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Biomedical subjects

T Hirata

Publications and source records attributed to T Hirata.

At least 469 records · Page 26Linked to original sources
PubMed1983

Survival and outcome of infants 501 to 750 gm: a six-year experience.

We investigated the outcome of 60 infants with birth weight 501 to 750 gm, admitted to our neonatal intensive care unit over six years. Twenty-five infants were inborn and 35 outborn. Twenty-eight survived 28 days or longer (47%), and 24 were discharged (40%). The infants who died had a significantly increased incidence of intracranial hemorrhage, and their mothers had a significantly decreased use of tocolytic drugs and betamethasone. Of the 24 survivors, two died after discharge, leaving 22 long-term survivors. Of these, 18 (82%) were observed until 20 months to 7 years of age. Mean height and weight were near the fifth percentile until 3 years of age, then increased to the tenth to fiftieth percentiles between 4 and 6 years. Mean head circumferences always remained between the tenth and fiftieth percentiles. Mean IQ was 100.0 +/- 17.9 for the inborn and 87.2 +/- 15.1 for the outborn infants (excluding two whose IQ was less than 50). Two infants (11%) had neurologic sequelae, 12 (67%) were completely normal, and four (22%) were functional and of borderline or below average intelligence. No statistical differences were found between the inborn and outborn children. This study indicates that, with aggressive therapy, outcome of the infant with birth weight 501 to 750 gm is much improved.

Critical Care↗
PubMed1983

Gabexate mesilate (FOY) therapy of disseminated intravascular coagulation due to sepsis.

Gabexate mesilate (FOY), a synthetic serine proteinase inhibitor, has an anticoagulant activity in the absence of antithrombin-III. We investigated FOY therapy for the treatment of disseminated intravascular coagulation (DIC) associated with sepsis in 15 patients (group F), and compared it with heparin therapy in 8 patients (group H). Successful treatment was observed in 13 patients in group F and in 4 patients in group H. The efficacy of the therapy in both groups was not significantly different. However, in patients whose antithrombin-III values were less than 20 mg/dl at the initiation of the therapy, FOY therapy was successful in 6 of 7 patients, whereas heparin therapy was not at all successful in 4 patients (rho less than 0.05). We conclude that FOY can be used as effectively as heparin for the treatment of DIC, and that FOY therapy is superior to heparin therapy in DIC associated with decreased antithrombin-III.

Adult↗
PubMed1983

Amino acids and thiobarbituric acid reactive substances in cerebrospinal fluid and plasma of patients with septic encephalopathy.

Amino acids and thiobarbituric acid reactive substances (TBARs) in the cerebrospinal fluid (CSF) and plasma were identified and assayed in 5 patients with septic encephalopathy. Levels of all the high molecular weight neutral amino acids (LNAAs) appeared to increase in the CSF. CSF levels of phenylalanine (PHE) and methionine (MET) increased significantly by factors of 20.9 and 9.5, respectively, and the plasma PHE level increased 7.5-fold. No significant changes in branched-chain amino acids were observed in either the CSF or plasma. The CSF/plasma ratios of valine (VAL), tyrosine (TYR), PHE, and MET significantly increased to 0.21, 0.46, 0.52, and 0.52, respectively. TBAR levels increased 4-fold in the CSF and also were slightly increased in the plasma, suggesting that lipid peroxidation in the central nervous tissues is markedly increased. We conclude that increases in LNAA levels and in lipid peroxidation in the central nervous tissues may play important roles in the development of septic encephalopathy.

Aged↗
PubMed1983

Kinetic studies on inactivation of Citrobacter freundii cephalosporinase by sulbactam.

The inactivation kinetics for inhibition by sulbactam (CP45,899) of Citrobacter freundii GN346 cephalosporinase were studied in detail and compared with those of type Ib penicillinase or TEM-2 beta-lactamase mediated by R plasmid RGN823. The rate constant for progressive inactivation of the cephalosporinase was significantly larger than that measured with the penicillinase. The number of sulbactam molecules required to cause complete inactivation of one cephalosporinase molecule (turnover number) was 80. The turnover number for the penicillinase was 5,200. The powerful inhibition by sulbactam of this cephalosporinase is similar to clavulanic acid inhibition of the penicillinase (turnover number, 115; reported by others). The affinity of sulbactam for the cephalosporinase, expressed as Ki, was 500 microM; this value was much higher than that for the penicillinase, which was estimated to be 0.5 microM. These results indicated that sulbactam is an effective progressive inactivator but a poor competitive inhibitor for the cephalosporinase. Our study also revealed that the cephalosporinase and sulbactam formed a long-lived inhibitor-enzyme complex which we termed the pseudo-irreversible complex. The half-life of the complex was 550 min at pH 7.0 and 30 degrees C.

Binding, Competitive↗
PubMed1983

Two-dimensional echocardiographic demonstration of so-called aneurysm of the membranous ventricular septum in adults--value of combined "manual scanning".

Using two-dimensional (2-D) echocardiography we evaluated the applicability of the left ventricular (LV) short axis view combined with manual scanning technique for the detection and evaluation of aneurysms of the membranous ventricular septum (AMS). In 12 patients with angiographically proven AMS, we recorded from the left sternal border the short axis view of the left ventricle continuously displayed from the aortic to the ventricular level by tilting the transducer manually along the LV long axis plane. We then compared the detectability of AMS by this method with that by other standard fixed 2-D echocardiographic views. This method proved to be best for the detection of AMS (12/12), followed by an apical four-chamber view (10/12), a parasternal LV long axis view (8/12) and an apical two-chamber (2/12) view. For the detection of AMS and for three-dimensional evaluation of the structure of the AMS and the original orifice of ventricular septal defect the method was shown to be clinically applicable.

Adolescent↗
PubMed1983

Diurnal profile of gallbladder size in diabetic patients: ultrasonographic evaluation of diabetic neurogenic gallbladder.

The diurnal change of gallbladder size was clearly measured with a real time ultrasonography. To visualize the gallbladder, 21 diabetic patients and 11 healthy subjects were scanned right subcostally in the supine position nine times between 8:00 a.m. and 8:00 p.m. Photographs of the images were produced on Polaroid film, and the area of gallbladder was calculated. The diurnal changes of the gallbladder size were expressed as the percentage of the size measured at 8:00 a.m. after an overnight fast. The gallbladder in normal control started contracting immediately after breakfast and reached 57.2 +/- 7.6% at 9:00 a.m. In the diabetic patients with and without autonomic neuropathy the gallbladder contracted to 80.9 +/- 14.5% and 72.4 +/- 14.8%, respectively, at 9:00 a.m. while the nadir of the diurnal profile curve in healthy subjects was 24.5 +/- 3.6% at 3:00 p.m., in the diabetic patients with and without autonomic neuropathy those were 57.7 +/- 6.1% at 6:00 p.m. and 41.3 +/- 8.3% at 8:00 p.m., respectively. This implies that the gallbladder contraction was delayed and poor in diabetic patients. In this paper, the gallbladder tonicity index is proposed, which is useful for the easy evaluation of autonomic state of gallbladder in diabetes mellitus.

Adolescent↗
PubMed1983

Electron microscopic observations of intracytoplasmic inclusions in human and murine leprosy bacilli.

The intracytoplasmic inclusions of Mycobacterium leprae in human lepromata and M. lepraemurium in murine lepromata were studied in ultrathin serial sections at the electron microscopic level. The inclusions were mostly homogeneous and spherical, and did not exist uniformly throughout the bacillary cells. They did not appear to be delimited by membranous structures and apparently had no internal structure. There seemed to be fundamentally little difference between M. leprae and M. lepraemurium in the fine structure of these inclusions. However, the large diffuse inclusions observed in the cells of M. lepraemurium may be a special feature of murine bacilli.

Animals↗
PubMed1983

[Cervical spondylolysis--a case report and review of the literature].

Spondylolysis of the sixth cervical vertebra was reported in a thirty-seven-year-old man. He complained of sleeplessness and had no history of trauma. Plain cervical spine films and CT scan showed separation of the bilateral pars interarticularis and hypoplasia of the superior and inferior articular processes of C6. And they showed compensated hyperplasia and upward deviation of the right superior articular process of C7, but there was no instability of cervical vertebra. Spina bifida occulta at C6 and deviation of the spinous process of C7 to the left side were observed clearly on CT scan. We gave him no surgical treatment because of his normal neurological state and absence of instability. Cervical spondylolysis is very rare disease, so only 48 cases have been reported in literature. Our case is the first case that reports findings of CT scan. Radiographic findings and the absence of history of trauma suggest a congenital etiology of this illness. In the 49 patients including our case, 35 patients were males and 14 were females. 35 patients complained of neck and/or occipital pain, 12 of pain and/or sensory disturbance of upper extremities, and 8 of shoulder pain and/or stiffness. The prevalent site of involvement appears to be C6 with only 14 cases involving another level, C2, C3, C4 or C5. 36 patients had spina bifida occulta and it was most frequently detected at the level of C6.

Adult↗
PubMed1983

Malignant lymphoma presenting with neoplastic angioendotheliosis of the central nervous system.

In this paper we report a case of malignant lymphoma with neoplastic angioendotheliosis in the brain. A 44-year-old man with transient episodes of deafness, hypersomnia, and anorexia over a 5-month period acutely deteriorated. He presented with low grade fever, dementia, frontal lobe signs, general hyperreflexia, muscle weakness of the extremities, and ataxia. He did not have hepatosplenomegaly, lymph node swelling, or skin eruptions. On the 15th day after admission to the hospital he developed convulsions and died. Post-mortem examination revealed multiple infarcts in the central nervous system, especially in the bilateral cerebral white matter and basal ganglia, where mononuclear tumor cells were widespread within the lumens of small blood vessels, accompanied by lymphocytic infiltration and degenerative and occulsive changes of the vessels. Intravascularly in many visceral organs and in the adrenal glands, both intra- and extravascularly, proliferation of tumor cells was observed. Furthermore, a small nest of malignant lymphoma of diffuse mixed cell type was found in a para-aortic lymph node, and the lymphoma cells were identical to tumor cells observed in the brain and other organs.

Adult↗
PubMed1982

New approach to regional anticoagulation in hemodialysis using gabexate mesilate (FOY).

Gabexate mesilate (FOY), a synthetic serine proteinase inhibitor, prevented and controlled bleeding during hemodialysis of 3 patients with active bleeding sites and/or hemorrhagic tendencies. The effectiveness of regional anticoagulation was evaluated by activated coagulation time (ACT). The ACTs of blood sampled from the outlet of dialyzer were significantly prolonged; however, systemic ACTs were almost normal. ACTs immediately after dialysis were not prolonged compared with those before dialysis. In 1 patients, renal function was improved after dialysis. No harmful side effects of FOY were observed. We consider FOY to be superior to other drugs for hemodialysis in that: (1) it can provide sufficient regional anticoagulation; (2) it has a very short half-life and need not be antagonized after dialysis; and (3) it can be used in patients with sepsis and/or disseminated intravascular coagulation (DIC) because it inhibits proteinase and also prevents platelet aggregation.

Aged↗
PubMed1982

Platelet sensitivity to adenosine diphosphate and to prostacyclin in diabetic patients.

We studied the platelet sensitivity to adenosine diphosphate (ADP) and to prostacyclin (PGI2) in order to clarify the mechanism of the onset or development of diabetic retinopathy. The platelet sensitivity to ADP in diabetics with simple and proliferative retinopathy was significantly increased as compared with that in diabetics without retinopathy and in controls. The platelet sensitivity to PGI2 in diabetics with simple and proliferative retinopathy was decreased significantly as compared with the normal value. There was a significant negative correlation between the platelet sensitivity to ADP and that to PGI2 in all diabetics. Since the effect of PGI2 on platelets is to inhibit its aggregation, the decreased sensitivity to PGI2 implies a tendency to accelerate platelet aggregation. The increased platelet aggregation due to the alteration of the platelet sensitivity is considered as an important factor in diabetic microangiopathy.

Adenosine Diphosphate↗