Biomedical subjects

N Yoshimura

Publications and source records attributed to N Yoshimura.

At least 397 records · Page 22Linked to original sources

PubMed1993

Effect of blood access on the platelets of azotemic patients initiating dialysis therapy.

The effect of blood access on platelets and clotting factors was investigated in 46 azotemic patients. Arteriovenous fistula was used in 10 patients (AVF group), and polyurethane double-lumen catheters were inserted through the subclavian vein in 6 patients (PUS group) or through the femoral vein in 15 patients (PUF group). Indwelling urokinase-immobilized single-lumen catheters and double-lumen catheters were placed in the femoral vein of 5 patients (UKS group) and 10 patients (UKD group), respectively. Blood cell counts, beta-thromboglobulin (beta-TG), platelet factor 4 (PF4), prothrombin time, and activated partial thromboplastin time were measured before insertion while catheters were indwelling and after catheters were pulled out. Although the platelet count decreased to 83% of the initial value during indwelling in the PUF group and 89% in the PUS group, it did not decrease in the AVF, UKS, and UKD groups. There were no differences between the PUF and PUS groups nor between the UKS and UKD groups. Plasma beta-TG increased in the PUF and UKD groups with indwelling catheters but did not change with the AVF. From these results, we conclude that the AVF did not activate platelets, the urokinase-immobilized catheter activated platelets, and the polyurethane catheter activated and decreased platelets. This might be due to the different surface properties of each blood access. Thus, the urokinase-immobilized catheter seems to be more favorable than the polyurethane catheter for emergency blood access.

Arteriovenous Shunt, Surgical↗

PubMed1993

Beneficial circulatory support by left heart bypass with a centrifugal (BioMedicus) pump for aneurysms of the descending thoracic aorta.

A comparative study between left heart bypass with a centrifugal (BioMedicus) pump and with a temporary external shunt was performed to assess the efficacy of distal organ perfusion in the surgical treatment of 31 patients with aneurysm of the descending thoracic aorta. Eighteen patients were supported with a centrifugal pump, and the remaining 13 were supported by temporary shunt with either a Gott shunt or a Dacron graft. Heparinless bypass with a centrifugal pump provided a significant decrease of intraoperative blood loss and blood transfusion by the combined application of Cell-Saver. The pressure difference between upper and lower extremities decreased (p < 0.05) in the centrifugal pump group even with aortic cross-clamping, and the urine output increased during operation. Among 13 patients supported with the temporary shunt, 3 had postoperative renal failure, and 2 died of it. All patients with a centrifugal pump survived without any complications. It could be concluded that the left heart bypass with a centrifugal (BioMedicus) pump was safe and was favorable for support of the distal circulation during aortic cross-clamping and to prevent ischemic complications such as renal failure and spinal cord injury.

Adult↗

PubMed1993

Breakdown of the blood-retinal barrier after radiofrequency-induced ocular hyperthermia.

To study the possible application of hyperthermia in the treatment of proliferative vitreoretinopathy (PVR), we induced hyperthermia in 15 normal rabbit eyes by a radiofrequency capacitive heating device. The retinal surface of each eye was warmed to a presumed temperature of 41 or 43 degrees C for 30 min. The thermal effect on the blood-retinal barrier (BRB) was evaluated before and 2 h after the hyperthermic regimen by means of vitreous fluorophotometry. Heat treatment to 43 degrees C at the retinal surface for 30 min increased the fluorescein leakage compared with the 41 degrees C treatment. This finding suggests that retinal hyperthermia at 43 degrees C for 30 min may cause breakdown of the BRB.

Animals↗

PubMed1993

A 3-year follow-up study of ocular hypertension by pattern electroretinogram.

A 3-year following-up study of the pattern electroretinogram (PERG) was performed in 15 eyes of 8 ocular hypertensive (OHT) patients. At first PERG recording, the amplitude of the first positive wave P1 was statistically significantly reduced in the OHT patients compared with age-matched controls (p < 0.05). There was no difference in the amplitude of the second negative wave N2 (p > 0.05). At 40 months, the amplitude of both P1 and N2 decreased and the latency of P1 was elongated. Among the changes, the decrease in N2 amplitude was the most drastic (p = 0.0001 compared with the control, p < 0.05, compared with the first recording). Glaucomatous visual field defects developed 5 years after the first PERG recording and 2 years after the reduction in N2 amplitude in 1 patient. Decreased N2 amplitude of the PERG may be an important warning sign predicting the development of glaucoma in OHT patients.

Adult↗

PubMed1993

[The effect of perioperative portal venous inoculation with donor lymphocytes in combination with immunosuppressive agents on rat cardiac allograft survivals].

The synergistic effects of inoculation with donor lymphocytes via portal vein (PV) in combination with FK506 or monoclonal anti-T lymphocyte antibody (OX19) on cardiac allograft survival were investigated in rat heart transplant model (Lewis engrafted BN heart). The recipients were divided into the six groups. A) Control B) FK506 group C) PV group D) FK506+PV group E) OX19 group F) OX19+PV group. The recipients of PV group and FK506 group displayed a prolongation of cardiac allograft survival [MST: 11.2 +/- 1.0 and 12.4 +/- 1.0 days] compared with control group [MST: 7.3 +/- 0.3 days]. However, MST of FK506+PV group was 10.6 +/- 0.8 days, showing no synergistic effect of FK506 with PV administration. Significant prolongation of the graft survivals was not observed between OX19 group and OX19+PV group [MST: 17.2 +/- 2.1 and 15.0 +/- 1.2 days]. Serum from PV-treated hosts on day 7 after transplantation had suppressor effect (92.7%) on the MLR of Lewis responder cells toward donor BN cells. On the other hand, suppressor effect of serum from FK506+PV group was significantly reduced (5.8%) compared with PV alone. These results indicate that FK506 might inhibit the generation of suppressor factor which was induced in the serum after administration of donor lymphocytes, and that generation of suppressor factor might be dependent on T cell.

Animals↗

PubMed1993

[Blalock-Taussig shunts in infants less than 6 months of age with special reference to the long-term administration of prostaglandin E1].

Classical Blalock-Taussig (B-T) shunt operation was performed in 14 neonates (group N) and 22 infants (group P). A mean age of group N patients was thirteen days and that of group P patients was two months. Preoperatively prostaglandin E1 (PGE1) was administered in all patients and was continued for a mean of 7 days (range 2 hours to 21 days) in group N, and a mean of 78 days (range 42 to 158 days) in group P. Body weight (4359 +/- 339 g), size of subclavian artery (3.7 +/- 0.5 mm in diameter) and size of pulmonary artery (6.4 +/- 1.2 mm in diameter) at operation of group P patients were larger than those (3212 +/- 490 g, 3.4 +/- 0.4 mm, 5.1 +/- 1.3 mm) of group N. But there were no differences in operation time (165 +/- 22 minutes in group N vs 174 +/- 25 minutes in group P) and clamp time of pulmonary artery (31 +/- 10 minutes in group N vs 30 +/- 5 minutes in group P) between 2 groups. There was no operative death in both groups. There were one late death in group N and three late death in group P. Five patients in group N and nine patients in group P required additional B-T shunt at the mean follow up interval of two years.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗

PubMed1993

[A case of complete remission of metastatic skin carcinoma (erythema type) from advanced gastric cancer by CDDP administration].

A 75-year-old female with skin metastasis from advanced gastric cancer (portion A, tub2, ss beta, n2, P0H0, Borrmann 3-type) was successfully treated with CDDP at a dosage of 25 mg/body every week or two. She had undergone R2 curative subtotal gastrectomy in October 1986, and had orally taken tegafur 300 mg/day as postoperative adjuvant chemotherapy. Three years after the operation, she had skin erythema at chest and neck. A pathological examination revealed that the skin erythema was a metastasis of gastric cancer. After administration of 5-FU and MMC, the skin lesion diminished in size, but in November of 1990, it expanded again. Administration of 5-FU, MMC and epirubicin was not effective. The skin lesion expanded extensively and changed to nodular type. CDDP was intermittently administered from August 1991 to December 1991, 25 mg/body div. every week or two; the total volume of CDDP reached 225 mg. The metastatic skin carcinoma disappeared and a complete response was obtained. CEA, which had been high (190 ng/ml), regained the normal level. Thrombocytopenia and liver dysfunction developed as side effects, but reduced after cessation of CDDP administration. The patient has been well for 3 years and 6 months since the onset of the skin metastasis.

Adenocarcinoma↗

PubMed1993

[Markedly decreased cardiac uptake with 123I-MIBG scintigraphy in a case of pure progressive autonomic failure].

A 70-year-old man with about 25 years' history of autonomic nervous system disturbances including orthostatic hypotension is presented. He had had no extrapyramidal and cerebellar signs, and was diagnosed as having pure progressive autonomic failure. His cardiac imaging with 123I labeled MIBG (metaiodobenzylguanidine) showed extremely diminished uptake, but the imaging with 201-thallium showed a normal cardiac uptake. Those results indicate non-cardiac disease-associated (neurogenic) postganglionic sympathetic fiber abnormality innervating the heart. Also, adrenomedullary imaging with 123I labeled MIBG showed no adrenal image, which suggests the possibility that there should be dysfunction in the adrenal medulla of this patient. This imaging study is thought to be useful for evaluating autonomic nervous system function in neurologic diseases.

3-Iodobenzylguanidine↗

PubMed1993

[A case of juvenile onset ataxia with dystonia, myoclonus, sensorineural hearing loss and mental retardation].

A 35-year-old female was reported who presented early onset and slowly progressive ataxia and retrocollis which appeared at the age of nine. On admission, neurological examination revealed cerebellar ataxia, dystonia of the neck and the right arm, myoclonus of the neck and the shoulder, slight mental retardation, supranuclear upper gaze palsy, and sensorineural hearing loss. Laboratory examination showed high serum CK activity. Electromyography and muscle biopsy findings suggested slight muscular involvement. CSF level of HVA and 5-HIAA were reduced. MRI demonstrated marked cerebellar atrophy and slight atrophy of the brain stem. To our knowledge, the characteristic combination of the neurological sign in this case has not been reported. This case was compared with EOCA (early onset cerebellar ataxia with retained tendon reflexes) and other juvenile onset cerebellar ataxia and dystonia.

Adult↗

PubMed1993

[Traumatic tricuspid regurgitation--report of two cases and review of operated cases].

Two cases of nonpenetrating traumatic tricuspid regurgitation were reported. The first case, a 46-year-old man who had an episode of traffic accident 21 years ago, was admitted with complaints of peripheral edema and dyspnea on exertion. The second case was a 16-year-old man who noted to have cardiac murmur and cardiomegaly after 4 years of a traffic accident. In both cases, cardiac catheterization showed increased right atrial pressure with high v wave, and echocardiogram showed severe tricuspid regurgitation with ruptured chordae tendineae of the anterior leaflet. Tricuspid valve replacement was performed successfully in both the cases. Twenty-two operated cases of traumatic tricuspid regurgitation have been reported in Japan; 17 of ruptured chordae tendineae, 3 of ruptured papillary muscle, and 2 of primary laceration of anterior leaflet. The patients with ruptured papillary muscle were operated from 2 months to 7 years (average 4 years) after trauma, while those with ruptured chordae tendineae were operated from 5 months to 25 years (average 10 years) after trauma. Tricuspid valve replacement was performed in 17 of 22 cases. From the review of 22 cases, tricuspid valve replacement should be indicated for traumatic tricuspid regurgitation in consideration of the severity of valve destruction regardless of the interval after trauma.

Adolescent↗

PubMed1993

Trabeculotomy ab externo: an alternative treatment in adult patients with primary open-angle glaucoma.

Seventy-nine adult patients with primary open-angle glaucoma (POAG) were randomly assigned to treatment by modified trabeculotomy ab externo (TAB) (n = 44) and by trabeculectomy with adjunctive mitomycin C (TMC) (n = 35), and the postoperative outcomes achieved with these two techniques were compared. With TAB, the probability of successful intraocular pressure control 1 year postoperatively was .8644; with TMC, .8432; the difference is not significant (P = .7956). However, postoperative complications such as corneal epithelial damage, bleb leaks, hypotony, flat anterior chamber, and serous choroidal detachment were significantly less frequent in the TAB group. Largely because of this latter consideration, in selected cases, TAB may be a viable alternative to TMC.

Adult↗

PubMed1993

[Relations between neuropsychological findings and lateral asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type].

We studied 16 right-handed patients clinically diagnosed as dementia of Alzheimer type (6 men, 10 women; aged 63-85, mean 72.8 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebrovascular disease (Hachinski ischemic scores for all patients were 4 or below 4). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow (rCBF) was evaluated by single photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP), using the Matsuda's quantitative method (Am J Physiol Imag 1: 186, 1986). Regional tracer uptake was measured in regions of interests (ROIs) over right and left frontal, temporal, parietal and occipital cortical regions; basal ganglia; and cerebellar hemispheres. The subjects were divided into three groups on the basis of lateral asymmetries in the temporal and parietal cortexes of rCBF (left < right, n = 5; right < left, n = 3; left = right, n = 8). We decided that lateral asymmetry was present when rCBF for each ROI between left and right sides differs by more than 10%. General score (MMS, T-IQ) was not correlated with asymmetry of cerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe was significantly lower than other group, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1993

The effects of cyclosporin on renal microsomal cytochrome P-450 systems.

The effect of CsA on the renal microsomal cytochrome P-450 system was examined by using two animal models. Male Lewis rats and male white rabbits were treated with olive oil alone (Group A) or with CsA (30 mg/kg/day, Group B) by oral gavage for 7 and 14 days. Blood urea nitrogen and serum creatinine levels were determined at serial intervals after administration of CsA. In rats, BUN and S-Cr were increased, indicating the development of nephrotoxicity in group B by the 14th day after administration; BUN 78.8 mg/dl, S-Cr 3.2 mg/dl, but not in group A (BUN 29.3 mg/dl, S-Cr 0.7 mg/dl). In the rabbit experiments, BUN and S-Cr significantly increased in group B after 7 days of treatment but not in group A. P-450 content of the kidney microsomes prepared from rat and rabbit was examined. The renal specific P-450 content in group A was 68.8 pmol/mg protein in rats and 52.1 pmol/mg protein in rabbits, whereas those in group B showed 135.6 and 221.0 pmol/mg protein at day 14, respectively. SDS-PAGE also showed a significant increase in the content of P-450 after the CsA administration. Kidney microsomal aminopyrine N-demethylase activities were increased about 2.5 and 1.7 fold in rats and in rabbits, respectively. Monooxygenase activities for laurate and prostaglandin A1 were not significantly changed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

[Hypercapnea during facial surgery under local anesthesia].

We examined the ventilation of patients whose faces were draped during facial surgery under local anesthesia. Ten patients who underwent eye surgery received hydroxyzine 25 mg and pentazocine 15 mg i.m. before local anesthesia. Arterial blood samples and end-tidal respiratory gases from nasal cannulae were collected at the following selected times: before draping their faces, 10 min, 30 min, 60 min after draping, and after the drapes were removed. Both arterial carbon dioxide tension (42 +/- 1 mmHg before draping and 46 +/- 1 mmHg at 10 min) and end-tidal carbon dioxide tension (33 +/- 2 mmHg before draping and 36 +/- 1 mmHg at 10 min) were elevated significantly after their faces were draped. Hypercapnea was completely eliminated by suctioning the expired gases. It is concluded that hypercapnea is inevitable during face or neck surgery under local anesthesia, and that the expired gases should be monitored and removed.

Adult↗

PubMed1993