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Biomedical subjects

M Hayashida

Publications and source records attributed to M Hayashida.

At least 55 records · Page 3Linked to original sources
PubMed1998

Genetic and epidemiological research at the National Institute on Alcoholism, Kurihama National Hospital.

The National Institute on Alcoholism, Kurihama National Hospital, Japan, was designated as a WHO Collaborating Center on Research and Training of alcohol-related problems in 1988. As part of the collaboration and contribution to the WHO, the institute has made significant efforts for the advancement of alcohol research. This article summarizes recent research activities at the institute, focusing on two areas of research: epidemiological and genetic studies.

Academies and Institutes↗
PubMed1998

[Fluid volume deficit: profile of defining characteristics in patients with burns].

The present study aimed at describing the profile of defining characteristics in patients with the nursing diagnosis "Fluid volume deficit" related to active loss of fluid secondary to burns. Data were collected by means of a tool, containing 29 possible defining characteristics of this diagnosis. Seven nurses, that worked at the Burnt Unit for at least five years ago, provided opinions about the degree to which each defining characteristic is indicative of this diagnosis. Nurses rated each defining characteristic of diagnosis being tested on a scale of zero to one. The results confirmed all, except one (increased body temperature) defining characteristics presented by NANDA for this diagnosis and indicated 10 new defining characteristics.

Attitude of Health Personnel↗
PubMed1998

[Relationship between cardiac output and PETco2 as well as Paco2 during high-dose fentanyl anesthesia].

We investigated the relationship between cardiac output and PETCO2 as well as blood PCO2 in 10 patients undergoing cardiac surgery of long duration under high-dose fentanyl anesthesia. After anesthetic induction, the minute ventilation was kept constant at 10 ml.kg-1 x 10 cycles.min-1 and a pulmonary artery catheter was inserted. PETCO2, PaCO2 and cardiac index (CI) were measured simultaneously. PaCO2 was corrected for body temperature, and alveolar dead space-to-tidal volume ratio was calculated as VD/VTalv = (PaCO2-PETCO2)/PaCO2. After body, temperature became stabilized, the measurements were started and repeated every 10 to 20 minutes during the prebypass period. One hundred and eight sets of data were taken from 10 patients. PETCO2 correlated positively with CI. Similarly, PaCO2 correlated positively with CI, but VD/VTalv, did not correlate with CI. PETCO2 correlated closely and positively with PaCO2, but it correlated negatively and only marginally with VD/VTalv. When examined in individual patients, PaCO2 correlated positively with PETCO2 in all patients, while VD/VTalv correlated negatively with PETCO2 only in 3 patients. By multiple regression analysis, VD/VTalv change accounted for only 22.3 +/- 15.0% of PETCO2 change, while PACO2 or PaCO2 change accounted for 77.6 +/- 15.0% of PETCO2 change. Decreased CI was associated with decreased CO2 delivery from the tissue to the lung (DCO2) and PaCO2 decreased with decreasing DCO2. Decreased CI was also associated with decreased oxygen uptake (VO2), and PaCO2 decreased with decreasing VO2. A decrease in CI resulted in an increase in VA/Q, and PaCO2 decreased when VA/Q increased. PETCO2 decreased when cardiac output decreased. A decrease in PACO2 explained the decrease in PETCO2 better than an increase in VD/VT did. Decreased cardiac output might cause hypocapnia through decreased CO2 delivery to the lung, decreased CO2 production and/or increased ventilation-to-perfusion ratio.

Adult↗
PubMed1998

Short-term follow-up after endoscopic mucosectomy of early esophageal cancer and aldehyde dehydrogenase-2 genotype in Japanese alcoholics.

The risk of the future development of primary esophageal cancer after endoscopic esophageal mucosal resection of esophageal cancer is not known; hence, there are no established guidelines for follow-up surveillance programs. Simultaneous occurrence of multiple cancers associated with esophageal cancer is common among heavy drinkers who have the inactive form of aldehyde dehydrogenase-2 (ALDH2) as a risk factor. Thirty-four Japanese male alcoholics with intraepithelial or mucosal squamous cell carcinoma in the esophagus were treated by endoscopic esophageal mucosal resection, followed by endoscopy and esophageal iodine staining, to find the additional development of primary esophageal cancer. Primary esophageal squamous cell carcinoma was detected in nine patients (26.5%) at 3-21 months after the first cancer diagnosis. Cancer occurred more frequently in patients with inactive ALDH2 than it did in those with active ALDH2 [42.1% (8 of 19) versus 6.7% (1 of 15), P = 0.047], and it occurred more frequently in those with multiple esophageal cancers than it did in those without them [60.0% (6 of 10) versus 12.5% (3 of 24), P = 0.009]. Kaplan-Meier estimates of the proportions of patients with additional primary esophageal cancers showed that patients with inactive ALDH2 (P = 0.024) or multiple esophageal cancers (P = 0.007) had a significantly increased likelihood of the development of additional cancer. Close follow-up examinations using endoscopy and iodine staining are needed for such high-risk patients.

Adult↗
PubMed1998

[Factors aggravating bronchial asthma in urban children (I)--The involvement of indoor air pollution].

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of indoor air pollution in relation to housing style. The asthma group consisted of 210 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 180 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual atmospheric environment and housing style were surveyed by questionnaire. Also, the amount of mite allergen (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) in room and bedding dust and the concentration of cotinine in urine were examined as objective indicators for the load of environmental allergen and the indoor air pollution by tobacco smoke, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-specific immunoglobulin E (Dp-IgE) was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined by comparing the proportion of the exposed subjects between the three groups of atopic asthma, non-atopic asthma and non-asthma. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also determined for the same factors by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. Reinforced concrete housing material, which results in mal-ventilation, increased the load of indoor air pollutants such as tobacco smoke. 2. A higher amount of mite allergen in bedding dust increased Dp-IgE. 3. Heating with stove, which results in a higher room humidity as well as temperature, enhanced Dp proliferation and appeared to be involved in increasing the risk of atopic asthma. 4. Reinforced concrete housing material appeared to be involved in suppressing Dp-IgE and increasing the risk of non-atopic asthma. But some air pollutants such as tobacco smoke and mite allergen showed no relationship to these involvements.

Air Pollution, Indoor↗
PubMed1998

[Factors aggravating bronchial asthma in urban children (II)--The involvement of atopy and serum fatty acids, and their interaction with urban living environment].

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of food habits as well as individual factors such as age, sex, and history of atopic dermatitis, and the interaction with urban living environments. The asthma group consisted of 202 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 81 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual factors and the urban living environments (atmospheric environment, housing style) were surveyed by questionnaire. Also, the mite (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) specific immunoglobulin E (Dp-IgE, Df-IgE) and the composition of serum fatty acid were examined as objective indicators for atopy and dietary habits, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-IgE was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also examined by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. As age increased, the risk of atopy increased but the risk of asthma decreased. 2. The risk of asthma increased as Dp-IgE rather than Df-IgE increased. 3. For the composition of serum fatty acid, the lower quartile ranking (LQR) group for a saturated fatty acid, stearic acid, and the upper quartile ranking (UQR) group for a mono-unsaturated fatty acid, oleic acid, had a higher risk of nonatopic asthma. 4. The LQR group for omega 6-poly-unsaturated fatty acid such as linoleic acid, had a lower risk of atopy. 5. The UQR group for a omega 3-poly-unsaturated fatty acid, eicosapentaenoic acid, had a higher risk of nonatopic asthma. The UQR of eicosapentaenoic acid and living environments within 25 m from a major road or housing of reinforced concrete structure showed involvement in synergistic increase in the risk of non-atopic asthma.

Asthma↗
PubMed1998

[Does mixed venous desaturation during a bed bath indicate cardiopulmonary decompensation in postoperative cardiac patients?].

The bed bath procedure consists of cleansing patients' body, passive position change, changing gown and making a bed. During the procedure, mixed venous desaturation was observed consistently in postoperative cardiac patients. We investigated the cause of the phenomenon in 22 patients undergoing cardiac surgery in their first postoperative day. The patients were breathing oxygen-enriched air via a Venturi mask. Cardiac index (CI), transluminal SvO2, arterial blood gas, Hb, DO2, VO2, FIO2, A-aDO2 and Qp/Qs were measured before and during the bed bath, while the patients were in the supine and left lateral position, respectively. Mean 8.5 +/- 1.5 minutes were required to complete the bed bath. During the bed bath, SvO2 decreased from 71 +/- 7% to 59 +/- 9% (P < 0.001), and returned to the baseline 6.5 +/- 7.4 minutes after the completion of the bed bath. VO2 increased markedly from 128 +/- 27 to 194 +/- 47 ml.min-1.m-2 (P < 0.001), while DO2 increased slightly from 480 +/- 91 to 513 +/- 110 ml.min-1.m-2 (P < 0.05). Among the determinants of DO2, CI increased slightly from 3.3 +/- 0.6 to 3.6 +/- 0.8 l.min-1.m-2, Hb remained unchanged and SaO2 decreased from 98.5 +/- 0.8 to 98.0 +/- 1.1%. FIO2 also decreased, while A-aDO2 and Qp/Qs remained unchanged. There was a negative correlation between VO2 change and SvO2 change, but no correlation between DO2 change and SvO2 change. There was a positive correlation between SaO2 change and SvO2 change, as well as between FIO2 change and SaO2 change. Therefore, the major cause of mixed venous desaturation was not the decreased DO2 or cardiopulmonary decompensation but the increased VO2 due to increased activity of the skeletal muscles. However, the decrease in SaO2 due to markedly increased O2 demand and the limited increase in CI might partially contribute to the marked decline in SvO2 through the limited increase in DO2.

Aged↗
PubMed1998

[Body temperature changes during combined inhalational and epidural anesthesia].

We investigated the effects of combined inhalational and lumbar epidural anesthesia on body temperature in 8 women for long-lasting lower abdominal surgery. Probes for forehead deep temperature and skin-surface temperatures were placed on the forehead, forearm, fingertip and toe tip on patients' arrival at the operating room. Tympanic membrane temperature was also measured. Lumbar epidural block was established with 2% lidocaine 10 ml. Twenty minutes later, general anesthesia was induced and maintained with nitrous oxide-oxygen-isoflurane. Epidural anesthesia was maintained with intermittent dose of 1% mepivacaine. Before the end of surgery, isoflurane concentration was increased from about 0.5% to 2% and was maintained at this level for 20 minutes, after which it was reduced. With the establishment of epidural blockade, toe tip temperature increased and fingertip temperature decreased, while core temperature remained unchanged. After induction of general anesthesia, fingertip temperature increased, while core temperature decreased. The core temperature drop during the anesthetic induction was significantly affected by the increase in toe tip temperature. Before the end of surgery, core temperature remained at a reduced but constant level, while fingertip temperature continued to decrease. With the application of 2% isoflurane, fingertip temperature increased, while core temperature decreased. The core temperature drop was significantly affected by the increase in fingertip temperature. After the reduction of isoflurane concentration, these temperature changes were reversed fully. At the end of surgery, fingertip temperature decreased, while core temperature increased. During mild hypothermia, isoflurane depressed thermoregulatory vasoconstriction dose-dependently until its concentration reached 0.6-0.7%. In conclusion, anesthetics-induced redistribution of body heat significantly affects the core temperature throughout anesthesia. Peripheral hypothermia results in core temperature drop when the redistribution is induced by anesthetics. Thermoregulatory vasoconstriction may not only suppress heat loss but also increase core temperature through centralization of body heat.

Adult↗
PubMed1998

[Effects of cardiac output on blood and tissue pH during general anesthesia with constant ventilation].

We investigated the effects of cardiac output on blood and tissue pH in 106 adult patients undergoing cardiac or non-cardiac surgery under general anesthesia. After anesthetic induction, the minute ventilation volume was kept constant at 10 ml.kg-1 x 10 cycles.min-1. A pulmonary artery catheter and a nasogastric tube incorporating a tonometer were inserted. During surgery, cardiac index (CI), pH, Pco2, BE, So2 and Hb of arterial and mixed venous blood as well as gastric intramucosal pH (pHi) were measured simultaneously. Oxygen uptake index (Vo2I) and blood CO2 contents were calculated. The measurements were repeated every 10 to 20 minutes during surgery or during the prebypass period. Two patients with preoperative cardiogenic shock were excluded from data analysis because of development of severe acidosis and 624 sets of data from 104 patients were analyzed. Arterial and mixed venous pH correlated negatively with CI. Blood Pco2 and base excess (BE) correlated positively and negatively, respectively, with CI. Blood lactate concentration measured 142 times in the last 30 patients correlated positively with CI. Vo2I correlated positively with CI and Paco2 correlated positively with Vo2I. Veno-arterial differences in Pco2 and Cco2 correlated negatively with CI. Due to the difference, Caco2 correlated positively with CI, while Cvco2 did not correlate with CI. pHi correlated negatively with CI but only marginally. By multiple regression analysis, pHi was not affected significantly by CI, while it showed positive correlation with pHa, Hb, Sao2 and negative correlation with blood temperature. When cardiac output increased, blood pH decreased due to increased Pco2 and decreased BE. An increase in Paco2 might result from both an increase in Vo2 or Vco2 and decreased ventilation-to-perfusion ratio. A decrease in BE might result from increased washout of acids (e.g. lactate) from the tissue to the central circulation. In contrast to blood pH, pHi or tissue pH was not affected significantly by cardiac output unless patients were in cardiogenic shock.

Adult↗
PubMed1997

Premature aging syndrome with osteosarcoma, cataracts, diabetes mellitus, osteoporosis, erythroid macrocytosis, severe growth and developmental deficiency.

We describe a premature aging disorder in a 15-year-old girl with severe growth and developmental deficiency. Her clinical findings included osteosarcoma, nuclear and subcapsular cataracts, insulin-resistant diabetes mellitus, osteoporosis, epilepsy, foot ulcers, erythroid macrocytosis, and unusual facial appearance. Hyaluronic acid levels in serum and urine were normal. Cultured skin fibroblasts had a normal potential for in vitro growth. This finding represents a new and unique premature aging syndrome.

Abnormalities, Multiple↗
PubMed1997

Apolipoprotein E epsilon 4 allele and pupillary response to tropicamide.

OBJECTIVE: This study was designed to investigate in cognitively normal subjects the possible association between hypersensitive pupil dilation response to the cholinergic antagonist tropicamide and the presence of the apolipoprotein E epsilon 4 (APOE4) allele, a well-defined genetic risk factor for Alzheimer's disease. METHOD: The authors measured tropicamide-induced changes in pupil area in 44 cognitively normal Japanese subjects with and without the APOE4 allele. RESULTS: The subjects with the APOE4 allele had significantly greater increases in pupil area than the others. The significant correlation of changes in pupil area with age for the subjects with the APOE4 allele was lacking for those without this allele. CONCLUSIONS: The results suggest that a hypersensitive pupil dilation response to tropicamide is already present in cognitively normal individuals with the APOE4 allele. This association also suggests the potential involvement of APOE4 in the mechanism of pupil dilation.

Aging↗
PubMed1997

[An investigation of drug abuse and the utility of toxicology screening for use in emergency centers].

The results of toxicology screening of samples from 725 patients admitted to the Critical Care Medical Center (CCMC) of Nippon Medical School during a 10-month period from 1992-1993 (Group A) and a 4-month period from 1995-1996 (Group B) were discussed. We investigated the drug use of emergency patients using immunoassay. EMIT and Triage. The results were confirmed by Gas Chromatography/Mass Spectrometry (GC/MS). Blood samples were analyzed for ethanol (EtOH) by head space gas chromatography. Overall, 18% of the 725 cases tested positive for drugs, 13% for EtOH. Recently the positive rates of drugs and EtOH have been increasing. The positive rates for drugs in Group A and Group B were 15% and 23%, and EtOH were 11% and 17%, respectively. False positive cases caused by the cross-reactivity to analog were found in both EMIT and Triage. But the reliability of both methods was sufficient for clinical use. Rapid in easy toxicology screening can provide useful clinical information for patients admitted to a CCMC, especially for patients who have been injured, have sustained unknown-etiology consciousness disturbances, have CPAOA (Cardio Pulmonary Arrest on Arrival) or have committed drug abuse. We conclude that toxicology screening using immunoassay methods is suitable for use in an emergency center.

Adolescent↗