Search PubMed⌕ Search

Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 541 records · Page 30Linked to original sources
PubMed1996

A family of multiple endocrine neoplasia type 2A: genetic analysis and clinical features.

Since a heterozygous missense mutation of the RET proto-oncogene in the germline was found to cause multiple endocrine neoplasia type 2A (MEN 2A) in 1993, some 20 different mutations of this gene have been identified in MEN 2A kindreds. We report an MEN 2A family in which serine (AGC) substitutes for cysteine (TGC) at codon 618 in exon 10 of the RET proto-oncogene. The mutation was identified by sequencing PCR products of exons 10 and 11 in the proband. Since this mutation results in creation of a new cleavage site for Alu I restriction enzyme, most of the other members of the family were screened by digestion of the PCR product of exon 10 with this enzyme. Eleven of 20 subjects across four generations examined have the mutation of the RET proto-oncogene, and all of the adult gene carriers except one woman had MTC. Characteristics of this family are 1) pheochromocytoma has been found in only the proband, 2) no obvious hyperparathyroidism has been observed, and 3) the prognosis is favorable, with nobody dying of MEN 2A itself. Genetic analysis of MEN 2A is definitely useful and essential for screening of a MEN 2A family. It is very important to accumulate cases with MEN 2A and investigate the phenotype and the prognosis in each mutation.

Adult↗
PubMed1996

Proprioceptive representation of the levator veli palatini muscle in the solitary nucleus of the rat.

The levator veli palatini muscle is innervated by motoneurons of the glossopharyngeal nerve, which are located within the ambiguus nucleus; however, little is known about the afferent fibers of this muscle. A horseradish peroxidase study was conducted in rats following injection into the levator veli palatini muscle branch to reveal the location and the distribution of dendrites of the afferent fibers of the muscle. Terminal labels were densely distributed in the lateral region of the solitary nucleus, which receives afferents of the glossopharyngeal nerve, ipsilateral and contralateral to the injection site. The relationship of the levator veli palatini muscle with respiration was suggested by the localization of labeled terminals at sites where the afferents from the respiratory organs project densely, and by the demonstrated proprioceptive role of the afferent fibers passing through the muscle spindles contained in the levator veli palatini muscle.

Afferent Pathways↗
PubMed1996

Identification of two missense mutations in the GIP receptor gene: a functional study and association analysis with NIDDM: no evidence of association with Japanese NIDDM subjects.

Gastric inhibitory polypeptide (GIP) potently stimulates insulin secretion from pancreatic islets in the presence of glucose as an incretin. Because the insulinotropic effect of GIP is reduced in NIDDM, it should be clarified whether defects in the GIP receptor gene contribute to the impaired insulin secretion in NIDDM. Using genomic DNA samples from Japanese NIDDM and non-NIDDM subjects, we have investigated the entire coding region of the GIP receptor gene by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP). We have identified two missense mutations, Gly198-->Cys (Gly198Cys) in exon 7 and Glu354-->Gln (Glu354Gln) in exon 12. Investigation of the function of GIP receptor with either of these mutations reveals a half-maximal stimulation value of GIP-induced cAMP response in Chinese hamster ovary cells expressing the GIP receptor with Gly198Cys of 6.3 +/- 1.2 x 10(-10) mol/l (n = 3), which was considerably higher than that of the normal GIP receptor, 9.4 +/- 3.8 x 10(-12) mol/l GIP (n = 3), whereas that of the GIP receptor with Glu354Gln was not significantly different from that of the normal GIP receptor. To assess the possible role of the GIP receptor gene in genetic susceptibility to NIDDM, we have examined the allelic frequencies of Gly198Cys and Glu354Gln in NIDDM and control subjects. Association studies show no relationship between NIDDM and either of the two mutations.

Alleles↗
PubMed1996

[Progressive systemic sclerosis associated with massive pleural and pericardial effusion in a 90-year-old woman].

A 90-year-old woman was admitted to our hospital in December 1993 because of dyspnea on exertion and malaise. She had been well until October 1993, when she first noticed Raynaud's phenomenon, skin tightening, digital ulceration and scarring of her hands. On physical examination, generalized edema was found, along with acrosclerosis with contracture, especially in the fingers, wrists, and elbows. Inspiratory crackles were noted. A roentgenogram of the chest and an echocardiogram revealed pulmonary fibrosis, pulmonary congestion, and massive pleural and pericardial effusions. The pleural effusion was a transudate. Progressive systemic sclerosis was diagnosed, and furosemide and isosorbide were given. The edema and pulmonary congestion resolved, but the pleural and pericardial effusions did not. Prednisolone was given, which reduced the pleural effusion but not the pericardial effusin. The pleura and the pericardium are not usually involved in progressive systemic sclerosis, and this disease rarely occurs in patients over 70 years old. To the best of our knowledge, this was one of the oldest patients with progressive systemic sclerosis. The combination of massive pleural and pericardial effusions, and the advanced age of onset make the present case unusual.

Aged↗
PubMed1996

[Dissection of the interventricular septum with aorto-left ventricular communication due to infective endocarditis--report of a rare case].

Dissection of the interventricular septum is an uncommon manifestation, which is rarely associated with infective endocarditis, aneurysm of sinus of Valsalva and thoracic trauma. We report a 34-year-old male case with aorto-left ventricular communication due to infective endocarditis. The patient had chief complaints of dyspnea on exertion and precordial discomfort. Preoperative laboratory data showed normal white blood cell counts, a slightly elevated CRP, and negative blood culture in bacterial examinations. Echocardiogram revealed progressive dissection of the interventricular septum and stenosis of the left ventricular outflow tract. Disturbance of conduction including progressive atrioventricular block and bundle branch block were found in the electrocardiogram. The dissection extended over 2 x 2 x 2.5 cm in diameter, with an entry located at the basis of the right coronary cusp and reentry communicated to the left ventricle. Operative procedures included the aortic valve replacement with prosthetic valve due to severe inflammation, in addition to resection of the dissecting cavity. Pathological examination of the resected tissue accorded with infective endocarditis in active phase, showing necrosis, small cell infiltration and microabscess. However, a bacterial colony was not found in the surgical specimen. Postoperative course was uneventful and the patient was discharged in satisfactory conditions.

Adult↗
PubMed1996

[Successful aorto-coronary bypass grafting and concomitant left ventricular myotomy-myectomy in a patient with coronary artery disease associated with hypertrophic obstructive cardiomyopathy].

A 65-year-old man complained chest oppression at rest and dizziness. Echocardiography showed subaortic stenosis with outflow gradient of 100 mmHg, although interventricular septal thickness was only 12 mm and left ventricular posterior wall thickness was 11 mm, and mild mitral regurgitation. Selective coronary angiography demonstrated 90% stenosis in left main truncus, 50% stenosis in first diagonal branch, and hypoplastic right coronary artery. Emergent coronary artery revasculization concomitant with left ventricular myotomy myectomy was performed. Immediately after weaning off the cardiopulmonary pump, IABP was employed for cardiac assistance, because of residual left ventricular outflow pressure gradient, which was provoked by cathecholamine and amyl nitrite. He was discharged in 1 month in NYHA class I. Echocardiography 3 months after operation showed no residual outflow pressure gradient, no systolic anterior motion of mitral anterior leaflet, and mild approximately mitral regurgitation. Careful operative management, including myocardial protection and avoiding perforation of ventricular septum and postoperative medical care are mandatory to this group of patients. This case is the first successful coronary artery bypass grafting and concomitant left ventricular myotomy-myectomy reported in Japan.

Aged↗
PubMed1996

The effect of urapidil on neurogenic bladder: a placebo controlled double-blind study.

PURPOSE: We assessed the efficacy and safety of urapidil, a new alpha-blocker, for the treatment of neurogenic bladder dysfunction in a prospective double-blind trial. MATERIALS AND METHODS: A total of 136 patients was randomly assigned to receive placebo (group 1), or treatment with 30 mg. of urapidil for 4 weeks (group 2) or 30 mg. for 2 weeks followed by 60 mg. for 2 weeks (group 3). RESULTS: Urinary frequencies decreased significantly only in group 3. The sum of obstructive symptom scores decreased significantly in all groups. However, a significant difference in subjective symptoms was not noted among the groups. Average and maximum flow rates, and residual urine improved significantly in groups 2 and 3 but not in group 1. Regarding cystometric parameters, no significant changes were noted in any group. In the pressure-flow study, the pressure at maximum flow rate and minimum urethral resistance (pressure at maximum flow rate divided by the square of maximum flow rate) decreased significantly only in group 3. In the urodynamic assessment, significant improvement was noted in groups 3 versus 1. There were no significant differences between the sexes or among underlying diseases with regard to symptomatic and urodynamic improvements. Side effects were noted in 2 patients in group 3 and 1 in group 2, none of which was severe. CONCLUSIONS: Urapidil improved voiding dysfunction in patients with a neurogenic bladder and decreased urethral resistance in a dose related fashion.

Adrenergic alpha-Antagonists↗
PubMed1996

[Has the lifesaving technician system improved the outcome of out-of-hospital cardiopulmonary arrest patients?].

The role of the lifesaving technician (LST) system on the outcome of out-of-hospital cardiopulmonary arrest patients was examined retrospectively. The percentage of the patients resuming spontaneous circulation before arrival at the hospital was 2.2-4.3 times higher in the group with the prehospital care by LSTs ('93: 3.9% and '94: 2.0%) than by ordinary ambulance personnel (OAP) (0.9%), but there was no difference in the percentage of return of spontaneous circulation (LST '93: 33.0%, '94: 27.3%, OAP 37.8%), survival rate (LST '93: 3.1%, '94: 1.4%, OAP 1.8%) and discharge rate (LST '93: 1.0%, '94: 0.7%, OAP 1.8%) of the patients with cardiopulmonary arrest on arrival. Time interval from fire department receipt of call to ambulance departure and arrival at the hospital was significantly longer in the groups with the prehospital care by LSTs than by OAP. There was no difference in the outcome of cardiopulmonary arrest patients with the prehospital care by LSTs between '93 and '94. Our results suggest that making much more effort with more advanced technics to start the spontaneous circulation on the spot may be required to improve the outcome of out-of-hospital cardiopulmonary arrest patients.

Aged↗
PubMed1996

[A case of redo operation for ascending aortic aneurysm after modified Bentall operation for Marfan syndrome associated with type A acute dissecting aortic aneurysm].

A 37-year-old man who had undergone modified Bentall operation in December 1986 had redo operation for ascending aortic aneurysm. Initial operation, in other institute, included aortic root replacement using composite graft and reconstruction of coronary arteries. Left coronary ostium was directly anastomosed to composite graft while a saphenous vein was grafted between composite graft and right coronary artery concomitant with closing right coronary ostium. In addition, composite graft was wrapped with native aortic wall and Cabrol trick was carried out. In December 1994, this patient required redo operation for a 90 mm size of ascending aotric aneurysm which had been used for wrapping in the initial operation. The findings at reoperation revealed patent Cabrol trick, occluded saphenous vein graft, dehiscent proximal anastomosis of saphenous vein graft and partial dehiscence of distal anastomosis of composite graft. The repairs included new saphenous vein grafting to right coronary artery and re-anastomosis of distal site of composite graft. Cabrol trick was closed and composite graft was not wrapped. His post-operative course was excellent and post-operative scintigram indicated ameriolation of inferior wall ischemia.

Acute Disease↗
PubMed1996

A case of strangulated transomental hernia diagnosed preoperatively.

A patient with an unusual case of internal hernia was treated successfully with surgery for strangulated transomental hernia, diagnosed preoperatively by abdominal computed tomographic examination (CT). The herniation occurred through congenital defects in the gastrocolic omentum. Herniation of this nature is extremely rare, and abdominal CT examination is very useful for preoperative diagnosis.

Adult↗
PubMed1996

[Angiography of extremities].

In the last decade, the indications, risks and limitations of arteriography were dramatically changed because of the improvement of contrast agents and the advent of digital subtraction angiography (DSA). The most widely used contrast agents, at present, are nonionic monomers which have low osmolality and consequently cause less sensation of heat, vasodilatation and pain of injection. These alleviate the pain of angiography for patient and the serious complications were markedly decreased, however, the adverse effects of contrast mediums still remains, particularly the late onsets of adverse effects. The advent of DSA made it possible to perform arteriography in the outpatient department since the catheter size became thin and consequently less invasion for patients. Because the diagnostic procedure was specialized and individualized, the arteriography of lower extremities is often performed by radiologists. The arteriography for patients having arteriosclerosis obliterans (ASO) requires the precise understandings of pathophysiology and vascular anatomy. Therefore, the vascular surgeons and radiologists have to discuss before examinations, which could provide correct anatomical information and minimize the invasion.

Angiography, Digital Subtraction↗
PubMed1996

[Experience in administration low dose all-trans retinoic acid for a child with acute promyelocytic leukemia].

Ten year old boy with acute promyelocytic leukemia (APL) was treated with all-trans retinoic acid (ATRA). Immediately after the oral administration of ATRA (nine mg/m2 three times a day), DIC was controlled, and complete remission was achieved at day 39. The patient received ATRA therapy for 47 days, and then followed by conventional chemotherapy. Plasma ATRA level after 90 minutes of drug administration was 84.6 ng/ml. The superoxide generating activity of neutrophils in the bone marrow and peripheral blood was measured by chemiluminescence. The phagocytic function of neutrophils was markedly reduced in the ATRA-induced remission period, and was normal in the chemotherapy-induced remission. APL could be induced complete remission by three divided small doses of ATRA, and the ATRA-induced differentiated neutrophils might have lower phagocytic function.

Child↗
PubMed1996

[Cavernous hemangioma of urinary bladder: a case report and review of the literature].

We report a case of cavernous hemangioma of the urinary bladder treated with transurethral resection (TUR). A 58-year-old woman was admitted to our department with the chief complaint of macroscopic hematuria. Cystoscopy revealed a red sessile tumor 2 cm in diameter, at the internal urethral orifice. The tumor had a mostly low signal intensity, partly high signal intensity, on T1-weighted, coronal magnetic resonance (MR) images. Computed tomography and T2-weighted MR images did not delineate the tumor. TUR was performed, and the specimen was pathologically diagnosed as cavernous hemangioma of the urinary bladder. A brief description of the case is provided and the literature is reviewed.

Female↗
PubMed1996

[Gastric inhibitory polypeptide (GIP) and GIP receptor (GIPR)].

Gastric inhibitory polypeptide, originally isolated from porcine intestine, is a gastrointestinal hormone belonging to the vasoactive intestinal peptide (VIP)/glucagon/secretin family. GIP consists of 42 amino acid residues which is derived by proteolytic processing of a GIP precursor. In vivo and in vitro experiments have indicated that GIP auguments glucose-stimulated insulin secretion, suggesting that GIP plays an important role in the regulation of insulin secretion as an incretin. Thus, GIP now is generally referred to as glucose-dependent insulinotropic polypeptide. It is also suggested that GIP may be involved in the pathogenesis of non insulin-dependent diabetes mellitus (NIDDM). GIP exerts its biological actions by binding to its specific receptors, which appear to be coupled to G proteins. We have isolated a cDNA encoding a GIP receptor from a hamster insulinoma(HIT-T15) cDNA library. The hamster GIP receptor is a 462 amino acid protein having seven transmembrane segments. Expression of recombinant of hamster GIP receptors in Chinese hamster ovary (CHO) cells shows that it binds specifically to GIP with high affinity (IC50 = 9.6 nM) and is positively coupled to adenylate cyclase. RNA blot analysis reveals that a 3.8-kb GIP receptor mRNA is expressed at high levels in rat pancreatic islets as well as in HIT-T15 cells.

Animals↗
PubMed1996

[Perioperative airway management for a patient with tuberculous tracheal stenosis].

Perioperative airway management for sleeve pneumonectomy in a 66-year-old female with tuberculous tracheal stenosis which was 2 cm above the carina to the right main bronchial orifice is reported. Endotracheal intubation was required, because she complained of dyspnea due to airway stenosis in preoperative period for anti-tuberculous chemotherapy. A special tracheal tube developed for laryngomicrosurgery (MLT tube, Mallinckrodt Co. Ltd., 21 Fr size) was used in this patient. However, 13 days after intubation with an MLT tube, sleeve pneumonectomy was done because because of right lung atelectasis and progressive hypoxemia. Left one lung ventilation was successful by an MLT tube during right thoracotomy and a spiral tube (28 Fr) was inserted to the left main bronchus in the operative field during the resection of the carina. For this type of patient with tracheo-bronchial stenosis, it is essential to select an endotracheal tube with appropriate length and diameter.

Aged↗