Biomedical subjects

R Hayashi

Publications and source records attributed to R Hayashi.

373 records · Page 21Linked to original sources

PubMedDate not supplied

Reconstruction of large chest wall defects using a combination of a contralateral latissimus dorsi and a rectus abdominis musculocutaneous flap.

A combination of a contralateral latissimus dorsi musculocutaneous flap and a rectus abdominis musculocutaneous flap used in the reconstruction of large chest wall defects is reported in three patients. This combination is an easy and reliable procedure, without microsurgery, for reconstructing large chest wall defects or deformities and is applicable to patients whose ipsilateral branches of the subclavicular and axillary vessels cannot be used, and to those who need reconstruction of the subclavicular area and axilla as well as the breast mound area.

Abdominal Muscles↗

PubMedDate not supplied

Processes of care. Comparisons of certified nurse-midwives and obstetricians.

Prenatal and intrapartum care provided to 1,181 women, all meeting risk requirements for nurse-midwifery care, by certified nurse-midwives (n = 471) and obstetricians (n = 710) are compared using indicators of physical and of educational/psychosocial components of maternity care. Data are from clinical records and questionnaires completed by the women. Bivariate analyses show that the two provider groups differ on some, but not all, processes of care. When the woman's evolving health status, personal characteristics, and preferences are controlled, there are significant differences that confirm two models of care. The nurse-midwifery approach emphasizes educational/psychosocial care and restrained, individualized use of technology. The obstetrics approach emphasizes more routine use of state-of-the-art technology. This study contributes new information to substantiate different models but also shows that both provider groups use elements of both. The difference in emphasis should encourage collaborative practice, given the shared basis for maternity care, whether it is provided by certified nurse-midwives or obstetricians.

Certification↗

PubMedDate not supplied

Effects of isopropyl unoprostone on rabbit ciliary artery.

PURPOSE: Isopropyl unoprostone (unoprostone), a prostaglandin F(2 alpha) (PG F(2 alpha))-related compound, is widely used for treatment of glaucoma in Japan and is reported to have effects on ocular circulation. To investigate the action of this drug, we have studied the effect of unoprostone on the isolated rabbit ciliary artery. METHODS: Under microscopic observation, ciliary arteries were prepared from rabbit eyes and mounted in a myograph system. The effects of unoprostone on the isolated rabbit ciliary artery were investigated in vitro using isometric tension recordings. RESULTS: Exogenously applied PG F(2 alpha) but not unoprostone evoked contraction in the rabbit ciliary artery. After precontraction with excess-[K](o) solution, unoprostone evoked dose-dependent relaxation. The relaxation was not blocked by 10 microM/L N(G)-nitro-L-arginine methylester (L-NAME), 1 microM/L 8-37 calcitonin gene-related peptide (8-37 CGRP) or 10 microM/L indomethacin. Moreover, unoprostone could induce relaxation even in preparations without endothelium. The relaxation induced by diltiazem was greater in muscle precontracted in excess-[K](o) solution than that precontracted by 10 microM/L histamine. On the other hand, unoprostone induced a similar amplitude of relaxation in muscles precontracted by either drug. CONCLUSIONS: These results indicate that unoprostone acts directly to relax rabbit ciliary artery. The relaxation was not dependent on the endothelium and was not caused by intrinsic prostoglandins CGRP, or nitric oxide. Moreover, the relaxation was different from that caused by a Ca(2)+ antagonist. The mechanism for this relaxation is not yet determined.

Animals↗

PubMedDate not supplied

Severe central fracture-dislocation of the hip migrated deep into the pelvis complicating ileal rupture and ipsilateral comminuted femoral fracture: CT characteristics.

A case of severe central fracture-dislocation of the hip migrated deep into the pelvis complicating ileal rupture and ipsilateral comminuted fracture of the proximal femur was described. Plain CT images of the pelvis were distinctive and quite useful for evaluating the severity of the injury. Osteomyelitis of the proximal femur occurred soon after resection of the femoral head and suturing of the peritoneum though laparotomy. Complete closure of the peritoneal laceration and rapid totally diverting colostomy would be recommendable in order to avoid infectious complications in such a severe central fracture-dislocation of the hip.

Abdominal Pain↗

PubMedDate not supplied

Changes in superoxide dismutase activities and concentrations and myeloperoxidase activities in leukocytes from patients with diabetes mellitus.

To investigate whether the two free-radical scavengers, Cu, Zn- and Mn-superoxide dismutase (SOD), are changed in leukocytes of diabetic patients, and the alteration of these enzymes correlates with the diabetic state, we measured the activity and concentration of these enzymes in leukocytes from diabetic patients. Both Cu, Zn-SOD and Mn-SOD activities in neutrophils and lymphocytes were significantly lower in patients with non-insulin-dependent diabetes mellitus than in healthy controls. The concentrations of these enzymes in leukocytes from diabetic patients, however, did not differ from those in controls. Cu, Zn-SOD and Mn-SOD activities in neutrophils inversely correlated with HbA(1c) concentrations. Myeloperoxidase activity in leukocytes was significantly reduced in NIDDM patients. These findings suggest that changes in these enzymes may affect the susceptibility to infection and immunocompetence of patients with diabetes.

Diabetes Mellitus, Type 2↗

PubMedDate not supplied

Specific sorbent of apolipoprotein B-containing lipoproteins for plasmapheresis. Characterization and experimental use in hypercholesterolemic rabbits.

Dextran sulfate was covalently bound to cellulose beads (LA01) and used as the specific sorbent of apolipoprotein B-containing lipoproteins. The binding profiles of very low density, low density, and high density lipoproteins to the material were consistent with simple Langmuir adsorption isotherms. Although the affinities of all lipoproteins for the sorbent were roughly similar, the surface area available for high density lipoprotein binding was much smaller than that for very low and low density lipoproteins (29, 927, and 1934 m2/liter of swollen beads, respectively). When human plasma was passed through a sorbent column, very low and low density lipoproteins were selectively adsorbed, while almost all the high density lipoproteins were recovered from the column together with the other major plasma components. An extracorporeal circulation system with this sorbent was used for the treatment of hypercholesterolemic rabbits (diet-induced and homozygous WHHL). With a 25 ml sorbent column, very low and low density lipoproteins were selectively removed from rabbit plasma, resulting in a reduction of plasma cholesterol concentration by 300 mg/dl.

Adsorption↗

PubMedDate not supplied

Selective removal of low density lipoprotein by plasmapheresis in familial hypercholesterolemia.

Plasma lipoproteins were selectively removed from familial hypercholesterolemic patients by using two types of plasmapheresis: double-membrane filtration and selective adsorption of very low density lipoproteins (VLDL) and low density lipoproteins (LDL). In both techniques, plasma was separated from blood cells by using hollow-fiber filters, and 100% of the VLDL and LDL was recovered in the filtrate. In double-membrane filtration, the second hollow-fiber filter trapped 84% of LDL + VLDL, 48% of high density lipoprotein (HDL), 24% of albumin, and 46% of the remaining plasma protein. By treating 3 liters of plasma from a patient weighing 60 kg, 60% of the LDL and 30% to 40% of the HDL were removed as a result of an exponential decay of each component with the respective trapping coefficients. When dextran sulfate-cellulose was used as a LDL sorbent, there was only loss of LDL and VLDL, and no loss of any other major plasma component or of HDL. The sorbent column (400 ml) was saturated with 7.5 g of LDL cholesterol by treatment with 3.5 liters of plasma; the maximum reduction of LDL cholesterol was thus about 300 mg/dl for the patient weighing 60 kg. No serious side effects were observed during the long-term trials (19 to 27 months for four patients on double-membrane filtration and 10 months for the two patients on dextran sulfate-cellulose treatment.

Adolescent↗

PubMedDate not supplied

A case of psychogenic tremor associated with blepharospasm and myoclonus: an analysis with surface electromyogram.

We report a 25-year-old woman with an unusual complex psychogenic movement disorders consisting of blepharospasm, tremor, and myoclonus. The tremor appeared in both arms and legs with resting, kinetic, and postural tremor of a variable amplitude, direction, and frequency. The analysis of the arm tremor with surface electromyogram revealed that it consisted of reciprocal and alternating contraction of the wrist flexor and extensor. No apparent co-activation of agonist-antagonist muscles could be seen at the onset of the tremor at rest or at its appearance while performing diadochokinesis.

Adult↗

PubMedDate not supplied

Morphology and properties of Asian and Caucasian hair.

Various aspects of Asian and Caucasian hairs were investigated and compared. We started by studying their cuticle structures--the number of cuticle layers, width of the cuticle cells, degree of their inclination, and the interval between surface cuticle edges. As a result of this study, on about two hundred subjects for each race, it was shown that there were statistically meaningful differences between all these attributes for the two hair types. Asian hair has more cuticle layers and wider cuticle cells than Caucasian hair, and the cuticular inclination of Asian hair is steeper and its cuticular interval is narrower than in Caucasian hair. In addition, it was also found that there are differences in how cuticle cells begin to fail. Under extension stress, Asian hair cuticles fail as large pieces while keeping their original shape. On the other hand, Caucasian hair cuticles tend to collapse to form small fragments. AFM measurements revealed that Caucasian cuticles are indeed more fragile than Asian cuticles. These results suggest that the strength of cuticular subcomponents is different between Asian and Caucasian hair and that the weakest point, where stress is first absorbed, differs between races. It was proven that the cuticles of Asian hair are more easily peeled off than Caucasian hair cuticles during daily grooming. This can be attributed to the difference in how stress is absorbed.

Adolescent↗

PubMedDate not supplied

[The health system in Japan and France].

In 1987, male life expectancy at birth rose to 75.6 years in Japan, but reached only 72 years in France. Nevertheless, per capita health expenditures were lower in Japan (6,074 French francs in 1986) than in France (6,721 French francs in 1986). This does not imply that the Japanese health system is "economic" at all levels. The average annual hospital stay (in short-term hospitals) in 1986 rose to 39.7 days in Japan, as compared to 13.6 days in France. Per capita consumption of pharmaceuticals in 1987 was US$ 208 in Japan, compared to US$ 136 in France. These differences come from two specific Japanese features. Japanese physicians (most of whom are in private practice, as are their French and American colleagues) are allowed to have beds in their office and to hospitalize their patients there. Consequently, the number of beds and the average hospital stay are much higher in Japan. Secondly, Japanese physicians can give pharmaceuticals directly to their patients, which raises pharmaceutical consumption considerably. Needless to say, the results obtained currently by the Japanese health system are extremely positive. This is probably due to the fact that nowadays the Japanese have succeeded in integrating the advantages of the Westernization process (hygiene, eradication of infectious diseases, etc.) without adopting its disastrous aspects (for example, unhealthy lifestyles). However, this is simply an assumption for the time being.

Delivery of Health Care↗

PubMedDate not supplied

Application of telethermography in the evaluation of preterm premature rupture of the fetal membranes.

The development of chorioamnionitis is a serious complication associated with preterm premature rupture of the fetal membranes (PPROM). There is no reliable early indicator of this infection. The objective of this study was to determine the sensitivity of telethermography (TTG) in the detection of subclinical chorioamnionitis in women with PPROM. Fourteen pregnant women with PPROM between 23 and 34 weeks' gestation were the subjects of the study. Serial frontal-abdominal TTG scans were obtained up to the time of delivery using the MARK-1026 telethermography imager. Following delivery, placental cultures and pathology results were obtained and infant sepsis evaluation was performed. Images were analyzed for temperature differences between umbilical, inguinal, four-quadrant average, and abdominal-wall hot spots. Data were compared with norms obtained from 12 pregnant women with intact membranes who served as gestational age-matched controls. Of five patients with pathology-proven chorioamnionitis and TTG scans within three days of delivery, four demonstrated significant increases in temperature differences between umbilical and abdominal-wall hot spots versus inguinal and four-quadrant averages (z-scores > or = 2.0). All three patients with negative pathology and cultures as well as scans within three days of delivery showed no increase in temperature differences of the above variables. No patient had any overt clinical sign of chorioamnionitis. This limited but consistent evidence demonstrates that telethermography is a sensitive, noninvasive diagnostic method for detecting subclinical chorioamnionitis in pregnant women with preterm rupture of the fetal membranes.

Chorioamnionitis↗

PubMedDate not supplied

Submillimeter-pixel MR images of hepatic cavernous hemangiomas.

Several criteria have been used for differentiating hepatic cavernous hemangioma from other tumors at magnetic resonance imaging (MRI). Included are signal intensity and lobulation of the tumor. We counted the frequency of presence of lobulation of liver hemangiomas on T2-weighted images (T2WI), and measured the signal-intensity ratio (SIR) on T1-weighted images (T1WI) and on T2WI with a 0.9 mm x 0.9 mm pixel size using a 0.5 T magnetic resonance system. Eighty-three cavernous hemangiomas in 44 patients and 67 malignant tumors in 44 patients were retrospectively studied. Seventy-five of the cavernous hemangiomas (90%) exhibited lobules of various sizes, and four of the malignant tumors (6%) exhibited lobulations. The cavernous hemangiomas had a significantly higher SIR than the malignant tumors on T2WI: 3.0 +/- 0.7 and 1.9 +/- 0.8 (p < 0.001), respectively. The presence of lobulation together with a high SIR was a useful measure for differentiating cavernous hemangiomas from other liver tumors.

Adult↗

PubMedDate not supplied

Power spectral analysis of auditory brainstem responses and MRI findings in patients with spinocerebellar degeneration.

Power spectrum analysis of auditory brainstem responses (ABR) and magnetic resonance imaging (MRI) findings were obtained from 14 patients, 9 with olivopontocerebellar atrophy (OPCA; Dejerine-Thomas type) and 5 with Holmes-type cerebello-olivary degeneration, and compared to data from normal controls. The power spectrum was divided into three components according to frequency: up to 400 Hz (slow component); from 400 to 800 Hz (middle component); and 800 to 3,000 Hz (fast component). In patients with OPCA, the slow component appeared significantly less often than in both groups, normal controls (p < 0.0005) and patients with Holmes-type degeneration (p < 0.005), and the middle component appeared significantly more often than in both groups (p < 0.0005). There was a significant positive correlation between the proportion of the slow component and midbrain diameter (p = 0.04) and a significant negative correlation between the proportion of the fast component and midbrain diameter (p = 0.02). We conclude that the power spectrum differs between OPCA and Holmes-type degeneration, and that the proportion of each component of the power spectrum is related to midbrain volume.

Adult↗