Biomedical subjects

M Yoshii

Publications and source records attributed to M Yoshii.

At least 91 records · Page 5Linked to original sources

PubMed1992

[Urinary managements of 332 stroke patients in the chronic phase].

Urinary managements of 332 stroke patients in the chronic phase were performed at Bobath hospital. Cerebrovascular accidents (CVA) were caused by cerebral infarction in 178 (53.6%), intracerebral hemorrhage in 123 (37.1%) and subarachnoid hemorrhage in 31 (9.3%). Voluntary urination appeared in 124 patients before treatment, however in 29 of them occasional incontinence were observed. One hundred forty-three patients used diapers and 64 were controlled by indwelling catheters. The remaining one patient was treated by intermittent catheterization. Sixty-two patients who seemed to have communicative abilities in daily living were assessed with regard to their cerebrovascular dementia by Hasegawa's Dementia Rating Scale. After treatment 235 patients (70.8%) were able to urinate voluntarily, and only 15 of them remained incontinent and could use small pads successfully. TURP was effective for the stroke patients with benign prostatic hypertrophy (BPH) or bladder neck sclerosis (BNS). Fifty-three patients (16.0%) with persistent urinary incontinence were managed by diapers or a system of condom drainage. Thirty-nine patients (11.7%) were kept dry with intermittent catheterization at home, and long-standing use of indwelling catheters were required in the remaining 5 patients (1.5%). These results indicate that the lower level of activity, mobility and mental state tended to prevent the stroke patients from improvement of urinary disorders.

Activities of Daily Living↗

PubMed1992

[Transurethral resection of the prostate in the urological management for patients with stroke].

We discuss the transurethral resection of the prostate (TUR-P) on 40 patients in the chronic stage of stroke, all of whom were refractory to conservative managements of urinary disturbance. All patients, between 35 and 89 years old (mean: 52.6 years), had only one episode of stroke and were diagnosed as benign prostatic hypertrophy or bladder neck contracture that appeared to cause urinary disturbance in these patients. At six months after TUR-P, all except for one patient, who needed an indwelling catheter due to a reinfarction, were catheter free. Of these cases 36 (92%) obtained independent micturition and did not develop urinary incontinence except transiently postoperatively. Two cases with impaired mobility and one case with progressive senile dementia required helpmates and/or a commode and so forth postoperatively. It is concluded that in chronic stroke patients TUR-P is recommended for those with benign prostatic hypertrophy or bladder neck contracture.

Adult↗

PubMed1992

Sulfonate analogues of chenodeoxycholic acid: metabolism of sodium 3 alpha, 7 alpha-dihydroxy-25-homo-5 beta-cholane-25-sulfonate and sodium 3 alpha, 7 alpha-dihydroxy-24-nor-5 beta-cholane-23-sulfonate in the hamster.

This report describes the chemical synthesis of a new bile acid analogue, namely, sodium 3 alpha, 7 alpha-dihydroxy-25-homo-5 beta-cholane-25-sulfonate from homochenodeoxycholic acid. The structure of the new compound was assigned by proton magnetic resonance and infrared spectrometry. Its metabolism was studied in the hamster in comparison with sodium 3 alpha, 7 alpha-dihydroxy-24-nor-5 beta-cholane-23-sulfonate and sodium taurochenodeoxycholate. After intraduodenal administration of the 3H-labeled analogues into bile fistula hamsters, both sulfonates were absorbed from the intestine and nearly 80% of the radioactivity was secreted into bile within 8 h. Intra-ileal administration revealed that these compounds resembled taurochenodeoxycholate in that they were much more rapidly absorbed from the ileum than from the proximal small intestine: more than 85% of the radioactivity was recovered in bile within 1 h. After intravenous infusion the sulfonates were efficiently extracted by the liver at rates similar to that of sodium taurochenodeoxycholate. Chromatographic analysis of the bile showed that, regardless of the route of administration, most (> 95%) of the sulfonates were not biotransformed and they became major biliary bile acids. Sodium 3 alpha, 7 alpha-dihydroxy-25-homo-5 beta-cholane-25-sulfonate and, to a lesser extent, sodium 3 alpha, 7 alpha-dihydroxy-24-nor-5 beta-cholane-23-sulfonate induced cholestasis at infusion rates at which sodium taurochenodeoxycholate produced choleresis.

Animals↗

PubMed1992

Surgical treatment of adrenal diseases at Nara Medical University and affiliated hospitals.

The effect of advanced diagnostic imaging on the surgical treatment of adrenal diseases was examined in 86 cases of adrenal disease surgically treated at the Department of Urology, Nara Medical University, and affiliated hospitals from August, 1962, to July, 1991. The number of cases included in the present study was 16 for the period before the introduction of CT (from 1962 to 1978), and 70, including 13 cases of adrenal incidental tumor, after the introduction of CT in 1979. There were no malignant tumors histopathologically, among the 13 cases of incidental tumor. Accurate localization of functioning adrenal disease was possible at a rate of 100% with angiography, including selective venous blood sampling, 98.6% with CT and 84.5% with ultrasonography. The rate was 100% with magnetic resonance imaging which was carried out on 19 cases (20 adrenal glands). Signs of malignancy were observed in the removed tissue of three cases from the pheochromocytoma group. As the diagnostic imaging technique has improved, the use of a flank approach has increased in the surgery for adrenal disease.

Adolescent↗

PubMed1992

[Linearity and nonlinearity of pattern ERG and pattern VECP].

To investigate the linearity and nonlinearity of both pattern electroretinogram (P-ERG) and pattern visually evoked cortical potential (P-VECP), a checkerboard pattern was presented to normal subjects with the reversal rate of transient and steady-state condition. Using a personal computer (BASIC) system, we made simulated waves (linear model) at 3 to 15 rev/s stimuli summated from an original wave evoked at 1 rev/s stimulation. Both simulated P-ERGs and P-VECPs were found to be different from the original ones, and the nonlinear component, which was interpreted as the difference between the original and simulated waves, was thought to increase with the increment of pattern reversal rate. However the 2 nd harmonic component of the original wave drastically decreased at above 7.5 rev/s stimulation. Thus, it is concluded that the nonlinearity of both P-ERG and P-VECP does not correlate with those 2 nd harmonic components.

Adult↗

PubMed1991

Luminance-unbalanced pattern onset-offset electroretinogram and visual evoked cortical potential.

The effects of a luminance-unbalanced pattern onset-offset mode of stimulation on electroretinograms and visual evoked cortical potentials were investigated. With the use of originally devised software, only offset luminance was varied from 14.7 to 62.3 cd/m2. A vertical grating pattern (1.5 c/deg, 38.8 cd/m2 mean luminance, 0.95 contrast) was presented for 260 ms and was absent for 260 ms to normal subjects. With an increase in the luminance level of the offset pattern from the lowest level, the amplitude of the onset electroretinogram increased by degrees, while that of the offset electroretinogram gradually decreased. Conversely, onset visual evoked cortical potential responses decreased gradually, and offset visual evoked cortical potentials increased correspondingly. Furthermore, the spatial tuning of the onset pattern electroretinogram was already ambiguous, even when there was only a 4-cd/m2 difference between onset and offset pattern luminances. Thus, luminance control is indispensable for pattern onset-offset stimulation.

Adult↗

PubMed1991

Aspirin does not inhibit cholesterol cholelithiasis in two established animal models.

The effect of aspirin on cholesterol cholelithiasis was examined in the hamster and the prairie dog. In the prairie dog, diets were composed of semipurified components of chow, plus cholesterol (1.2%), with and without aspirin. Animals were studied for either 2 weeks or 4 weeks. Cholesterol gallstones were present in all groups at the end of each period; aspirin did not alter the incidence of cholelithiasis. All animals studied had cholesterol crystals in the bile when they were killed. Liver cholesterol levels in prairie dogs with and without aspirin tended to be lower in animals fed chow than in animals fed semipurified diets. There were no significant differences in cholesterol levels in the plasma or bile. The cholesterol saturation index of all biles approached unity when animals were fed chow with aspirin; animals fed the semipurified diets had cholesterol saturation indices of less than 1.0. The prairie dogs fed aspirin plus cholesterol in the semipurified diet showed increased levels of biliary chenodeoxycholic acid amidates and concomitant decreased levels of cholic acid amidates compared with animals fed the same diet without aspirin. Hamsters fed aspirin plus cholesterol in a semipurified diet tended to have a greater incidence of gallstones than animals given no aspirin (80% vs. 55%). Liver and bile cholesterol levels were similar with and without aspirin; plasma cholesterol levels increased significantly with aspirin [14.20 vs. 7.80 mmol/L (549 vs. 301 mg/dL)]. Lithogenic indices in all hamsters were above unity; biliary lipids, total lipid concentration, and biliary bile acid composition were similar. These results show that the addition of aspirin to a lithogenic diet does not reduce the incidence of cholelithiasis.

Animals↗

PubMed1991

Metabolism of sodium 3 alpha,7 alpha-dihydroxy-5 beta-cholane-24-sulfonate in hamsters.

Metabolism of sodium 3 alpha,7 alpha-dihydroxy-5 beta-cholane-24-sulfonate, the sulfonate derivative of chenodeoxycholic acid, was studied in hamsters. In bile fistula hamsters, the sulfonate analogue was efficiently absorbed from the ileum and secreted rapidly into the bile without any modification such as conjugation. However, absorption from the jejunum was smaller than that observed for the ileum. After oral administration, the sulfonate analogue of chenodeoxycholic acid was recovered quantitatively in the feces as the unchanged form in contrast to simultaneously administered chenodeoxycholic acid, which was entirely converted to lithocholic acid during its passage through the intestinal tract. These results demonstrate that the sulfonate analogue is absorbed mainly from the ileum by active transport, enters the enterohepatic circulation like the endogenous conjugated bile acids, and completely resists bacterial degradation.

Animals↗

PubMed1991

Chemical synthesis and hepatic biotransformation of 3 alpha,7 alpha-dihydroxy-7 beta-methyl-24-nor-5 beta-cholan-23-oic acid, a 7-methyl derivative of norchenodeoxycholic acid: studies in the hamster.

A new bile acid analogue, 3 alpha,7 alpha-dihydroxy-7 beta-methyl-24-nor-5 beta-cholan-23-oic acid (7-Me-norCDCA) was synthesized from the methyl ester of norursodeoxycholic acid, and its hepatic biotransformation was defined in the hamster. To synthesize 7-Me-norCDCA, the 3 alpha-hydroxyl group of methyl norursodeoxycholate was protected as the hemisuccinate, and the 7 beta-hydroxyl group was oxidized with CrO3 to form the 7-ketone. A Grigard reaction with methyl magnesium iodide followed by alkaline hydrolysis gave 7-Me-norCDCA (greater than 70% yield). The structure of the new compound was confirmed by proton magnetic resonance and mass spectrometry. After intraduodenal administration of the 14C-labeled compound into the anesthetized biliary fistula hamster, it was rapidly and efficiently secreted into the bile; 80% of radioactivity was recovered in 2 h. After intravenous infusion, the compound was efficiently extracted by the liver and secreted into the bile (greater than 75% in 3 h). Most (93%) of the biliary radioactivity was present in biotransformation products. The major biotransformation product (48.7 +/- 6.0%) was a new compound, assigned the structure of 3 alpha,5 beta,7 alpha- trihydroxy-7 beta-methyl-24-nor-5 beta-cholan-23-oic acid (5 beta-hydroxy-7- Me-norCDCA). In addition, conjugates of 7-Me-norCDCA with taurine (13.7 +/- 5.0%), sulfate (10.3 +/- 3.0%), or glucuronide (5.1 +/- 1.7%) were formed. 7-Me-norCDCA was strongly choleretic in the hamster; during its intravenous infusion, bile flow increased 2 to 3 times above the basal level, and the calculated choleretic activity of the compound (and its metabolic products) was much greater than that of many natural bile acids, indicating that the compound induced hypercholeresis. It is concluded that the biotransformation and physiological properties of 7-Me-norCDCA closely resemble those of norCDCA. Based on previous studies, the major biological effect of the 7-methyl group in 7-Me-norCDCA is to prevent its bacterial 7-dehydroxylation in the distal intestine.

Animals↗

PubMed1991

[Urological management for stroke patients; relation between brain lesions and establishment of micturitional modality].

A total of 154 stroke patients, 96 males and 58 females, were analyzed to establish the micturitional modality according to the type of detrusor function and the level of activities of daily living (ADL). All patients had only one episode of stroke attack and were checked at least one month after the onset. Localization of cerebral lesion in each patient was evaluated by neurological findings and cerebral angiography in addition to computed tomography of the brain. In the patient groups classified according to the type of detrusor function, micturitional modality was established in 50% of the patients with the underactive type, 70% of those with the overactive type and in 88% of those with normal function. This suggests that the overactive and normal type of detrusor function may not affect establishment of micturitional modality. On the other hand, when classified according to the level of ADL, none established micturitional modality in patients with poor ADL. By contrast, in the patients on higher levels of ADL who were able to transfer themselves from or to a wheel-chair without any assistance it was established in 75%, and in those who were able to gait with or without a brace upon discharged from the hospital, in 91%. It is concluded that establishment of micturitional modality in stroke patients is closely related to the level of ADL or function of lower extremities, but not to localization of the brain lesion.

Activities of Daily Living↗

PubMed1991

[A study of relation between patterns of micturitional dysfunction and establishment of micturitional modality in stroke patients].

We managed 246 patients with bladder dysfunction due to the first stroke in our hospital between January, 1983 and December, 1988. Of these 221 were in the chronic stage of stroke. A total of 213 patients were evaluated for types of bladder dysfunction by cystometry. We examined the relation between hemiplegic side and type of dysfunction or micturition activity, but obtained no significant relationship. Establishment of voluntary voiding pattern was considered to depend on the improvement of daily life activities. The catheter-free rate was 89.4%, while 10.6% of the patients, who could not receive sufficient nursing care or had severe medical problems, were obliged to keep an indwelling catheter. We conclude that establishment of a bladder retraining program is necessary not only medically but socially for improvement of quality of life in stroke patients.

Activities of Daily Living↗

PubMed1991

[Clean intermittent catheterization in the management of spina bifida: a review of 113 cases].

One hundred and thirteen cases of spina bifida treated with clean intermittent catheterization (CIC) were reviewed. There were 42 males and 71 females, ranging from 4 months to 50 years. The major reasons for CIC from other voiding methods were vesicoureteral reflux (VUR) (48/113) old, and residual urine (36/113). The most common type of neurogenic bladder was hypoactive detrusor-active sphincter, in 56.6% of patients (64/113). The grade of paralytic disability of lower limb (Sharrard's classification) was low (group IV-VI) in 84 patients and high (group I-III) in 29 patients. Hydroureteronephrosis and VUR improved 52.1% (37/71) and 57.1% (36/63), urinary tract infection and urinary incontinence improved 70.9% (39/55) and 81.7% (72/87). Major complications were pyelonephritis (12 cases) and urethral pain (5 cases). We discussed the choice of voiding method in the management of spina bifida.

Adolescent↗

PubMed1990

Identification of 3,6,7,12-tetrahydroxy-5 beta-cholan-24-oic acids in human biologic fluids.

Unusual bile acids, 3 alpha, 6 alpha, 7 alpha, 12 alpha-, and 3 alpha, 6 beta, 7 beta, 12 alpha-tetrahyroxy-5 beta-cholan-24-oic acids, were identified in all amniotic fluid (four samples) and urine (six samples) from adult patients with cholestatic liver disease by gas-liquid chromatography/mass spectrometry. For the certain identification of these bile acids in the biologic samples, the chemical syntheses of 3 alpha, 6 beta, 7 alpha, 12 alpha- and 3 alpha, 6 beta, 7 beta, 12 alpha-tetrahydroxy-5 beta-cholan-24-oic acids were conducted.

Amniotic Fluid↗

PubMed1990

Differential block of sodium and calcium channels by chlorpromazine in mouse neuroblastoma cells.

1. The effects of chlorpromazine on the voltage-activated sodium and type I (transient) calcium channels were studied in cultured mouse neuroblastoma cells (N1E-115) using the whole-cell patch-clamp technique. 2. Chlorpromazine (2-10 x 10(-6) M) blocked both the sodium channel current and the calcium channel current as carried by Ba2+ in a reversible and dose-dependent manner. 3. The block was not associated with any change in the time course of the activation and inactivation of the sodium and calcium channel currents. 4. The dose-response relationships for the block of these channels measured with a holding potential of -120 mV indicated a 1:1 binding stoichiometry with apparent dissociation constants of 2.5 +/- 10(-6) M and 1.5 +/- 10(-5) M for the sodium and calcium channels, respectively. 5. The block was dependent on the holding potential for both channel currents. The apparent dissociation constant for the sodium channel was decreased to 0.65 +/- 10(-6) M when the membrane was held at -80 mV. The apparent dissociation constant for the calcium channel was decreased to 3.2 +/- 10(-6) M when the membrane was held at -60 mV. 6. The steady-state inactivation curve for the sodium channel was shifted by 12.4 +/- 1.8 mV to more negative potentials by exposure to 1 x 10(-6) M-chlorpromazine. The inactivation curve for the calcium channel was also shifted by 15.4 +/- 3.2 mV to more negative potentials by exposure to 1 x 10(-5) M-chlorpromazine. These results indicate a greater affinity of chlorpromazine for the inactivated state of the channels than for the resting state. 7. Chlorpromazine caused a marked use-dependent block of the sodium channel current, as demonstrated by a cumulative increase of the block during a train of depolarizing pulses. The use-dependent block was observed even with an interpulse interval as long as 2 s. 8. On the other hand, the block of the calcium channel current did not notably accumulate during a train of depolarizing pulses even when extremely prolonged (1 s) pulses were applied at a very short interpulse interval (200 ms). 9. The marked use dependence of the sodium channel block was due to a very slow repriming of the drug-bound sodium channels from inactivation, whereas the lack of use dependence of the calcium channel block was due to a rapid repriming of the drug-bound calcium channels.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1990

Spatial selectivity of pattern electroretinogram components.

Pattern electroretinograms were recorded to checkerboard stimuli of various check size to both onset-offset pattern and pattern reversal under most similar conditions of contrast and luminance. With onset-offset pattern the amplitude of the p-q and q-r components of the onset response showed a peak for checks of about 20 min of arc (spatial tuning), whereas the offset response was spatially nonselective at high contrast regardless of the luminance level. With pattern reversal the potentials were similar to those after algebraic summation of onset and offset responses both in waveform and check size of peak amplitude at 50 min of arc. From this we conclude that summation of contrast (onset) and luminance (offset) components is responsible for the shift from 20 min of arc (onset tuning) to 50 min of arc (reversal tuning). The study recommends the application of pattern stimuli in an onset-offset mode for studying antagonistic receptive field properties in the human electroretinogram.

Adult↗

PubMed1990

[Mesenteric desmoid found after surgery of familial polyposis coli; a case report].

A 51-year-old woman manifested with complaints of an abdominal mass 5 years after colectomy. In comparison with the cases previously reported, this desmoid had lower CT value (20-30 HU), and more vascularity with neovascularization on angiography. These findings seem to reflect the characteristic of much cellularity and malignancy of the desmoid.

Adenomatous Polyposis Coli↗

PubMed1990

Synthesis of new bile salt analogues, sodium 3 alpha, 7 alpha-dihydroxy-5 beta-cholane-24-sulfonate and sodium 3 alpha, 7 beta-dihydroxy-5 beta-cholane-24-sulfonate.

This report describes the chemical synthesis of two new bile salt analogues, namely sodium 3 alpha,7 alpha-dihydroxy-5 beta-cholane-24-sulfonate and sodium 3 alpha,7 beta-dihydroxy-5 beta-cholane-24-sulfonate from chenodeoxycholic acid and ursodeoxycholic acid, respectively. Each common bile acid was converted into the corresponding 5 beta-cholane-3,7,24-triol by treatment with ethyl chloroformate in the presence of triethylamine followed by sodium borohydride reduction. Reaction of the cholanetriol with p-toluenesulfonyl chloride at 4 degrees C afforded the partially tosylated product, 24-p-toluenesulfoxy-5 beta-cholane-3,7-diol, which was then treated with sodium iodide to produce 24-iodo-5 beta-cholane-3,7-diol. The 24-iodide was refluxed with sodium sulfite in aqueous ethanol to give the desired sulfonate analogue of the naturally occurring bile acid, chenodeoxycholic acid or ursodeoxycholic acid.

Bile Acids and Salts↗

PubMed1989

Psychotropic drugs block voltage-gated ion channels in neuroblastoma cells.

Effects of neuroleptics and tricyclic antidepressants on voltage-gated ion channels were investigated in the neuroblastoma cell line N1E-115 using the whole cell variation of patch electrode voltage-clamp techniques. Imipramine, chlorpromazine and haloperidol in micromolar concentrations blocked sodium, calcium and potassium channel currents in a reversible and concentration-dependent manner. The order of potency was chlorpromazine greater than imipramine greater than haloperidol. These direct blocking actions on neuronal ion channels might play a role in clinical effects of these drugs.

Animals↗