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Biomedical subjects

S Yoshida

Publications and source records attributed to S Yoshida.

At least 865 records · Page 48Linked to original sources
PubMed1996

Pituitary apoplexy after subtotal thyroidectomy in an acromegalic patient with a large goiter.

A case of pituitary apoplexy occurring after subtotal thyroidectomy in an acromegalic woman with a large adenomatous goiter is described. The patient had severe apnea because the large goiter was causing airway compression. Prior to the planned hypophysectomy, a subtotal thyroidectomy was performed to relieve tracheal stenosis. Shortly after the operation, the patient developed a headache that lasted for several days. The serum levels of growth hormone and somatomedin-C spontaneously normalized seventeen days after this episode and have remained normal for two years. Pituitary apoplexy was thought to have caused the observed results without deterioration of the pituitary function.

Acromegaly↗
PubMed1996

Insulin resistance and body fat distribution.

Body fat distribution can be assessed by computed tomography (CT). The ratio of umbilicus was used to classify obese subjects as having visceral fat obesity (VFO) or subcutaneous fat obesity (SFO). Serum triglyceride and total cholesterol levels and plasma glucose area in an oral glucose tolerance test were higher in patients with VFO than in those with SFO. Significant positive correlations were demonstrated between V/S ratio and plasma glucose area, serum triglyceride level, and total cholesterol level as well as systolic or diastolic blood pressure. VFO was more frequently associated with coronary artery disease. Moreover, VFO was more often accompanied by multiple risk factors than was SFO. Steady-state plasma glucose (SSPG) level was significantly higher in patients with VFO than with SFO, suggesting that insulin resistance may be more remarkable in VFO than in SFO. Furthermore, visceral fat accumulation was also associated with these complications even in nonobese subjects. Visceral fat area (VFA) was significantly correlated with fasting plasma glucose, serum triglyceride, and total cholesterol levels. Animal models such as Goto-Kakizaki (GK) rats with ventromedial hypothalamus (VMH) lesions and Otsuka-Long-Evans-Tokushima-Fatty (OLETF) rats were accompanied by visceral fat accumulation and an early stage of aortic atherosclerosis. Aging, sex hormone, genetic, and dietary factors and physical inactivity may induce visceral fat accumulation. Visceral fat is characterized by its high lipogenic activity as well as its accelerated lipolytic activity. High levels of portal free fatty acids (FFAs) may eventually result in an enhancement of hepatic triglyceride synthesis, causing hyperlipidemia. High portal FFA levels would also induce insulin resistance, thereby causing glucose intolerance, hypertension, and finally atherosclerosis. We propose a term, "visceral fat syndrome," as a highly atherogenic state, which includes visceral fat accumulation, glucose intolerance (insulin resistance), hyperlipidemia, and hypertension.

Adipose Tissue↗
PubMed1996

[Behavioral consistency when parents drive their children to preschool].

How drivers signal, park, escort their children across a street to a preschool, and depart was videotaped unobtrusively for 39 days, to test for consistency of driver behavior and children's crossing behavior. Data were analyzed for 17 pairs of drivers and children, observed more than ten times under identical conditions. Frequency of identical actions was analyzed on the basis of category systems, whereby a sequence of behavior was broken down into several items. A variety of individual differences and inter-behavioral differences in consistency were detected, and in general drivers were more consistent than children. Drivers' signals and accompanying of children were somewhat inconsistent, while some of their choice behaviors were very stable. Inconsistent behavior was discussed in terms of the lack of or insufficient specification of drivers' and children's schemas. Repeated naturalistic observation can not only identify behavioral consistency and reveal the structure of relevant schemas in daily life but also can predict behavior.

Adult↗
PubMed1996

[Benign intracranial hypertension and continuous CSF pressure monitoring: case report].

The authors report a case of benign intracranial hypertension (BIH) treated with a ventriculoperitoneal shunt. A 62-year-old man was referred to the Kobe City General Hospital with several episodes of transient visual obscuration. Neurological examination on admission revealed bilateral papilledema and a right lower quadrantic homonymous hemianopsia. Computed tomography (CT) showed normalized ventricles and a low-density area in the left occipital lobe without mass effects. From the findings of magnetic resonance images (MRIs) the occipital lesion was diagnosed as a chronic intracerebral hematoma. Because the hematoma did not show mass effects. BIH was suspected to be responsible for the papilledema. In spite of intravenous administration of dexamethasone and glycerol for a week, a lumbar puncture showed an opening pressure of 360mm H2O. Several subsequent lumbar punctures failed to improve intracranial hypertension. The mean opening pressure of the last 6 punctures was 392mm H2O. The mean terminal pressure dropped to 32mm H2O after removal of 10m/ of cerebrospinal fluid (CSF). A spinal subarachnoid drainage was inserted at the level of L4-L5 interspace for continuous CSF pressure monitoring. The mean CSF pressure ranged from 20 to 40mmHg. The continuous recording showed typical B waves frequently and plateau waves (A waves) occasionally. Removal of only 8m/ of CSF caused significant pressure reduction immediately. Then, pressure returned to the predrainage level about 35 minutes later. These findings supported the diagnosis of BIH. A ventriculoperitoneal shunt was inserted, which resulted in rapid and complete resolution of the papilledema. Postoperative CSF monitoring returned to normal pressure and waves. This case emphasizes the usefulness of continuous CSF pressure recording for the diagnosis and subsequent therapy of BIH.

Cerebrospinal Fluid Pressure↗
PubMed1996

[A case of dilated cardiomyopathy with early back-diffusion of 123I-BMIPP].

A 28-year-old woman was pointed out cardiomegaly and diffuse hypokinesis of left ventricle by ultrasonography in community hospital. Coronary angiography showed normal coronary artery and, left ventriculography revealed diffuse hypokinesis (LVEF 40%). She was diagnosed idiopathic dilated cardiomyopathy by myocardial biopsy and other clinical information. Myocardial scintigraphy with 201Tl. revealed dilatation of left ventricle and diffuse inhomogeneous accumulation of 201 Tl. Dynamic 123I-BMIPP SPECT image 2 minutes after injection showed BMIPP accumulation in all segment, though, static image 15 minutes after injection indicated reduced BMIPP accumulation. These findings suggested existence of the early back-diffusion in inferior segment. Early back-diffusion of BMIPP may become a marker of abnormal fatty acid metabolism in patient with dilated cardiomyopathy.

Adult↗
PubMed1996

[Cytomegalovirus retinitis and Pneumocystis carinii choroidopathy in a patient with AIDS].

A case of Pneumocystis carinii (P. carinii) choroidopathy is reported. The patient was a 17-year-old man with acquired immunodeficiency syndrome (AIDS) who developed bilateral, multifocal, yellow-white, round, flat choroidal lesions ranging in size from 1/8 to 1/6 of the disc diameter while undergoing treatment for cytomegalovirus retinitis. He had had P. carinii pneumonia 43 months previously, and received inhaled pentamidine as suppressive therapy. Over a 4-week period of observation, the choroidal lesions appeared to enlarge slowly and increased in number in the posterior pole, with no clinical evidence of intraocular inflammation and retinal involvement. He was diagnosed as having P. carinii choroidopathy and treated with intravenous pentamidine. Three months after systemic pentamidine therapy was begun the choroidal lesions disappeared. Despite the fact that P. carinii choroidopathy is a rare opportunistic ocular infection, ophthalmic manifestations may be an important initial marker of extrapulmonary disseminated infection in some patients. Therefore we recommend ophthalmologic examinations in patients with AIDS who receive long-term aerosolized pentamidine prophylaxis for pneumonia.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Diagnosis of lung cancer using functional image of 201Tl SPECT with parameter of 201Tl retention--evaluation of its applicability to post irradiated lung cancer].

Thallium-201 (201Tl) SPECT is a useful method for detecting lung cancer. Moreover, the 201Tl Retention Index (R.I.) reported by Tonami et al is now available for differentiating pulmonary lung cancer from benign lesions. The diagnosis of recurrent tumors is, however, difficult to establish as they are often shaded by radiation pneumonitis or fibrosis. Therefore, we employed functional images (F.I.) obtained using as parameter a modified version of the R.I. First we indicated the statistical value of untreated solitary lung tumor as follows: sensitivity 84.6%, specificity 80.0%, and accuracy 83.3%. In our assessment, the lesions with tumor size over 2.0 cm and R.I. by Tonami et al over 12.7 were detected as positive images. Secondly in assessment of 22 cases (23 lesions) of post irradiated lung cancer, the results obtained were: sensitivity 80.0%, specificity 92.3%, and accuracy 87.0%. 201Tl SPECT functional images seem to be useful for the diagnosis of recurrent lung cancer by shaded radiation pneumonitis and fibrosis.

Adenocarcinoma↗
PubMed1996

[Characteristics of regional sympathetic innervation in diabetic patients with silent myocardial ischemia assessed by 123I-metaiodobenzylguanidine imaging].

The purpose of this study was to clarify any association between clinically detectable silent myocardial ischemia (SMI) and myocardial 123I-metaiodobenzyl-guanidine (MIBG) uptake. Subjects of this study were (1) patients with SMI with diabetes (n = 15), (2) patients with angina pectoris with diabetes (n = 15), (3) patients with SMI without diabetes (n = 8) and (4) normal subjects (n = 23). Subjects underwent planar and single photon-emission-computed tomography (SPECT) imaging 15 min and 3 hours after injection of 123I-MIBG. H/M ratio was significantly lower in diabetic SMI (2.1 +/- 0.3) and non-diabetic SMI (2.3 +/- 0.3) than control subjects (2.6 +/- 0.3). The inferior-to-anterior wall count ratio (I/A) in diabetic SMI group was the lowest among all groups (p < 0.05). A significant difference was observed in relative regional uptake in the inferior segment of the distal left ventricle between SMI and angina group in patients with diabetes mellitus (p < 0.05). The decreased MIBG uptake in the inferior wall may be an important sign of cardiac sympathetic dysfunction, suggesting the abnormalities in cardiac nervous system play an important role in the mechanism of diabetic silent myocardial ischemia.

3-Iodobenzylguanidine↗
PubMed1996

Changes in significance of axillary lymph node dissection for patients with breast cancer.

Axillary lymph node dissection has been a routine part of breast cancer treatment for more than 100 years. As so few patients have been shown to have positive nodes, more consideration should be given to eliminating axillary node dissection for duct carcinoma in situ (DCIS) and T1a lesions. And for patients with T1/2N0M0 cancer of the breast, lumpectomy alone without axillary dissection followed by radiation therapy of the intact breast and regional lymph nodes should be a reasonable treatment without any arm morbidity. Between September 1989 and September 1994, we have treated 40 breast cancer patients with this method and no local recurrence nor distant metastasis has been encountered so far. Therefore, it is concluded that axillary dissection should be performed routinely only for N1b lesions and larger.

Axilla↗
PubMed1996

[Effects of basic fibroblast growth factor on the development of mouse preimplantation embryos].

Basic fibroblast growth factor (bFGF) is known to be a mesoderm inducer of the Xenopas embryo, although the role of this factor in mammalian preimplantation embryos is not known. This study was performed to examine possible roles of bFGF in murine preimplantation development. To determine the expression of bFGF and FGF receptor 1 (FGFR 1) mRNA in mouse embryos and uterine endometrial epithelial cells, a reverse transcription-polymerase chain reaction (RT-PCR) technique was used. In the mouse embryos, bFGF mRNA was not detected but FGFR 1 mRNA was expressed in the blastocyst stage. Long and short forms of FGFR1 mRNA generated by alternative splicing were expressed. Both bFGF and two forms of FGFR 1 mRNA were detected in mouse endometrial epithelial cells. Immunoblot analysis indicated that bFGF protein was present in the uterine luminal fluid during the preimplantation period, and the level of expression of the protein was relatively constant. The addition of bFGF to the culture medium had no effects on the rate of blastocyst formation of 2 cell stage embryos, but it significantly increased the protein synthesis in blastocysts. These results suggest that bFGF derived from the mouse uterine endometrium affects the development of preimplantation embryos in a paracrine fashion.

Animals↗
PubMed1996

Antitumor activity of zinostatin stimalamer (YM881) in human hepatoma cell lines and VX2 liver tumor-bearing rabbits.

Antitumor activities of zinostatin stimalamer (YM881) were examined in human hepatoma cell lines (SK-Hep1 and HuH2) and VX2 liver tumor-bearing rabbits. YM881 inhibited the growth of human hepatoma cells in a dose-dependent manner. The IC50 values of YM881 causing a 50% inhibition of growth of SK-Hep1 and HuH2 cells were 6.7 and 27 nM, respectively. In VX2 tumor-bearing rabbits, administration of YM881 suspended in Lipiodol, an iodinated fatty acid ethylester of poppyseed oil, (YM881/Lipiodol suspension, 0.2 mg/0.2 ml/body) into the hepatic artery showed significant (p < 0.01, vs. sham-operated and Lipiodol-treated groups) inhibitory effects on tumor growth and histopathological changes at 1 and 2 weeks after administration. In contrast, Lipiodol (0.2 ml/body) tended to inhibit the growth of VX2 tumor (p < 0.1, vs. sham-operated group) at 1 week after administration, but showed only moderate effects at 2 weeks after administration. Minimal necrosis was observed at 1 and 2 weeks after administration of Lipiodol, and histopathological findings were similar to those in the sham-operated group. From the present study, it is suggested that YM881/Lipiodol suspension showed antitumor activity in VX2 tumor-bearing rabbits presumably due to the inhibition of the growth of hepatoma cells by YM881 itself. Lipiodol, on the other hand, is considered to augment the antitumor activity of YM881 by maintaining high YM881 concentrations in tumor tissue.

Animals↗
PubMed1996

[Sulfamethoxazole-trimethoprim-induced pneumonitis in a patient with hemophilia B who was infected with the human immunodeficiency virus].

Severe cellular immunosuppression developed in a 25-year-old man with hemophilia B who was infected with the human immunodeficiency virus (HIV). Four days after administration of sulfamethoxazole-trimethoprim (SMX-TMP) for prophylaxis against Pneumocystis carinii pneumonia (PCP), diffuse uptake of both lungs was confirmed on a 67Ga scintigram. Reticular shadows were also seen throughout both lung fields on a chest CT scan. These findings were compatible with PCP, according to the guidelines for presumptive diagnosis of the acquired immunodeficiency syndrome, published by the Centers for Disease Control and Prevention. The dose of SMX-TMP was increased, but interstitial pneumonitis worsened and was accompanied by fever, skin rash, and liver dysfunction, which are common in HIV-infected patients receiving SMX-TMP. No evidence of PCP or of any other opportunistic infection was found by bronchoalveolar lavage. Adverse reactions diminished after SMX-TMP administration was stopped. The 67Ga scintigram and chest CT findings also returned to normal. We concluded that the interstitial pneumonitis was induced by SMX-TMP. SMX-TMP is the first choice anti-PCP drug, but a high incidence of adverse reactions in patients with HIV infection has been reported. Therefore the possibility of SMX-TMP-related pulmonary toxicity must be considered in HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1996

[A study of arterial infusion chemotherapy for gastric cancer patients with peritoneal metastasis].

We analyzed the clinical response, toxicities, out-patient and overall survival time among 41 gastric cancer patients with peritoneal metastasis to evaluate chemotherapies and drug delivery routes. Sixteen patients were treated by arterial infusion (AI) and 25 by systemic therapy (ST), with either 5-FU/MTX (FMTX) therapy or 5-FU/CDDP (FP) therapy. Partial response was observed in 8 patients (50%) among 16 with AI and in 6 (24%) among 25 with ST (p = 0.09). There were no differences in the incidence of side effects (> or = grade 2 according to WHO criteria) between AI and ST group, at 25% and 36%, respectively. No significant differences were observed in either survival time or home care duration among patients with AI chemotherapy and those with ST procedure.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

[Standardization of use of 4-F size catheter for selective transcatheter angiography and intervention of abdomen].

To evaluate the safety and efficacy of a new 4 French (F) catheter/sheath system with large lumina for selective abdominal arteriography and intervention, the usefulness of the 4F sheath (4F group, 88 patients) was compared with that of a 5.5F sheath and a 7F sheath (5.5F group, 7F group, 156 patients). The compression time of the arterial puncture site and the ambulation time in the 4F group were significantly shorter than those in the 5.5F and 7F groups. The hemorrhagic complication rate in the 4F group (15%) was less than those in the 5.5F group (23%) and 7F group (27%). The severity of hemorrhagic complications in the 4F group (hematoma 2.3%, woozing 14%, and rhexis 0%) was significantly less than in the 5F group (3%, 21%, 0%) and 7F group (11%, 19%, 2.4%). The controlability of the 4F catheter as compared with a 5F catheter was estimated in 35 patients by questionnaire. The torque transmissibility and the endurability of the kink of the 4F catheter were poor in comparison with the 5F catheter. However, with respect to the ability to follow over a guidewire, the 4F catheter showed great advantage over the 5F catheter. It is concluded that the 4F catheter/sheath system is feasible for general use in selective abdominal arteriography and interventions.

Abdomen↗