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Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 613 records · Page 34Linked to original sources
PubMed1995

[Current advances and future direction of arthroscopic surgery for disorders in the knee joint].

An aim of this paper is to report current advances and future direction of arthroscopic surgery for disorders in the knee joint. Recently, advances of operative techniques and improvement of surgical instruments allow almost all disorders in the knee joint cavity to be arthroscopically treated. Patients of the age greater than 3 years can undergo this surgery. Arthroscopic surgery involves release of synovial malformation, capsular strung, and postoperative adhesion, removal of free bodies, excision of benign tumors, partial synovectomy, multiple drilling or pinning of osteochondral lesions, partial or total meniscectomy, plastic resection of bony spurs, repair of the torn menisci and ligaments, reconstruction of ligaments and menisci, and etc. Arthroscopic surgery has many advantages compared with open surgery: First, more precise operation can be performed in arthroscopic surgery, resulting in better final outcome, because this surgery gives rather wider visual field for intraarticular operation. Secondly, arthroscopic surgery is less invasive. Therefore, patients have less postoperative pain and adhesion, quickly regain the normal range of knee motion, and early return to the normal activities. Thirdly, operation scar after arthroscopic surgery is more acceptable for patients from the cosmetic viewpoint. There are few disadvantages in arthroscopic surgery if well-trained surgeons carefully operate patients according to the correct indications of this surgery. In the near future, arthroscopic surgery will be more frequently and wide-spread performed in Japan. Therefore, instructional and training systems for arthroscopic surgeons should be established as soon as possible. Improvement of the hardware involving arthroscopes and surgical instruments may be one of keys for future advances of arthroscopic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗
PubMed1995

[Positive and negative effects of progestins on platelet-activating factor acetylhydrolase activity in rat plasma].

Platelet-activating factor acetylhydrolase (PAF-AH), the enzyme that inactivates PAF, is regulated by steroid hormones including progestin. It has been reported that 17 alpha-ethynylestradiol decreases plasma PAF-AH activity and medroxyprogesterone increases the enzyme activity. In this study, we elucidated the effects of various progestins on plasma PAF-AH activity and lipoprotein cholesterol levels. Plasma PAF-AH activity in female adult rats treated with either progesterone or 17 alpha-hydroxyprogesterone (50mg/kg, 3 days) did not change significantly. Both medroxyprogesterone and megestrol acetate (50mg/kg, 3 days) significantly increased plasma PAF-AH activity, but both norethindrone acetate and norethynodrel (50mg/kg, 3 days) significantly decreased the enzyme activity. In addition, not only did medroxyprogesterone increase plasma PAF-AH activity but plasma lipoprotein cholesterol and norethindrone acetate decreased both of them. A significant correlation between plasma PAF-AH activity and the lipoprotein level was found (r = 0.974, p < 0.01). When PAF (10nmol/kg) was administered to female adult rats pretreated with progestins, the mortality of the rats that had low plasma PAF-AH activity due to norethindrone acetate was increased in the same manner as observed in the 17 alpha-ethynylestradiol-pretreated group. These findings indicate that progestins have various effects on plasma PAF-AH activity and the lipoprotein level. In addition, some progestins, which have an estrogenic effect on enzyme activity, may be related to the thrombotic episodes observed in oral contraceptive users.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1995

Deficiency of blood coagulation factor XIII in Crohn's disease.

OBJECTIVE: Refractory fistula formation is one of most intractable complications in Crohn's disease. Recently, the role of blood coagulation Factor XIII has been recognized as an important wound-healing factor. We investigated the plasma concentration and functional activity of blood coagulation Factor XIIIa, active subunit of the Factor XIII, in patients with Crohn's disease and in healthy volunteers. METHODS: Peripheral blood was obtained from 24 patients with Crohn's disease and from 10 healthy volunteers. The functional activity of Factor XIIIa was measured by its transglutaminase activity, and plasma concentration was measured by the immunoelectrophoresis method. RESULTS: The differences in Crohn's disease patients and healthy volunteers were not significant. However, Crohn's disease patients with fistula had significantly lower functional activity than Crohn's disease patients without fistula. CONCLUSIONS: The deficiency in this wound-healing factor might be one reason for refractory fistulas in Crohn's disease, and supplementation of the factor might be useful therapeutically.

Adult↗
PubMed1995

[Clinical usefulness of pediatric population parameter of slow-releasing preparation of sodium valproate].

We predicted the serum level of a slow-releasing preparation of sodium valproate (VPA-SR) in 9 children with epilepsy by pediatric population parameter obtained previously or by two adult parameters. The accuracy of prediction was evaluated as an absolute error standing for the difference between the measured and the predicted serum concentration in each patient. The mean absolute error (MAE) based on the pediatric population parameter was 5.5 +/- 5.2%, although MAEs from two adult parameters were 13.8 +/- 9.9 and 15.1 +/- 9.2%, respectively. Statistical analysis revealed that the pediatric population parameter was significantly more accurate for the prediction to serum concentrations. In conclusion, the pediatric population parameter was greatly useful for pharmacokinetic analysis of VPA-SR by Bayesian method in children with epilepsy.

Adolescent↗
PubMed1995

[A case of focal encephalitis with psychological symptoms similar to chorea minor].

We reported a patient with choreic movements, emotional lability, and compulsive-obsessive behavior that developed 4 weeks after onset of fever and lasted for several years. There was no evidence of streptococcal infection or rheumatic fever. T2-weighted MRI showed hyperintense lesions in the bilateral caudate nuclei and putamina. A diagnosis of focal encephalitis was made according to initial fever, convulsion, and CSF pleocytosis. Treatments with haloperidol and prednisolone were effective in some degree. The neurobehavioral syndrome as well as the involuntary movements in this patient can be attributed to the striatal damage, which may disrupt the basal ganglia-limbic-frontal lobe tracts. A symptomatic similarity between the syndrome in this patient and chorea minor suggests a striatal damage in chorea minor, where the causative lesions remain unknown.

Affective Symptoms↗
PubMed1995

[ACTH-independent bilateral adrenocortical macronodular hyperplasia (AIMAH): report of a case].

We treated a case of ACTH-independent bilateral adrenocortical macronodular hyperplasia (AIMAH), a rare disease. The patient was a 49 year-old man having chief complaints of facial edema, muscle wasting and typical Cushing's syndrome symptoms. He was diagnosed with AIMAH by specific hormonal tests for Cushing's syndrome and CT scan. Bilateral total adrenalectomy was performed in a two-stage operation for bilateral macronodular adrenocortical hyperplasia. The resected adrenal tumor weighed 57 g on the right side and 78 g on the left, and both had a yellowish nodular surface. The histological appearance was typical AIMAH. A total of 23 AIMAH reported cases was reviewed.

Adrenal Cortex↗
PubMed1995

[Current state in heart transplantation].

The Registry of the International Society for Heart and Lung Transplantation reported that 31,157 transplantations were performed throughout the world until 1993, including 26,704 heart transplantations, 1,567 heart-lung transplantations, 1,943 single lung transplantations and 943 bilateral or double lung transplantations. Heart transplantations were carried out at two hundred fifty-one institutes in the world and more than 3,000 patients received heart transplantations every year. The number of heart transplantations, however, became plateau in 1988 and since 1991 the number of operations rather decreased because of the shortage of donor hearts. Indications for adult heart transplantation include coronary artery disease in 47.2% and cardiomyopathy in 43.5%, representing the most frequently reported indications. Retransplantations represent only 2.3% of the total heart transplantations. The results for heart transplantation reveal that the 1, 3, 5, and 12-year actuarial survival are 80%, 72%, 64% and 40%, respectively. Comparing the data before and after 1982 when cyclopropane was introduced for transplantations, a substantial improvement in actuarial survival is obtained. For instance, 3-year actuarial survival before 1981 was 40% whereas since 1982 3-year actuarial survival is improved up to 75%. However, the patients in the older age (more than 65 years old) and pediatric patients, particularly less than one year old, have a significant reduction in outcome compared with younger adult patients and the outcome of heart retransplantation was still poor. Because of the shortage of donor heart quite a large number of patients develop hemodynamic deteriorations before transplantation and mechanical assist device is one of strategies to treat these patients as bridge to heart transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Endoscopic ultrasonography diagnosis of pancreatic cancer.

Endoscopic ultrasound (EUS) was developed for the detection of small pancreatic cancer because the complete demonstration of the pancreas by conventional ultrasonography (US) was sometimes prevented by intestinal gas and echoic reduction due to the deeper position of the pancreas head and tail. In this article, the diagnosis, staging, limitations, and hazards of EUS for diagnosing pancreatic cancer are described.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1995

[Management of polypoid lesions of the gallbladder by endoscopic ultrasonography (EUS)--a retrospective study to establish the diagnostic criteria and a prospective study to evaluate its reliability].

The diagnostic criteria of endoscopic ultrasonography (EUS) in the management of polypoid lesions of the gallbladder was established by a retrospective study using 57 cases with polypoid lesions of the gallbladder that were all resected and confirmed histologically. By this study, EUS findings of polypoid lesions of the gallbladder were classified into the following six groups; Type I with a foamy high echogram, Type II with a globular high echogram, Type III with a papillary high echogram, Type IV with a papillary solid echogram, Type V with a nodular solid echogram and Type VI with a nodular solid echogram including multiple spotty an-echoic areas which suggested the presence of Rokitansky-Aschoff sinus. Comparing the types of EUS findings with histological diagnosis, Type I and II corresponded to cholesterol polyps. Type III and IV contained benign pseudo tumors such as cholesterol polyp or hyperplastic polyp as well as tumorous lesions such as adenocarcinoma or adenoma. Type III with over 10 mm in size and IV with over 5 mm in size had a possibility of tumorous lesions. Type V usually corresponded to adenocarcinoma, and Type VI to adenomyomatous hyperplasia. From these results, the following criteria was established; (1) Polypoid lesions showing Type I, II, III with less than 10 mm in size, IV with less than 5 mm in size and VI should be followed-up as benign diseases. (2) Polypoid lesions of Type III with over 10 mm in size and IV with over 5 mm in size was considered to be relative indications for surgery as tumors. (3) Polypoid lesions of Type V was an absolute surgical indication as malignant. The reliability of this EUS criteria was followingly evaluated by a prospective study using 94 cases with polypoid lesions of the gallbladder; 32 cases with open or laparoscopic cholecystectomy and 62 cases with over one year follow-up observations. The criteria corresponded well with the histological or follow-up findings in Type I, II, III with less than 10 mm in size, IV with less than 5 mm in size, V and VI. It had, however, a tendency of over indications to surgery in Type III with over 10 mm in size and IV with over 5 mm in size because these types were widely set not to overlook tumorous lesions such as adenoma and small adenocarcinoma.(ABSTRACT TRUNCATED AT 400 WORDS)

Endoscopy, Digestive System↗
PubMed1995

[The internal thoracic artery of poor quality: was cardiac massage a cause of ITA stenosis?].

The case of stenotic left internal thoracic artery (LITA), with a very rare and interesting histological findings is reported. The patient, a 65-year-old man, fell into shock, due to acute myocardial infarction and received cardiopulmonary resuscitation at home immediately. Three months later, patient underwent coronary artery bypass grafting. The LITA was dissected from the chest wall with a tissue pedicle by usual manner. However, it was abandoned to use for grafting, because of extremely poor blood flow even after balloon dilatation was noticed. Histological study revealed a significant granulation of LITA media, led to severe stenosis of LITA lumen on it's portion. On other side, either proximal and distal portion of LITA remained intact. It seems that this unusual histological change of LITA media developed after LITA over stretching due to cardiac massage during cardiopulmonary resuscitation. If patient, scheduled for coronary bypass surgery, has in a personal history the presence of cardiac massage, traffic accident, some contact sport or any other chest trauma, it is recommended to perform LITA angiography preoperatively, if an intention to use the LITA for coronary artery bypass grafting exists.

Cardiopulmonary Resuscitation↗