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Biomedical subjects

K Miyazawa

Publications and source records attributed to K Miyazawa.

At least 253 records · Page 14Linked to original sources
PubMed1989

[A screening index for primary hyperparathyroidism using discriminant functions].

In order to obtain a useful screening index for primary hyperparathyroidism (PHPT), seven patients with PHPT and fifty-one patients with nonparathyroid hypercalcemia (NPHC) were studied retrospectively. Serum calcium, inorganic phosphate (IP), alkaline phosphatase, albumin (Alb), chloride (Cl), total protein, urea nitrogen and creatinine (Cre) were analyzed at the same time. Discriminant analysis using a stepwise variable select method was applied to these patients. A discriminant function (F 1) was derived from three laboratory tests; F 1 = -0.660 x [IP] + 0.142 x [Cl] + 0.564 x [Alb] - 14.4 (PHPT: F 1 greater than 0.641). F 1 had sensitivity of 100% and specificity of 72.5% (14 false positives) in diagnosing PHPT. Next, another discriminant function (F 2) was derived from PHPT and the false positive patients; F 2 = -2.61 x [IP] + 0.286 x [Cl] - 4.24 x [Cre] - 19.3 (PHPT: F 2 greater than 0.412). When F 2 was applied to positive patients by F 1, final sensitivity was 100% and specificity was 98%. This screening method was tested prospectively in fifty-six consecutive samples of hypercalcemia (PHPT 4, NPHC 52), resulting in sensitivity of 100% and specificity of 98%. It was proved that our screening method using two step discriminant functions was very useful to diagnose PHPT.

Adolescent↗
PubMed1989

[Second generation shock wave lithotripsy: experience with the Siemens Lithostar].

In 1980, extracorporeal shock wave lithotripsy (ESWL) was incorporated as a nonsurgical method of stone removal in the cases of nephrolithiasis and rapidly found worldwide acceptance. Several devices commonly designated "second generation" lithotripters vs "first generation" Dornier HM3 are now under experimental or clinical trial. We report our clinical experience of ESWL using a Siemens Lithostar and compared it with that obtained using a Dornier HM3. One hundred patients were treated during the period of April through October, 1986 using an HM3, and 100 other patients were treated using a Lithostar from April to August, 1988. More cases were treated with a Lithostar than with a HM3. Nearly 10% of all patients treated by ESWL required additional therapeutic approaches (excepted ureteral stent) either with HM3 or Lithostar. However, in the cases of ureteral stone, with the Lithostar more cases required adjuvant procedures (TUL) than HM3. Significantly more shock waves were needed with Lithostar than HM3 for complete fragmentation of the same size of renal and ureteral stones. The stone-free rate during a one month period after ESWL was nearly the same for HM3 and Lithostar (HM3: 84.3%, Lithostar: 83.5%). Lithostar is a multifunctional lithotriptor which has most of the advantages required by the lithotripter.

Evaluation Studies as Topic↗
PubMed1989

Paired Papanicolaou smears in the evaluation of atypical squamous cells.

Between February 1985 and April 1988, 360 women were seen at Tripler Army Medical Center's cervical clinic as part of a prospective study to assess the value of paired Papanicolaou smears in the follow-up of atypical squamous cells in a cervical cytologic smear. The evaluation consisted of paired repeat Papanicolaou smears and colposcopy. Colposcopically directed biopsies and/or endocervical curettage were performed in 86% of the subjects. The results of the paired Papanicolaou smears were negative/negative in 202 patients (56%). Cervical intraepithelial neoplasia was diagnosed histopathologically in 16% of all patients and in 10% of those with negative/negative repeat smears. We conclude that the presence of atypical squamous cells in a Papanicolaou smear should be considered abnormal and that colposcopy and colposcopically directed biopsies should be performed for these patients.

Adolescent↗
PubMed1989

The significance of a negative Papanicolaou smear with hyperkeratosis or parakeratosis.

The significance of a cytologic diagnosis of hyperkeratosis or parakeratosis on a Papanicolaou smear reported as negative is unknown. We conducted a review of 170 women without uterine descensus who presented to Tripler Army Medical Center cervical clinic with a negative Papanicolaou smear but with hyperkeratosis or parakeratosis noted on the slide. All patients underwent colposcopy, and 64% had either cervical punch biopsy or endocervical curettage. Six women (3.5%) had cervical intraepithelial neoplasia documented histopathologically. We conclude that the cellular findings of hyperkeratosis or parakeratosis on a Papanicolaou smear are not associated with an increased histologic or colposcopic detection of cervical intraepithelial neoplasia.

Adolescent↗
PubMed1989

Expectant management of persistent ectopic pregnancy. A case report.

Monitoring serum human chorionic gonadotropin (hCG) titers after conservative surgery for ectopic pregnancy has been recommended to rule out persistent ectopic pregnancy. With this increased monitoring, the occurrence of persistent ectopic pregnancy has been reported with increasing frequency. Management techniques for this complication have thus far been surgical or medical. We used expectant management for a case of persistent ectopic pregnancy, monitoring serial serum hCG titers to the limits of detectability over a period of 69 days.

Adult↗
PubMed1988

Modulation of stimulus-dependent human platelet activation by C-reactive protein modified with active oxygen species.

C-reactive protein (CRP) is one of the most characteristic acute phase proteins which appear in the serum during certain inflammatory diseases. We report here that human CRP acquired the ability to augment platelet reactivity when treated with an Fe2+ (Cu2+)-ascorbate system. CRP modified by such treatment showed no appreciable activation of platelets in the absence of platelet activators such as platelet-activating factor, thrombin, or ADP. However, in the presence of the modified-CRP, irreversible activation of platelets occurred with sub-optimal doses of platelet-activating factor and other stimulatory agents for platelets. CRP without any treatment did not show any modulating activity. Each component of the Fe2+-ascorbate system was required for modification of CRP, suggesting that CRP was modified through an oxidative process. The modification of the CRP structure was confirmed by the change in the fluorescence spectrum of 8-anilino-1-naphthalene sulfonate complexed with CRP, the increased susceptibility of CRP to proteolytic enzymes and the altered reactivity to anti-CRP mAb. We also found an inactivating system for the modified CRP in plasma. The modified human CRP did not show any modulating activity toward rabbit platelets, suggesting that the activity is species specific.

Ascorbic Acid↗
PubMed1988

Tetrodotoxin in two species of ribbon worm (Nemertini), Lineus fuscoviridis and Tubulanus punctatus.

Extracts of two species of ribbon worm, Lineus fuscoviridis and Tubulanus punctatus, had lethal potencies in mice from 15-503 MU/g of worm and from less than 10-540 MU/g, respectively. The toxins were partially purified by ultrafiltration and column chromatography using Bio-Gel P-2 and Bio-Rex 70 (H+ form). Thin-layer chromatographic, high performance liquid chromatographic and gas chromatography-mass spectrometric analyses revealed the presence of tetrodotoxin and anhydrotetrodotoxin plus some unidentified compounds.

Animals↗
PubMed1988

Use of theophylline in the investigation of pseudothrombocytopenia induced by edetic acid (EDTA-2K).

In automated cell counting of edetic acid (EDTA-2K) anticoagulated blood, thrombocytopenia is occasionally seen which bears no relation to any underlying disease. In this study a heparin and soluble theophylline mixture was used to measure accurately platelet numbers in patients with such pseudothrombocytopenia. In four normal volunteers, a theophylline concentration of more than 7 mg/ml produced no significant difference in platelet numbers between theophylline and heparin and EDTA-2K anticoagulated bloods. When blood treated with EDTA-2K was used in seven patients with pseudothrombocytopenia, falsely low platelet counts were observed in three patients immediately after sampling; in blood treated with theophylline, white cell and platelet counts remained unchanged for up to six hours after sampling. Microscopical examination of the EDTA-2K anticoagulated blood showed massive platelet clumping, but no aggregates were seen in theophylline anticoagulated blood. It is concluded that theophylline can be useful in the investigation of pseudothrombocytopenia when an automated cell counter is used.

Adult↗
PubMed1988

Effect of local cardiac sympathectomy on regional myocardial contraction.

To investigate the response of locally sympathectomized myocardium to sympathetic stimulation, 90% phenol solution was painted on the left ventricular anterior wall surface in 13 open chest anesthetized dogs. Two pairs of ultrasonic crystals were implanted into the mid-myocardium and the left ansa subclavia was stimulated (LSS) at a frequency of 4 Hz. Heart rate, left ventricular systolic pressure and peak dP/dt increased following LSS before and after phenol application. After phenol application, the increase in peak dP/dt was significantly lower than before phenol application (p less than 0.01) despite similar increases in both heart rate and left ventricular systolic pressure. Before phenol application, norepinephrine (NE) overflow was observed following LSS (1.60 ng/ml) but after phenol application NE overflow decreased to 0.45 ng/ml, indicating that phenol interrupted sympathetic nerve conduction. During LSS, in both anterior and posterior walls, %shortening (%dL) increased from 13 +/- 1 (mean +/- SE) to 22 +/- 3% and 12 +/- 1 to 20 +/- 2%, respectively. After phenol application, LSS caused an increase of %dL in the posterior wall from 10 +/- 1 to 17 +/- 2%, while in the anterior wall it decreased from 15 +/- 2 to 8 +/- 3%. At the end of the experiment, when NE was infused to maintain the left ventricular systolic pressure similar to that obtained during LSS, %dL increased from 15 +/- 2 to 21 +/- 3% in the anterior wall. Pressure-length loop during LSS showed an early systolic expansion in the phenol treated anterior wall which disappeared during NE infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Laparoscopic management of fallopian tube prolapse.

Sporadic cases of fallopian tube prolapse and various methods of management have been reported since the initial case described in 1902. Two cases were managed recently by a combined vaginal and laparoscopic approach. Total salpingectomy was accomplished with minimal difficulty and limited invasiveness. A brief summary of each case and detailed description of the operative technique are presented.

Adult↗