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Biomedical subjects

M Hashimoto

Publications and source records attributed to M Hashimoto.

At least 595 records · Page 33Linked to original sources
PubMed1995

[Retrospective study of sputum culture after esophagectomy].

We retrospectively investigated the sputum cultures of patients who underwent esophagectomy (n = 104) from just after operation to 11 postoperative days and evaluated the factors which influenced the cultures. We divided the 0-11 postoperative days into three periods (0-3 postoperative days (p.o.d.), 4-7 p.o.d., 8-11 p.o.d.). The sputum cultures were positive at a rate of 56.7% to 65.4% of patients during the period of observation (0-11 p.o.d.). Gram-negative bacillus was mostly detected. MRSA increased time-dependently. Diabetes mellitus, preoperative irradiation recurrent nerve palsy did not influence the positive rate of the sputum cultures. The positive rate of gram-negative bacillus and gram gram-positive coccus in the sputum of the patients who were given sefem-first generation antibiotics was lower than of patients who were given sefem-second generation antibiotics at 8-11 p.o.d. (p < 0.05). The positive rate of gram-negative bacillus in the sputum of patients who underwent esophagectomy with laryngectomy for cervical esophageal cancer was lower than that of patients who underwent esophagectomy without laryngectomy for thoracic or abdominal esophageal cancer at 4-7 p.o.d. (p < 0.05). The positive rate of gram-negative bacillus in the sputum of patients who underwent intraoperative tracheostomy was lower than that of patients who did not undergo intraoperative tracheostomy at 4-11 p.o.d. No patients had pneumonia during the period of observation except for the secondary lung complications. In conclusion, although we have done a good job of management, we should select the appropriate antibiotics with the patient's background in mind.

Aged↗
PubMed1995

[A case of dermatofibrosarcoma protuberans who underwent chest wall reconstruction].

Dermatofibrosarcoma protuberans (DFSP) is a slowly growing tumor that occurs in the dermis, and it has a tendency to recur repeatedly. We reported a case, 50-year-old woman, who underwent chest wall reconstruction due to recurrence of DFSP. Since the first operation for the tumor 35 years ago, she had undergone surgical procedures 30 times. We had to resect parts of the rib cartilages and the sternum because we suspected the tumor had reached to the anterior mediastinum. There has been no recurrence for 8 months since this operation. Importance of extensive resection of the tumor to prevent a recurrence and long term follow-up should be stress.

Dermatofibrosarcoma↗
PubMed1995

[A case of deep neck abscess and acute mediastinitis, secondary to peritonsillar abscess].

A 60-year-old female visited a hospital complaining of fever and pharyngeal pain. She was diagnosed as peritonsillar abscess. Initial conservative treatment was not curative, and deep neck and mediastinal abscess developed. After cervical drainage, she was referred to our hospital. Drainage tube was inserted via epigastrium into anterior mediastinum upwardly under local anesthesia. Postoperative course was uneventful, and she was cured and discharged after about 1 month of hospitalization. We stressed the importance of recognition of the mediastinitis as a complication of cervical infections. And immediate drainage procedure is required as soon as the diagnosis is established.

Abscess↗
PubMed1995

[A case of giant bronchogenic cyst complicated with postoperative esophageal perforation].

A 42-year-old man with giant bronchogenic cyst occupied from the middle and posterior mediastinum was treated surgically. The tumor was stoutly adhered to anterior aspect of the esophagus and membranous portion of the right bronchus. In dissecting the tumor, muscular coat of the esophagus was partly severed, which was repaired interruptedly with absorbable suture material. However, esophageal perforation was detected by barium swallow on the 3rd postoperative day. Conservative therapy included intrathoracic drainage and antibiotics was successfully undertaken. It is imperative to dissect the tumor very carefully if the giant bronchogenic cyst adheres to the esophagus or other surrounding organs.

Adult↗
PubMed1995

[A survey of utilization of urinary alarm systems in nursing homes].

A questionnaire survey was performed on 63 nursing homes and 1006 care workers in the nursing home, in order to elucidate the actual state of utilization of urinary alarm systems (systems). About 3% of the nursing homes in all of Japan are utilizing the system with 12.5% of all institutionalized elderly having a diaper sensor of those nursing homes with the system, 86% use the system continually. In 51% of the nursing homes, care workers change diapers immediately after sensor alarm is triggered. The reasons for not being able to change the diaper immediately were either care workers had other pressing work, or simultaneous or overlapping sensor alarm calls occurred. The usefulness of the system was recognized for "prevention of decubitus" (66%), "prevention of contact dermatitis from diapers" (82%), "decrease of ammonia smell" (27%), and "discontinuation of diaper" (26%). As for problems associated with the system or factors that increase work load, responses included "sensor does not respond sometimes" (67%), "increased diaper changes" (53%), "increased nurse calls due to urinary urgency" (41%), and "disconnection of the sensor by the patient" (34%). The percentage of care workers who reported an increase in work load was 73%, especially where the ratio of care workers number/institutionalized elderly was low.

Adult↗
PubMed1995

[A case of predominantly right-temporal lobe atrophy with disturbance of identifying familiar faces].

A right-handed 72-year-old man (I.K.) who complained of difficulty identifying familiar faces was investigated on a series of tests of face perception (face matching, recognition of age and sex, and meaning of facial expressions), facial identity (faces of families and famous persons as retrograde ones and his doctor's faces as anterograde ones) and other neuropsychological abilities. His scores of face perception tests were normal or mildly disturbed. His memory performances measured with WMS-R and Rey-Osterrieth figure were normal. But he could identify none of anterograde and retrograde faces and failed to experience any familiarity with those faces. In addition, he could not recognize none of voices of family members and a doctor, despite of being able to recognize about the age and sex of voice. On the other hand, he could describe personalities of his family members and doctors, but knew none of famous people. Memory for personal events in the recent and remote past was well preserved, while that for social events was severely disturbed in both past. In addition to impairment of identification of familiar faces, he had severe problems with identifying famous common buildings and animals. He also presented Gogi (word meaning) aphasia and impairment of semantic memory for some common objects. Tyrrell et al. reported a similar case and McNeil et al. examined the patient on covert recognition of face in detail. On their task, he showed no covert effects and they attributed the result to impairment of face recognition units themselves. Their way of thinking seems to give an explanation of I.K.'s disturbance of anterograde and retrograde memory for faces.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

[Physical properties of Strecker stents].

Strecker stent is a balloon-expandable metallic stent that is made of knitted tantalum wire mesh in order to Maintain flexibility. Therefore, the prosthesis is well suited to irregular and tortuous tube organs. We performed several physical experiments using 8 mm and 6 mm diameter stents made of 0.1 mm diameter wire filament. The bearing power of the 8 mm diameter stent against the circumferential compression pressure was divided into two groups, that is, 77-100% and under 66% of expansile rate. The capacity bearing the circumferential compression pressure of the latter group was greater than that of the former. Further, the bearing power of the 6 mm diameter stent was greater than that of the 56% expansile rate of the 8 mm diameter stent. The smaller the expansile rate of the stent, the smaller the minimum radius of curvature within the limits of the stent's plastic. To evaluate the suitability of the stent in clinical use, we made two projections on the inner surface of rubber tubes, and the stents were placed into the rubber tubes at different expansile rates. We evaluated the degree of contact of the stents against the rubber wall by taking soft X-ray photographs. The stents showed good suitability under the condition of incomplete expansion. For the above reasons, we concluded that, from the view-point of bearing power, the stent should be placed in the full expansile state. From the viewpoint of contact against the vessel wall, the stent should be placed in the incomplete expansile state.

Physical Phenomena↗
PubMed1995

[Amyloidosis of the small intestine secondary to rheumatoid arthritis and juvenile rheumatoid arthritis: report of two cases].

We herein report two cases of gastrointestinal amyloidosis, secondary to juvenile rheumatoid arthritis (JRA) in one, and rheumatoid arthritis (RA) in the other. A 21-year-old woman, who has been suffering from JRA for the past 12 years, was transferred to our hospital due to intense pain in the epigastrium and back, diarrhea, high fever, and paralytic ileus. Treatment by corticosteroid, antibiotics, protease inhibitor, and total parenteral nutrition was not effective. The laparoscopic surgery was performed because of repeated melena followed by an episode of hypovolemic shock. The resected specimen of the ileum showed histologically marked amyloid deposition in the arteriolar walls. A 83-year-old man with RA for 14 years, was admitted to our hospital with complaints of abdominal pain, nausea, and diarrhea. He underwent an emergency operation for perforation of the ileum. The resected specimen revealed amyloid deposition and non-caseating granulomas. The fragility and impaired blood supply caused by amyloid deposition in the vascular walls may have terminated in the severe intestinal lesion. Further clinicopathological studies along this line are keenly desired in order to establish therapeutic modalities for gastrointestinal amyloidosis.

Adult↗
PubMed1995

Twenty-four hour monitoring of pH in the gastric tube replacing the resected esophagus.

BACKGROUND: Peptic ulcers in the gastric tube replacing the resected esophagus develop silently and cause serious problems. In this study, the acidity of the gastric tube was examined by 24-hour pH monitoring to determine if the acidity of the gastric tube was sufficient to cause peptic ulcers. STUDY DESIGN: The acidity of a gastric tube was evaluated by 24-hour pH monitoring of both the fundus and the antrum in 55 patients treated for carcinoma of the esophagus. The correlation between the fasting serum gastrin concentration and the intraluminal acidity of the completely vagotomized gastric tube was examined. RESULTS: In the patients with high postoperative acidity in the fundus or the antrum (46 percent of the 41 patients examined), the intraluminal pH remained consistently low, even long after operative treatment. Significant correlations existed between the percentage of time that the pH remained below 3 preoperatively and postoperatively in both the fundus and the antrum (r = 0.4777, p = 0.0386, and r = 0.7597, p = 0.0002, respectively). The percentage did not decrease significantly postoperatively. A significantly negative correlation (r = -0.783401, p < 0.0001) was found between the fasting serum gastrin level and the proportion of time that the nocturnal pH in the antrum remained below 3. CONCLUSIONS: Even long after esophagectomy, the pH of the gastric tube is low enough to cause peptic ulcers, especially in patients with high preoperative acidity. In these patients, the intraluminal pH in the antrum of the gastric tube correlates inversely with the fasting serum gastrin level.

Aged↗
PubMed1995

[Care for patients with Pick's disease--by using their preserved procedural memory].

Pick's disease are more often complicated than Alzheimer's disease by behavioral disturbances such as social misconduct and stereotypy, that are troublesome and clinically difficult to manage. The purpose of this study was to investigate the possibility of improvement in care for patients with Pick's disease by using their presumably preserved procedural memory. Four inpatients and two outpatients with Pick's disease were studied. Case 1: A 54-year-old right-handed retired clerk presented with a 3-year history of increasing restlessness, word-finding difficulty and impaired comprehension of nominal terms. He was forced to retire from his work because of his social misconduct and incommunicability. On admission he wandered about the ward irritably, did not enter into any conversation, and destroyed all keys in the ward by putting a pencil into keyholes. Neuroradiological examination revealed circumscribed bilateral frontotemporal atrophy which was more marked on the left side. However, he has become more adaptive to the life in the ward and his expression has become peaceful since he began to play othello games with other patients and his doctors. Case 2: A 71-year-old right-handed housewife had progressively altered in her personality and behavior over 4 years. She was restless and showed striking palilalia with marked right frontotemporal atrophy when initially evaluated 2 years after her initial symptoms. Subsequently, her verbal output decreased. She ate large amounts of food and her overweight became a serious problem in her care at home. On admission she wandered about the ward irritably, ate meals of other patients, and put on a quilt on their head. However, these troublesome behavior disappeared when she was bent on knitting that was her former hobby. Case 3: A 63-year-old right handed physician presented with a 5-year history of increasing word-finding difficulty and impaired comprehension of nominal terms. His conversation was limited to continuous repetition of a few phrases. He wandered into several hospitals around his house in fixed order every day. On examination, he was mildly disinhibited and distractible with circumscribed bilateral frontotemporal atrophy which was more marked on the left side. Wandering away from home overnight necessitated admission to the hospital. In the ward he wandered about and tried to open each door restlessly and irritably. However, he has become calm and his expression has become peaceful since he was conducted to measure blood pressures of his nurses. Case 4: A 65-year-old right-handed retired office worker.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1995

[Ultrasound biomicroscopic imaging diagnosis of the anterior segment of the eye with high-frequency ultrasonic diagnostic equipment].

Micro-imaging displays of the anterior segment of the eye, such as of the anterior chamber angle, iris, ciliary body, ciliary zonule of Zinn, and anterior surface of the crystalline lens, were obtained in human eyes in vivo by means of a recently developed, high-frequency, high-resolution ultrasonic diagnostic unit (30 MHz). Much clearer displays than conventional ultrasonic imaging displays (5-15 MHz) were obtained, showing improved resolution, and greater morphologic diagnostic information was provided. Displays considered useful for making measurements were also provided. The subjects were 20 normal volunteers (35 eyes), 36 patients with glaucoma (58 eyes), 6 patients with uveal diseases (6 eyes), and 28 patients with pseudophakia (32 eyes). The equipment used was a model UX-02 ultrasonic diagnostic unit (RION), and the transducer was the three-element annular array type. The frequency was 30 MHz, the resolution was below 50 microns, and tissue penetration was 6 mm. This method enabled close ultrasound biomicroscopic imaging observations of details of the anterior and posterior chambers of the eyes in vivo and was also useful for clinical diagnosis and elucidation of the cause of glaucoma of various types. It also for the first time enabled evaluation of the position of fixation of an intraocular lens loop in the pseudophakic eyes containing an intraocular lens.

Adult↗
PubMed1995

[Effect of repeated toothbrushing instructions on periodontal health in a community].

This study was conducted to compare the effect of frequency of toothbrushing instruction using the Toothpick Method in a community periodontal health program. Two courses, one consisting of three monthly toothbrushing instructions and the other a single instruction session, were given to residents in a small town. Thirty-one subjects (mean age; 48.7 +/- 9.2) in the three-time instruction course and 40 subjects (mean age; 55.2 +/- 8.3) in the single instruction course participated in dental examinations. During the first visit, the subjects of the both groups attended a class for dental health education, and observed their dental plaque using a phase contrast microscope, and the condition of their teeth and periodontal tissue was recorded. They were instructed to brush their teeth by the Toothpick Method. After 1 year, the subjects of the both groups were examined and required to fill out a questionnaire. The percentage of sites with gingival redness and swelling significantly decreased after 1 month, 2 months and 1 year in the three-time instruction group. In the single instruction group, however, gingival redness and swelling did not change after 1 year. The percentage of sites with bleeding on probing significantly decreased in the both groups. The improvement ratio for the CPITN code was higher in the three-time instruction group than the other. The questionnaire showed that subjects in the three-time instruction group brushed their teeth more actively, and were more satisfied with the program than those in the single instruction group. These results show that the three-time instruction course was more effective than the single instruction course.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Expression of vascular endothelial growth factor and its receptor mRNA in angiosarcoma.

BACKGROUND: Vascular endothelial growth factor (VEGF), a specific mitogen for endothelial cells in vitro, can be angiogenic factor in vivo. VEGF is known to be produced by several tumor cells and plays an important role for neovascularization in tumor tissue. Recently, tyrosine kinase encoded by the flt gene was identified as a receptor for VEGF. Angiosarcoma (AS) is a rare malignant tumor that arises from endothelium. At present, little is known about a mechanism of proliferation of the AS. EXPERIMENTAL DESIGN: In an immunohistochemical study of 99 cases of AS, 11 cases showing a positive reaction for anti-VEGF Ab were selected for the present study. In these cases, expression of VEGF and its receptor (flt) mRNA was examined by in situ hybridization: sense and antisense probes for VEGF and flt mRNA were used. RESULTS: In situ hybridization study with antisense probes revealed that the VEGF mRNA was expressed in AS cells and mononuclear cells in all but one case. Intensity of VEGF staining by immunohistochemistry correlated well with VEGF mRNA expression. The flt mRNA was expressed in AS cells in all 10 cases that were positive for VEGF mRNA. Sense probe for VEGF and flt mRNA gave no positive reactions. CONCLUSIONS: These findings suggest a presence of paracrine or autocrine mechanism of proliferation in AS through VEGF and its receptor flt.

Aged↗
PubMed1995

[Percutaneous placement of intraluminal stent-graft for aortic dissection: experimental study].

Highly porous fabric vascular grafts fabricated of ultrafine polyester fibers (UFPF-graft; porosity, 7,000 ml, 9,000 ml, 11,000 ml at 120 mmHg) were attached between two Gianturco stents connected with two stainless steel struts. UFPF-grafts with two Gianturco stents were placed into the aortas of six adult mongrel dogs without firm contact with the luminal surface. From two days to four months after placement, all the UFPF-grafts were completely sealed with fresh thrombus or neointima. Within two months, complete endothelialization was observed on both surfaces of the neointima. In three dogs, aortic dissections were created experimentally. Then an UFPF-graft (porosity, 9,000 ml) with two Gianturco stents was placed at the site of entry of the dissection, followed by additional Gianturco stents to expand the UFPF-graft. X-ray angiography showed that the entries were closed immediately after placement, and false lumens disappeared within one hour after placement. These results indicated that the method has the possibility of treating aortic dissection with complete sealing of the fabric by the neointima.

Aortic Dissection↗
PubMed1994

Characterization of monoclonal antibodies to chitinase A1 and enhancement of chitinase A1 activity by monoclonal antibodies.

A total of eleven hybridomas which secrete antibodies against chitinase A1 were established. Among the eleven monoclonal antibodies (MAbs) obtained, six recognized the catalytic domain, three recognized the type III region and two recognized the chitin binding domain of chitinase A1. Of the two MAbs which recognized the chitin binding domain one was found to also react with chitinase D, but none of the other MAbs which recognized either the type III region or the chitin binding domain reacted with chitinase D despite the extensive amino acid sequence similarity between both the type III and chitin binding domains of the two chitinases. Two of the eleven MAbs enhanced chitinase activity significantly, while the other MAbs did not have any significant effect on chitinase A1 activity.

Animals↗