titers was increased.

Adult↗

PubMed1993

[A case of middle ear adenoma].

Middle ear adenomas are rare and difficult to diagnose. Recent histological studies suggest the presence of a distinct disease entity known as a middle ear adenoma. A 16-year-old boy with a middle ear tumor was treated by partial temporal bone resection, and the tumor was removed by a combined method using the middle cranial fossa and infratemporal fossa approaches. Histological and immunohistochemical studies on this tumor showed the findings of a benign adenoma. Left facial palsy was noted postoperatively, but it subsequently recovered almost completely.

Adenoma↗

PubMed1993

[Combined treatment of head and neck cancers by radiation therapy and chemotherapy with a small dose of CDDP].

Two-route infusion chemotherapy with a smaller dose of CDDP was applied for combined modality treatment with radiation therapy for head and neck cancer from 1985 to 1992. To determine the appropriate dose of CDDP in this treatment, we investigated parameters concerned with its toxicity by comparing two groups given 5 and 10 mg of CDDP as a daily dose. Complete response was attained in 18 of 24 cases in the 5 mg group and 8 of 11 cases in the 10 mg group. The toxicity due to CDDP in this protocol was found generally to be slight in both groups. Among the parameters of toxicity, creatinine clearance was most affected. A decrease in 24 hr. creatinine clearance was noted in 15 of 29 cases in the 5 mg group and 10 of 12 cases in the 10 mg group. We had to discontinue this treatment after the first course because of lowered creatinine clearance in a patient in the 5 mg group. Stomatitis due to radiation therapy appeared to become worse in combination with this chemotherapy. The 10 mg dose of CDDP can be applied as a safe combination treatment with radiation therapy for head and neck cancer. To improve the outcome of this treatment modality for carcinomas of the tongue and oral floor, the 10 mg dose of CDDP was thought to be more beneficial. However, in the case of cumulative doses of CDDP over 100 mg, precaution should be taken to avoid the risk from the toxicity of more CDDP administration.

Adult↗

PubMed1993

[A case of smoldering ATL associated with hypersensitivity pneumonitis].

A 37-year-old woman was admitted to our hospital with the complaints of cough, lymph node swelling. Chest X-ray film showed diffuse small nodular shadows in the bilateral lower lung fields. Bronchoalveolar lavage fluid revealed an increased proportion of lymphocytes (71%) with low OKT4/T8 ratio (0.26). Lung tissue biopsied by bronchofiberscopy showed the existence of interstitial pneumonia. Precipitating antibodies in this patient's serum against various antigens including Trichosporon cutaneum were positive. After admission, all symptoms resolved gradually without specific therapy. But, as soon as the patient was discharged and returned to her home, all symptoms including fever, cough, dyspnea and lymphadenopathy recurred rapidly. The diagnosis of hypersensitivity pneumonitis was made on the basis of these laboratory findings and clinical course. The patient died from respiratory failure after detection of anti-HTLV-I antibody, and autopsy revealed massive ATL cell infiltration of lung tissue, and immunoenzymatic analysis showed a high OKT4/T8 ratio (3.5). Chronic HTLV-1 infection since infancy was suspected in this case, to have modified the immune regulation of the lung, and to have led to the onset of hypersensitivity pneumonitis and the active immune response in the lungs, finally followed by the acute exacerbation of ATL.

Adult↗

PubMed1992

Histological changes during progression of adenoid cystic carcinoma.

Eight cases of adenoid cystic carcinoma were reviewed to determine whether and how the histological features of the tumour vary with the progress of the disease. The tumours were classified by their histological patterns as tubular, cribriform, trabecular or solid. The relative amount of each pattern seen in routine light microscopic sections was calculated histomorphometrically and compared in the primary tumour and recurrent and/or metastatic lesions in the same case. In the early stage, the tubular pattern predominated. Later, the highest percentage shifted to the cribriform, then to the trabecular and finally, in the late stage, to the solid pattern. There was no reverse direction of histological transformation from the solid to the tubular pattern. These results may help to explain previous reports that the tubular pattern usually represents a favourable prognosis, the solid pattern a poor prognosis and the cribriform pattern an intermediate prognosis.

Adult↗

PubMed1992

The effect of batroxobin on cochlear blood flow.

Cochlear blood flow is considered to be closely related to cochlear function. Among several etiologic factors implicated in inner ear diseases, disturbance of local blood flow is held to be one of the most important. With this in view, various pharmaceuticals are currently being used to increase local blood flow in patients with inner ear diseases. In the control of blood flow there are three major factors; systemic blood pressure (perfusion pressure), vascular tone, and blood viscosity. Batroxobin (BX) was developed to increase local blood flow by lowering blood viscosity through defibrinogenation; it is used in the treatment of thrombosis and occasionally for the treatment of sudden deafness. In the present study, we observed the effect of BX on cochlear blood flow in guinea pigs, using a laser Doppler flowmeter, and measured the blood fibrinogen concentration after BX infusion. There was an obvious increase in cochlear blood flow during the observation period of 3 h after 10 BU/kg were infused, and a slight increase when 2 BU/kg were infused. Blood fibrinogen levels decreased dramatically by 30 min after BX infusion (10 BU/kg), and the extremely low level attained was maintained throughout the 3-h observation period. Hemorrhage from the surgically opened ear was noted in 2 animals during the experiment and rectal bleeding in one.

Animals↗

PubMed1992

[Studies on the T-cell subset in lung tissue and BALF from patients with interstitial pneumonia].

The cellular components in bronchoalveolar lavage fluids (BALF) have been analyzed to obtain information on cellular kinetics in lung tissues of patients with diffuse pulmonary diseases. While various cells, alveolar macrophages, lymphocytes, and granulocytes appear in BALF, an increase in the percentage of lymphocytes has been noted in a variety of interstitial pneumonia. The T-cell subset of lymphocytes in BALF and biopsied lung tissues was, therefore, examined in patients with hypersensitivity pneumonitis (HP), sarcoidosis (Sar), idiopathic interstitial pneumonia (IIP) and rheumatoid arthritis with interstitial pneumonia (RA+IP) to compare the ratios of CD4/CD8 in BALF and lung tissues. The T-cell subset in BALF was analyzed by flow cytometry and the T-cell subset in lung tissues was detected with fresh frozen and thin-sliced specimens using an avidine-biotin complex (ABC) kit (Vecta Co. Ltd). The mean CD4/CD8 ratio in BALF was 0.36 in HP, 3.1 in Sar, 1.07 in IIP and 2.59 in RA+IP, while the mean CD4/CD8 ratio in lung tissues was 0.52 in HP, 2.59 in Sar, 1.11 in IIP and 2.25 in RA+IP, respectively. The ratios of CD4/CD8 in BALF and lung tissues from patients with these various interstitial pneumonia showed a positive correlation indicating that the changes of cellular components in BALF would reflect the changes in the lung tissues. Furthermore, CD4/CD8 ratios of lymphocytes infiltrating the alveolar portion and granuloma in lung tissues of HP were analyzed separately, because the CD4/CD8 ratios varied considerably from part to part of the lung tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolitis, Extrinsic Allergic↗

PubMed1992

[A case report of pulmonary infiltration with eosinophilia syndrome induced by Candida albicans].

A sixty six-year-old female who had been treated for bronchial asthma for about 25 years was admitted to the hospital with complaints of episodes of dyspnea, eosinophilia and infiltrative shadows in the chest X-ray film. An infiltrative shadow appeared to move from the left to the right lung field and finally formed a shadow of atelectasis in the middle field of the right lung. A sputum culture showed only Candida albicans. Allergic and immunologic examination revealed high IgE serum levels with specific IgE against Candida albicans in high titer, and Aspergillus fumigatus in low titer. The precipitating antibody was shown only against Candida antigen. Additionally, the blastogenic response to Candida antigen was high in comparison with other fungal antigens including Aspergillus fumigatus. The clinical features and laboratory findings of this patient were found to satisfy Rosenberg's criteria for allergic bronchopulmonary aspergillosis (ABPA), except for the existence of Candida albicans in place of Aspergillus species as the causative antigen. The pathogenesis of PIE syndrome has been studied and various allergic mechanisms against many antigens reported. In this patient Candida albicans could be playing the crucial role in the formation of PIE syndrome, which might be best described as allergic bronchopulmonary candidiasis (ABPC).

Aged↗

PubMed1991

Relationship between cochlear blood flow and perilymphatic oxygen tension.

To clarify the characteristics of the blood circulation in the cochlea, we correlated cochlear blood flow and perilymphatic oxygen tension at various blood pressures. Cochlear blood flow was measured in guinea pigs by laser Doppler flowmetry, and perilymphatic oxygen tension by polarography. Blood pressure changes were induced by angiotensin II injection, trimetaphan camsylate injection and blood withdrawal. Cochlear blood flow generally paralleled systemic blood pressure, indicating a close correlation. In contrast, perilymphatic oxygen tension was slower to increase and decrease. However, when systemic blood pressure was lowered more gradually, perilymphatic oxygen tension did not show the same lag. These findings indicate that perilymphatic oxygen tension parallels systemic blood pressure when changes induced are slower and in a physiological range.

Angiotensin II↗

PubMed1991

Autoregulation of cochlear blood flow. A comparison of cerebral blood flow with muscular blood flow.

The cochlear blood flow of healthy adult guinea pigs was measured with a laser Doppler flowmeter and flow dynamics were analyzed on the basis of autoregulation. Angiotensin II infusion was used to raise blood pressure, while phlebotomy was done to lower blood pressure. The characteristics of autoregulation of cerebral blood flow and muscular blood flow were also investigated. Cochlear blood flow was considered to have some autoregulation but was less than brain blood flow, which showed significant regulation. Muscular blood flow seemed to have no similar regulatory mechanism.

Angiotensin II↗

PubMed1991

Effects of a depressor on cochlear blood flow and perilymphatic oxygen tension.

To clarify the characteristics of the blood circulation in the cochlea, we investigated the relationship between cochlear blood flow and perilymphatic oxygen tension in guinea pigs with trimetaphan camsilate induced hypotension. Cochlear blood flow was measured by laser Doppler flowmetry, and perilymphatic oxygen tension by a polarographic method. Cochlear blood flow generally paralleled systemic blood pressure, while perilymphatic oxygen tension showed a slower response to the decrease of systemic blood pressure. Although there were individual differences in the changes of systemic blood pressure, cochlear blood flow and perilymphatic oxygen tension, they were found to be dose dependent. Since hypotension induced by trimetaphan camsilate is fairly reproducible in the dose range of this experiment, this drug can be used as a ganglion blocking agent in experiments on cochlear blood flow and perilymphatic oxygen tension during systemic hypotension. The change of perilymphatic oxygen tension with a slower response could be considered to be a factor in the homeostasis in the inner ear fluid.

Animals↗

PubMed1991

Feasibility of pulse oxymetry to measure arterial O2 saturation in studies on cochlear blood circulation.

To understand the characteristics of oxygen transport to the inner ear, the relationship between arterial O2 saturation and cochlear microcirculation was investigated under different respiratory condition in guinea pigs. To monitor arterial O2 saturation a pulse oxymeter instead of an arterial blood gas analyzer was used. When the arterial O2 saturation was measured in the foot pad by a pulse oxymeter under different respiratory conditions, the data showed a close correlation with the results of blood gas analysis. For the measurement of cochlear microcirculation, a pulse oxymeter was found to be a feasible respiratory monitor for animal experiments. With this apparatus our study demonstrated a slower reaction in the decrease of perilymphatic oxygen tension than of cochlear blood flow during stepwise induction of hypoventilation monitored by a pulse oxymeter. Under certain conditions of hyperventilation in which arterial O2 saturation and perilymphatic oxygen tension increased gradually, cochlear blood flow was found to decrease. This decrease of cochlear blood flow could be attributed to chemical controls which are regulated, as in the cerebral blood circulation, by the content of CO2 and H+ in the vascular bed in the cochlea.

Animals↗