[Clinical study of Helicobacter pylori infection].
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Antibodies, Bacterial↗
Biomedical subjects
N Yamada
Publications and source records attributed to N Yamada.
Risk factors and pathogenesis of atherosclerotic lesion.
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Animals↗
The inferior capsular shift operation for instability of the shoulder. Long-term results in 34 shoulders.
We reviewed 26 patients with 34 shoulders treated by the inferior capsular shift operation for inferior and multidirectional instability. The mean follow-up was 8.3 years. In total, 12 shoulders showed voluntary subluxation. Eight operations used an anterior and posterior approach, 11 were by the posterior route, and 15 shoulders had an anterior approach. In 30 shoulders (85%) the outcome was satisfactory and 20 (59%) scored good or excellent results on the Rowe system. Instability had recurred in nine shoulders (26%) from three months to three years after the operation. Six of the 12 shoulders with voluntary subluxation (50%) had recurrence, as against three of the other 22 (14%), a statistically significant difference. The operation is therefore not indicated for voluntary subluxation. The 19 shoulders which had been assessed in 1987 at a mean of 3.5 years after surgery, were also reviewed in 1995 and found to have no significant changes in instability or Rowe score. This shows that the capsular shift appeared to have maintained its tension over an eight-year period. After the use of a posterior approach, 64% of the shoulders showed a posterolateral defect on radiographs of the humerus.
Adolescent↗
Clinicopathological studies of odontoma in 47 patients.
A 14-year retrospective study was performed on 47 odontomas from the files of the 1st Department of Oral and Maxillofacial Surgery at Nihon University School of Dentistry. Fifty-seven percent of the patients were male and 42.6% were female. The age distribution was 8 to 48 years with a mean age of 22 +/- 9.0 years. There were no particular symptoms associated with the odontomas, and 63.8% of our patients had no symptoms. However, 12 patients complained of swelling and 9 of pain. The tumor was found in the maxilla in 42.6% and in the mandible in 57.4%. According to the WHO histological type classification, 53.2% of the tumors were classified as compound odontoma and 46.8% as complex odontoma. The size of the tumor ranged from 5 mm to 42 mm in diameter. The average complex odontoma was much bigger than the average compound odontoma. Ghost cells were found 11 cases in our series. In addition, odontogenic epithelium was found in 16 cases. Twenty seven patients had impacted teeth in association with odontoma and 24 of the 27 teeth were removed at the time of surgical enucleation of the tumor, while 3 cases were treated by orthodontically assisted eruption. There was no recurrence in any of the studied cases.
Adolescent↗
[Esophageal reconstruction for esophageal stricture after corrosive injury].
Swallowing a corrosive agent (alkali or acid) often causes severe pharyngeal, laryngeal or esophageal stricture (caustic stenosis), which is usually very difficult to treat. This paper reports two cases of esophageal stricture treated by esophagoplasty. Both cases had attempted suicide by swallowing a sodium hydroxide solution or acid. Case 1 was a 66-year-old man found to have severe hypopharynx and thoracic esophagus stenosis with supraglottic stricture. The supraglottic stricture was reconstructed with an ileocolon graft and laryngectomy. The intestinal anastomosis was patent, but the peristaltic motion in the ileocolon was not good. The patient continues to have difficulty achieving sufficient oral feeding and to receive supplemental feeding via a jejunostomy. Case 2 was a 81-year-old woman with severe thoracic esophagus stenosis after gastrectomy. The lesion was reconstructed with a jejenum graft. The intestinal anastomosis was patent. She achieved oral alimentation of both liquids and solids without aspiration after surgery. Esophagectomy in these cases can be difficult and hazardous due to extensive fibrosis and many adhesions to adjacent structures. In both cases, the reconstructed intestine passed through the ante-sternal route, so there was severe scar formation in the mediastinum, and an esophago-skin fistula formed in the cervical skin. Cervical vessels and intestinal vessels were anastomosed for blood supply to the reconstructed intestinal tract. This method is useful because it is safe and results in good deglution.
Aged↗
Brief survey of leprosy situation in Congo: sero-epidemiologic profile in correlation with some emerging viral infections.
The Democratic Republic of Congo (DRC, former Zaire) in central Africa remains the foremost country for leprosy in Africa, with a total of 4877 registered cases, of which 4573 are new cases since 1997. These numbers are well above the regional average. About 94% of these patients are under multidrug therapy (MDT) coverage in the Congo, which ranks 8th in coverage rate among the surrounding nine nations. Available data on anatomo-clinical profile and bacillarity are provided, with reservations on the use of these data drwn due to relatively small sample sizes. The seroprofile of the disease was reviewed with regard to the association of other immunity impairing infections like HBV infection and the recently highly incident retroviral epidemics (HIV-1, HTLV-1, and HTLV-2). The leading role of non-governmental organizations is cited for improving leprosy patient conditions and also for future prospects, where the necessity of coordinated strategies with the government is emphasized. Recommendations for new trends and steps relevant to improving existing and future leprosy control strategies are put into perspective.
Communicable Disease Control↗
[Histopathological changes of peripheral nerves and blood vessels in Hansen's disease].
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Animals↗
[Effects of coronary artery bypass surgery on the stunned and hibernating myocardium in the cases with depressed left ventricular function].
Chronic left ventricular (LV) dysfunction may result from irreversible damage (cell death), stunned myocardium (ST), or hibernating myocardium (HB). However, both of ST and HB are expected to be reversible. In this report, the effects of coronary artery bypass grafting on the regions of ST and HB were evaluated in 37 patients with less than 40% of LV ejection fraction. The patients were divided into two groups. Group I consisted of the patients whose postoperative LV ejection fraction rose by more than 10% compared to the preoperative value. Group II included the remaining patients with no significant improvement. After successful revascularization, 61% of HB changed to ST and 52% of ST to normal in group I. These changes were significant in comparison with group II because 48% of HB and 83% of ST in group II remained unchanged. Immediate or rapid recovery of HB hardly occurred in both of the groups. To recover normal function, HB may pass through a stage of ST on reperfusion. On the other hand, it is difficult to determine whether HB and ST with no significant changes after reperfusion are irreversibly damaged or reversible and take time to return to normal.
Aged↗
[ASO as a risk factor of emergency CABG].
The presence of lower extremity arterial occlusive disease (arteriosus sclerosis obliterance of lower extremity) is an important risk factor for patients undergoing emergency coronary artery bypass operations. Those patients had higher mortality and morbidity rates related to the complications of intraaortic balloon pumps (IABP). If lower extremity ischemia is observed, rapid procedures such as removal of the IABP with or without thrombectomy and femorofemoral crossover interposition of a graft should be performed.
Aged↗
Developmental abnormalities of glycosylphosphatidylinositol-anchor-deficient embryos revealed by Cre/loxP system.
One mode used to link membrane proteins to a cell membrane is by means of a special glycolipid anchor termed glycosylphosphatidylinositol (GPI). Pig-a, an X-linked gene, is involved in the first step of GPI-anchor biosynthesis. Disruption of this gene causes cessation of GPI biosynthesis on the endoplasmic reticulum, thereby leading to the absence of GPI-anchored proteins on the cell surface. We have previously reported that mice with high chimerism was never obtained from Pig-a disrupted ES cells, suggesting that GPI-anchored protein(s) may have important roles for mouse development such that the absence of GPI-anchored proteins causes a lethal effect to mice. In this study, this lethal effect has been investigated by using a conditional approach to "knockout" the Pig-a gene. For this, mice harboring a Pig-a gene flanked by two loxP sites (Pig-aflox) were mated with hCMV-Cre transgenic mice, which express Cre recombinase before implantation. The allele disruptions were identified by PCR analysis of embryo yolk sac DNA. Embryos harboring a complete disruption of Pig-a gene ceased to develop beyond the ninth day of gestation. Female embryos in which one Pig-a allele was disrupted by Cre such that only half of the cells in the embryo proper did not express GPI-anchored proteins due to random X inactivation developed until 19 days post coitum (dpc), but showed abnormal phenotypes such as insufficient closure of neural tube and cleft palate. These data further highlight the importance of GPI-anchored proteins during mouse embryonic development.
Animals↗
Value of diffusion-weighted imaging and apparent diffusion coefficient in recent cerebral infarctions: a correlative study with contrast-enhanced T1-weighted imaging.
BACKGROUND AND PURPOSE: The clinical usefulness and the time course of diffusion-weighted imaging and apparent diffusion coefficient (ADC) in acute and subacute cerebral infarction have not yet been established, although it is known that contrast-enhanced T1-weighted spin-echo imaging can detect a subacute infarct. Our aim was to study which imaging technique is useful in detecting recent infarcts, and whether an increase in ADC or a decrease in signal intensity on diffusion-weighted images is correlated with enhancement on T1-weighted spin-echo images. METHODS: Forty-one infarctions with a duration of 9 hours to 27 days were studied in 29 patients. The ADC and signal intensity on diffusion-weighted images were compared with the contrast-enhancement ratio (CER) on T1-weighted spin-echo images (CER = signal intensity after contrast injection/signal intensity before contrast injection). RESULTS: ADC was linearly correlated with CER, and signal intensity on diffusion-weighted images was inversely correlated with CER. The correlation between ADC and age of the infarct in the subacute phase was weak. CONCLUSION: Diffusion-weighted and contrast-enhanced T1-weighted spin-echo images complement each other in detecting subacute infarcts. Neovascularization and disruption of the blood-brain barrier in infarcts can be important in increasing ADC in subacute infarcts.
Aged↗
[Atherosclerosis and lipids: overview].
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Arteriosclerosis↗
Insulin action on heart and skeletal muscle FDG uptake in patients with hypertriglyceridemia.
UNLABELLED: Abnormal heart and skeletal muscle 18F-fluorodeoxyglucose (FDG) uptake in patients with insulin resistance has been demonstrated. Although the existence of whole-body insulin resistance has been reported in hypertriglyceridemics, its specific role in heart and skeletal muscle FDG uptake in hypertriglyceridemics has not been clarified. METHODS: We compared heart and skeletal muscle FDG uptake using PET and the whole-body glucose disposal rate (GDR) during insulin clamping in 17 hypertriglyceridemics and 12 age-matched control subjects to increase our knowledge of whole-body insulin resistance and its relationship to heart and skeletal muscle FDG uptake in hypertriglyceridemics. RESULTS: GDR was significantly reduced in hypertriglyceridemics compared with control subjects (4.50 +/- 1.37 mg/min/kg versus 10.0 +/- 2.97 mg/min/kg, P = 0.00001), as were the skeletal muscle FDG Ki = (k1 x k3)/(k2 + k3) (SFKi: 0.007 +/- 0.003 mL/min/g versus 0.018 +/- 0.01 mL/min/g, P = 0.0001) and skeletal muscle FDG uptake ([SMFU] 0.725 +/- 0.282 mg/min/100 g versus 1.86 +/- 1.06 mg/min/100 g, P = 0.00023). However, myocardial FDG Ki (MFKi) tended to be reduced in hypertriglyceridemics compared with that in control subjects (0.062 +/- 0.017 mL/min/g versus 0.068 +/- 0.015 mL/min/g), but the difference was statistically insignificant (P = 0.3532). Moreover, myocardial FDG uptake (MFU) in hypertriglyceridemics (6.47 +/- 1.72 mg/min/100 g) tended to be reduced compared with that in control subjects (6.97 +/- 1.73 mg/min/100 g), but the difference was statistically insignificant (P = 0.4485). GDR was significantly correlated with SFKi (r = 0.69, P = 0.0022), SMFU (r = 0.612, P = 0.009), MFKi (r = 0.57, P = 0.0174) and MFU (r = 0.505, P = 0.0385) in hypertriglyceridemics. CONCLUSION: Both heart and skeletal muscle glucose utilization were related to insulin resistance in hypertriglyceridemics. However, the less severe reduction in MFU (compared with SMFU) suggests that myocardium may have a mechanism to oppose insulin resistance in hypertriglyceridemics.
Case-Control Studies↗
[Coronary bypass surgery within thirty days of acute inferior myocardial infarction].
Between April 1988 and November 1998, 82 patients underwent isolated coronary artery bypass grafting within 30 days of acute myocardial infarction. The infarct-related artery was the proximal right coronary artery (27 patients; group 1) and the left coronary artery (55 patients; group 2). In group 2 the infarct-related artery was the left main coronary artery (8 patients), the left anterior descending coronary artery (33 patients), and the left circumflex coronary artery (14 patients). There was no difference between groups 1 and 2 with regard to sex, age (65 +/- 9 vs 66 +/- 10, respectively), presence of diabetes, renal insufficiency, previous myocardial infarction, and preoperative use of an intraaortic balloon pump (67% vs 71%, respectively). Compared with group 2, group 1 patients more often had three-vessel or left main disease (93% vs 65%, respectively; p = 0.018), a higher number of bypass grafts (3.0 +/- 0.8 vs 2.5 +/- 0.7, respectively; p = 0.014), and a greater incidence of postoperative complete atrioventricular (AV) block (30% vs 6%, respectively; p = 0.005). The hospital mortality rate for patients who underwent surgery within 48 hours after acute myocardial infarction did not differ between groups 1 and 2 (22% vs 18%, respectively). However, patients in both groups who underwent surgery between 48 hours and 30 days after infarction had significantly different mortality rates (22% vs 0%, respectively; p = 0.037). Patients with postoperative complete AV block had high mortality rates of 38% in group 1 and 67% in group 2. We conclude that patients who undergo coronary bypass surgery within 30 days of acute inferior myocardial infarction have a high incidence of postoperative complete AV block, which result in increased mortality.
Aged↗
[Clinical experience with gelatin-resorcine-formol glue for repair of postinfarction ventricular septal rupture].
We report a surgical technique for treatment of postinfarction ventricular septal rupture (VSR). An 82-year-old woman underwent successful surgical repair of a VSR two days after suffering anterior myocardial infarction. After repair of the VSR with a Dacron patch, the left ventriculotomy was closed with mattress sutures over felt strips using the gelatin-resorcine-formol glue to reinforce the left ventricular wall. The patient was doing well four months after surgery.
Aged↗
Overexpressed lipoprotein lipase protects against atherosclerosis in apolipoprotein E knockout mice.
Lipoprotein lipase (LPL) is known to play a crucial role in lipoprotein metabolism by hydrolyzing triglycerides; however its role in atherogenesis has yet to be determined. We have previously shown that low density lipoprotein receptor knockout mice overexpressing LPL are resistant to diet-induced atherosclerosis due to the suppression of remnant lipoproteins. Plasma lipoproteins and atherosclerosis of apolipoprotein (apo) E knockout mice which overexpress the human LPL transgene (LPL/APOEKO) were compared with those of control apoE knockout mice (APOEKO). On a normal chow diet, LPL/APOEKO mice showed marked suppression of the plasma triglyceride levels compared with APOEKO mice (54 vs. 182 mg/dl), but no significant changes in plasma cholesterol and apoB levels. Non-high density lipoproteins (HDL) from LPL/APOEKO mice had lower triglyceride content, a smaller size, and a more positive charge compared with those from APOEKO mice. Cholesterol, apoA-I, and apoA-IV were increased in HDL. Although both groups developed hypercholesterolemia to a comparable degree in response to an atherogenic diet, the LPL/APOEKO mice developed 2-fold smaller fatty streak lesions in the aortic sinus compared to the APOEKO mice. In conclusion, overproduction of LPL is protective against atherosclerosis even in the absence of apoE.
Animals↗
Transplacental exposure to antipsychotic drugs during pregnancy and megacystis in the fetus.
Urinary retention is an adverse effect of antipsychotic drugs that has not been previously reported in the fetus. We have diagnosed megacystis in a fetus possibly caused by transplacental exposure to the antipsychotic drugs being administered to the mother. Two weeks after the mother stopped taking the drugs, the size of the enlarged fetal urinary bladder returned to normal. Sonographic examination of the neonate revealed an anatomically normal urinary tract, with a normal bladder capacity and urination.
Adult↗
[MR angiography of steno-occlusive lesions of intracranial arteries: a comparative study between turbo MRA and conventional MRA].
PURPOSE: To compare the quality and diagnostic accuracy of images of intracranial steno-occlusive lesions obtained by conventional MRA and turbo MRA reconstructed using the zero-filled interpolation technique in the slice-select direction. MATERIALS AND METHODS: Eighteen patients with suspected steno-occlusive lesions of the intracranial arteries were studied with two types of three-dimensional time-of-flight angiography and conventional digital subtraction angiography. In total, 45 steno-occlusive lesions were quantitatively measured using calipers and correlated with DSA stenosis. A phantom that simulated vessels with stenosis was also imaged using the two types of MRA under the same conditions as those employed in the clinical study. RESULTS: Compared with conventional MRA, turbo MRA reduced the jaggedness of vessels and offered appearances more similar to those of DSA in the antero-posterior and lateral views. The severity of stenosis was classified into five grades based on the percentage of occlusion: not significant (0-24%), mild (25-49%), moderate (50-74%), severe (75-99%), and occlusive (100%). Neither turbo MRA nor conventional MRA showed any discrepancy from DSA above grade-1 stenosis. CONCLUSION: The advantage of turbo MRA is its ability to reduce the jaggedness of vessels on conventional MRA, and to simplify the recognition of vessel contours without prolonging acquisition time. Turbo MRA and conventional MRA have equally high diagnostic accuracy for steno-occlusive lesions.
Aged↗