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Biomedical subjects

M Yagi

Publications and source records attributed to M Yagi.

At least 145 records · Page 8Linked to original sources

[Sudden deafness in the elderly].

We investigated the clinical features of 64 cases of sudden deafness in patients more than 60 years of age. Forty-eight cases (75%) had profound deafness, 13 moderate and three mild deafness. The audiograms of 25 cases showed a flat pattern, 13 a gradually descending curve, and 13 total deafness. In 60 cases, the unaffected ear also had hearing impairment of variable severity. Fifty-one of these 60 cases demonstrated a physiological hearing threshold shift termed presbycusis in the unaffected ear. Hearing impairment in 35 cases (55%) was cured or improved by medical treatment including steroids. But in the majority of cases, the hearing threshold level of the affected ear did not improve above that of the unaffected ear when the unaffected ear had a hearing impairment. In particular, hearing impairment in five cases with total deafness in the unaffected ear did not improve. The elderly often had various systemic complications, including nine cases of diabetes and seven of hypertension. We treated patients with diabetes using steroids under the consultation of diabetic specialists. As a result, there was no case of complications induced by steroids. We consider the effect of treatment of sudden deafness in the elderly to be best judged in various degrees of hearing impairment in the unaffected ear.

Aged↗

Postoperative adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs in patients with hepatocellular carcinoma.

Vascular invasion and intrahepatic metastasis by hepatocellular carcinoma are important factors predisposing to tumor recurrence. Recurrences of this malignancy occur frequently in residual liver, and its prevention is one of the most important factors in obtaining better surgical survival. Fifty patients who underwent hepatectomy for invasive hepatocellular carcinoma with vascular invasion and/or intrahepatic metastases were studied to evaluate the effect of adjuvant bolus hepatic arterial infusion of iodized poppyseed oil (Lipiodol) containing anticancer drugs in preventing recurrence and in prolonging survival. Patients were assigned to two treatment groups. Twenty-three of the fifty patients received adjuvant bolus infusion of Lipiodol containing doxorubicin and mitomycin C, whereas 27 patients received no therapy. The disease-free survival rate for the patients who received adjuvant therapy was significantly better (p < 0.05) than that for those who did not when measured at 172, 516, 688 and 860 days after hepatectomy, and the disease-free survival curve for patients with adjuvant therapy was significantly (p = 0.0237) better than that without adjuvant therapy. The cumulative survival rates and curves were not significantly different between the two groups. While adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs was effective in improving disease-free survival, the effect was not satisfactory. Further trials of adjuvant chemotherapy are required to improve the surgical survival of hepatocellular carcinoma patients.

Aged↗

Human platelet glycoprotein V: characterization of the polypeptide and the related Ib-V-IX receptor system of adhesive, leucine-rich glycoproteins.

Human platelet glycoprotein (GP) V (M(r) 83,300), whose primary structure is reported here, is a part of the Ib-V-IX system of surface glycoproteins (GPs Ib alpha, Ib beta, V, IX) that constitute the receptor for von Willebrand factor (vWf) and mediate the adhesion of platelets to injured vascular surfaces in the arterial circulation, a critical initiating event in hemostasis. System members share physical associations, leucine-rich glycoprotein (LRG) structures, and a congenital deficiency state, Bernard-Soulier syndrome. With PCR techniques and platelet cDNA templates, 1.4 kb of GP V cDNA sequence was obtained that encodes 469 GP V amino acids. A genomic 3.5-kb BamHI fragment was then isolated that includes 3.46 kb of GP V cDNA sequence: the 1.7-kb open reading frame plus 2 bases of the 5' and 1.8 kb of the 3' untranslated regions. Northern blot analysis reveals three GP V platelet transcripts of 3.8, 4.2, and 5.2 kb. A 16-amino acid signal peptide is present. Mature GP V is a 544-amino acid transmembrane protein with a 504-amino acid extracellular domain that encompasses a set of 15 tandem LRG repeats in a "flank-LRG center-flank" array [Roth, G. J. (1991) Blood 77, 5-19] along with eight putative N-linked glycosylation sites and cleavage sites for thrombin and calpain. GP V is a transmembrane, adhesive LRG protein that plays an undefined, but potentially critical, role in the expression and/or function of the Ib-V-IX receptor for vWf/shear-dependent platelet adhesion in arteries.

Amino Acid Sequence↗

An electrocochleographic study of acute low-tone sensorineural hearing loss.

Twenty-four patients with acute low-tone sensorineural hearing loss (ALHL) were examined using electrocochleography. The negative summating potential (SP) amplitude and the summating potential/action potential (AP) ratio were significantly greater in the ALHL patients than in normals. The SP/AP ratio was smaller in the ALHL patients than in patients with known Meniere's disease and moderate hearing loss, although the SP amplitude was somewhat greater in the former. An abnormal increase in the SP amplitude following click stimuli was found in 54% of the ALHL patients, while the SP/AP ratio was increased abnormally in 63% of these patients. These findings suggest that the pathophysiology of ALHL may be similar to that for endolymphatic hydrops.

Acoustic Stimulation↗

Hepatic resection using a water jet dissector.

A newly-designed water jet dissector was used for hepatic resections in humans. To evaluate its usefulness, the water jet dissector was compared to an ultrasonic surgical aspirator in terms of average blood loss and time of operation. In hepatectomies on patients associated with liver cirrhosis, the average blood loss during hepatic resection using the water jet dissector was significantly smaller (P < 0.05) than that with the ultrasonic surgical aspirator. However, in hepatectomies on patients without cirrhosis, the average blood loss during hepatic resection did not significantly differ between the two groups. Neither did the time of operation significantly differ between the two procedures in hepatectomies on patients with and without liver cirrhosis. No serious complications attributable to the use of the water jet dissector were encountered. The water jet dissector is thus considered to be a useful new device for use in the transection of the liver during hepatic resections.

Adenoma, Bile Duct↗

Anterior sagittal anorectoplasty as a redo operation for imperforate anus.

Based on the idea of transsphincteric approach by Peña, we applied anterior sagittal anorectoplasty (ASARP) as a redo operation in 10 patients, who present moderate to severe fecal incontinence postoperatively. Those patients exhibited anal opening located anteriorly to the center of contraction of external sphincter muscles. Operation is begun with making a circumferential skin incision in the mucocutaneous junction around the anal opening, extending posteriorly along the median line to the center of the external sphincter muscles. Upon confirming the vertical muscle and the external sphincter muscles, the rectal tube, being dissected free, is mobilized backward to be placed at the center of the vertical muscles and enclosed by the muscle. After the operation, an improvement was noted in either clinical symptoms or scores, being particularly marked for incontinence and staining scores. Anorectal manometry and barium enema studies also showed a significant improvement. These results provide ample justification of ASARP as a redo operation for imperforate anus being worthwhile trying in properly selected patients with poor anorectal function following the primary operation.

Anus, Imperforate↗

Alterations in pain threshold and psychomotor response associated with subanaesthetic concentrations of inhalation anaesthetics in humans.

We studied the effects of six inhalation anaesthetics at subanaesthetic concentrations of 0.2 MAC on pain threshold and psychomotor function in six healthy volunteers. When compared with 100% oxygen inhalation, nitrous oxide and methyoxyflurane significantly increased pain threshold as measured by a radiant heat algometer, and prolonged the response time to auditory stimuli. In contrast, halothane, enflurane, isoflurane and sevoflurane produced prolongation of the response time to auditory stimuli but did not influence pain perception. The pain threshold with nitrous oxide remained significantly increased 30 min after its discontinuation, while the response time returned to the preinhalation value. We conclude that nitrous oxide and methoxyflurane possess both analgesic and hypnotic actions but halothane, enflurane, isoflurane and sevoflurane do not have an analgesic action at subanaesthetic concentrations, and the analgesic action of nitrous oxide persists after its elimination.

Adult↗

Paget's disease of the esophagus.

Esophageal carcinoma simulated Paget's disease in a 60-year-old Japanese man with 3 months of difficulty swallowing and pain. Results of an esophageal biopsy indicated undifferentiated carcinoma, but after esophagectomy and partial gastrectomy, the resected esophagus showed that the mucosa was diffusely indurated with irregular, reticulated erosions. There was no tumor mass or ulcer. Histologic examination showed an extensive intraepithelial growth of cancer cells without any glandular or squamous cell differentiation. Tumor cells were large and round and contained large nucleoli and ample, clear, or pale-staining cytoplasm, similar to the cells of Paget's disease. Tumor cells multifocally invaded into the mucosal and submucosal ducts where they formed papillary and tubular nests, indicating adenocarcinomatous differentiation, but there was no invasive growth beyond the basement membrane. Tumor cells in the epithelial layer were negative for periodic acid Schiff (PAS) and alcian blue, but partly positive for epithelial membrane antigen (EMA) and CEA, whereas those in the submucosal ducts and glands were strongly positive for PAS, alcian blue, carcinoembryonic antigen, and EMA, especially at their luminal surfaces. Tumor cells were negative for S-100, neuron-specific enolase, and melanin. These findings indicate that the tumor in the present case was a primary esophageal carcinoma with partial adenocarcinomatous differentiation, showing an extensive intraepithelial Pagetoid growth of its undifferentiated component. This is the first case of esophageal Paget's disease presenting as intraepithelial growth alone.

Biopsy↗

Isolation of bilobalide and ginkgolide A from Ginkgo biloba L. shorten the sleeping time induced in mice by anesthetics.

The leaves of Ginkgo biloba L. and aqueous extract from them shortened the sleeping time induced in mice by anesthetics (hexobarbital, alpha-chloralose and urethane, i.p.). Two characteristic terpenoids in G. biloba, bilobalide and ginkgolide A, significantly shortened the sleeping time induced by anesthetics. A toxic substance, 4-O-methylpyridoxine (MPN), responsible for "gin-nan food poisoning" isolated from the seed of G. biloba, was not detected from the extract of the leaves of G. biloba. Therefore, the Ginkgo biloba extract has no toxicities for MPN.

Anesthetics↗

[Studies on the constituents of edible and medicinal plants. IV. Determination of 4-O-methylpyridoxine in serum of the patient with gin-nan food poisoning].

The serum 4-O-methylpyridoxine (MPN) levels in a 21 months-old patient with gin-nan food poisoning were determined by HPLC. The blood of the patient was taken at 8.5 and 15.5 h after taking about 50 ginkgo albumens. After deproteinization of the serum, the supernatant was pretreated with Sep-pak C18 cartridge and was applied to HPLC. HPLC was performed with a Hibar LiChrosorb RP-18 (4.0 mm i.d. x 250 mm, 7 microns) using a fluorescence detector (wave length of excitation and fluorescence; 290 and 400 nm, respectively). The serum MPN level was determined by the absolute calibration method. The determination limit of MPN in the serum was 0.05 micrograms/ml. The serum MPN concentration was 0.09 micrograms/ml at 8.5 h after taking ginkgo seeds, and was less than the determination limit of MPN (0.05 micrograms/ml) at 15.5 h. MPN, isolated from the seed of Ginkgo biloba L., is responsible for "gin-nan food poisoning," and its cardinal symptoms are mainly tonic and/or clonic convulsions and loss of consciousness. Infants are particularly vulnerable. This method may be available for proving the gin-nan food poisoning, chemically.

Chromatography, High Pressure Liquid↗

[Benefits of a community oriented fluoride mouth rinsing program].

The benefits of a school-based fluoride mouth rinsing in a community dental health program were evaluated. In village "M", children from 4 to 14 years old have been participating in a school-based fluoride mouth rinsing program since 1974. In addition, an informal association for dental health of children was inaugurated in 1975 to support the community dental health program. In village "K", there were no fluoride mouth rinsing programs. However, the usual dental health education conducted in all schools was similar in both communities. In order to compare these two communities, dental examinations were carried out in 1990. The total number of subjects from 6 to 14 years old was 331 in village "M" and 408 in village "K". In village "M" for longitudinal comparison, 12-year-olds, 1,054 in total, were examined annually from 1974 to 1990. The DMFT-index in all subjects in village "M" was 76.1% lower than in village "K". In village "M", the DMFT-index in 1990 decreased 79.0% compared to 1974. The economic benefits obtained through the caries reduction were evaluated. In 1990 the mean cost of dental treatment for subjects 14 years old was 27,840 yen per person in village "K" and 4,248 yen in village "M". The cost-benefit ratio was 18.8 and the cost-effectiveness ratio was 137 yen. These remarkable benefits from the prevention of dental caries appears to have been mainly obtained due to the participation of children aged 4 to 14 years old in a school-based fluoride mouth rinsing program.

Adolescent↗