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Biomedical subjects

Y Harada

Publications and source records attributed to Y Harada.

At least 505 records · Page 28Linked to original sources

[An investigation of X-ray examinations classified according to cases of dental diseases at Fukuoka Dental College Hospital].

This paper reports the results of an investigation on the types and frequencies of X-ray examinations given to patients with various types of their dental diseases from their first visit to the hospital to the end of treatment. The subjects were 337 patients (not including orthodontic patients and in-patients) randomly sampled out of all those who visited the Fukuoka Dental College Hospital in 1986. Out of these 337, the number of those who were given X-ray examinations was 284. 1. The Cases of dental diseases for which X-ray examinations were given were classified into the following seven: diseases caused by dental caries, trauma, inflammation, diseases of temporomandibular joint, diseases of salivary gland and other diseases, and other examinations. Out of these X-ray examinations, those given to the patients of diseases caused by dental caries and marginal periodontitis amounted to the 60% of the total X-ray examinations. 2. On the average, 3.3 radiographs were taken per patient. 3. In the examination of luxation, a case of trauma, 7.8 radiographs were taken per patient, the largest number of all diseases on this report. In the examination of marginal periodontitis, a case of inflammation, 5.4 dental radiographs and 0.5 panoramic radiograph were taken per patient. It is necessary to make the most of panoramic examination effective for this disease to decrease radiation exposure. 4. The diseases that have more difficulty of diagnosis and more necessity of observing the prognosis had a greater tendency to depend on X-ray examinations. 5. The percentage of the patients who did not receive X-ray examination was 15.7%. Out of these patients, the patients in pedodontics accounted for 34.5%.

Adolescent↗

Calcium channel receptor sites for (+)-[3H]PN 200-110 in coronary artery.

The receptor sites for 1,4-dihydropyridine (DHP) Ca++ channel antagonists in porcine coronary artery were identified and characterized by a binding assay using (+)-[3H]PN 200-110 as a radioligand. Specific (+)-[3H]PN 200-110 binding in porcine coronary artery was saturable, reversible and of high affinity (Kd = 0.24 nM) and it showed a pharmacological specificity as well as stereoselectivity which characterized the receptor sites for DHP Ca++ channel antagonists. DHP antagonists competed for the (+)-[3H]PN 200-110 binding in order: PN 200-110 greater than mepirodipine greater than nisoldipine greater than nicardipine greater than nitrendipine greater than nimodipine greater than nifedipine greater than (-)-PN 200-110. (+)-PN 200-110 was approximately 140 times as potent as the (-)-isomer. The potencies (PKi) of these eight DHP Ca++ channel antagonists in competing for (+)-[3H]PN 200-110 binding sites in porcine coronary artery correlated well with their pharmacological potencies. Specific (+)-[3H]PN 200-110 binding in the coronary artery was enhanced by d-cis-diltiazem and was inhibited incompletely by verapamil and D-600. In EDTA-pretreated coronary artery, the maximal number of binding sites for specific (+)-[3H]PN 200-110 binding was reduced (80%) markedly, and it was restored to the untreated level by the addition of Ca++ and Mg++.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Effect of leukotriene B4 on enhancement of superoxide production evoked by formyl-methionyl-leucyl-phenylalanine in myeloid differentiated HL-60 cells: possible involvement of intracellular calcium influx and high affinity receptor for leukotriene B4.

Exposure of a human leukemic cell line HL-60 to 1% dimethylsulfoxide (DMSO) for 4 days induced myeloid differentiation. DMSO-differentiated HL-60 cells displayed high and low-affinity binding sites for leukotriene B4 (LTB4). The pretreatment of myeloid differentiated HL-60 cells with 1-10 nM LTB4 enhanced superoxide production evoked by 100 nM formyl-methionyl-leucylphenylalanine (fMLP) to 127-137% of the controls stimulated by fMLP alone. A concentration eliciting a half maximal increase (EC50) of LTB4 for the enhancing effect on superoxide production evoked by fMLP was 0.32 nM. This was roughly similar to the dissociation constant (Kd) of high affinity receptors for LTB4 (0.23 nM). These results suggest that high affinity receptors transduce the enhancing effect of LTB4 on fMLP-induced superoxide production. Although it seems possible that enhancement of fMLP-induced superoxide production is associated with a substantial increase and/or an affinity alteration in receptors for fMLP, LTB4-pretreated cells failed to show significant changes in fMLP binding compared to non-pretreated ones. It seems likely that Ca2+ influx transduces enhancement of fMLP-induced superoxide production, because extracellular Ca2+ is necessary for an enhancing effect of fMLP-induced superoxide production. Also, EC50 of LTB4 for Ca2+ influx (0.78 nM) was similar to that of the enhancing effect of superoxide generation evoked by fMLP. Although pretreatment of LTB4 failed to enhance the maximal level of fMLP-induced intracellular Ca2+ rise, transient overshoot in intracellular Ca2+ evoked by fMLP declined more rqpidly after LTB4 pretreatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium↗

[Konno procedure for congenital aortic valve stenosis with pulmonary valve stenosis].

Although aortic and pulmonary valve stenosis are among the most common congenital heart defects, the combination of both aortic and pulmonary valve stenosis in the same patient appears to be very uncommon. Accurate diagnosis of combined valvular stenosis is imperative prior to surgical correction, otherwise surgery of one of the lesions may result in an insufficient hemodynamic improvement. A seven-year-old girl with congenital aortic and pulmonary valve stenosis associated with hypoplastic aortic annulus underwent Konno's operation, pulmonary valvotomy and resection of anomalous muscle of the right ventricular outflow tract simultaneously. The operation was successfully performed and postoperative course was uneventful.

Aortic Valve Stenosis↗

[Serological diagnosis of pulmonary aspergillosis--measurement of IgG-, IgM- and IgA- antibodies against Aspergillus fumigatus by means of ELISA].

Serological diagnosis plays an important role in the diagnosis of pulmonary aspergillosis, however, precipitation-in-gel test is neither sensitive nor quantitative. Recently, several investigators have used the ELISA technique for the detection of antibodies against Aspergillus fumigatus and reported the usefulness of this method. In this report, we measured IgG-, IgM-, and IgA- antibody titers against Aspergillus fumigatus by means of ELISA in sera from patients with several different lung diseases including pulmonary aspergillosis. The results obtained were as follows: 1) Measurement of IgG-antibody titers was most useful for the diagnosis of pulmonary aspergillosis. 2) Measurement of IgG-antibody titers was more sensitive than precipitation-in-gel test. 3) IgG-antibody titer was quantitative and reflected the clinical course of pulmonary aspergillosis.

Antibodies, Fungal↗

Medication-induced esophagitis in children.

Clinical and endoscopic features of two pediatric cases of esophageal ulcers caused by capsules of oxytetracycline and doxycycline are described. Several cases of medication-induced esophageal injury in children have been reported until now, all of which were in association with tablets or capsules. Antibiotics are known to be responsible for medication-induced esophagitis in adults. In this study, 4 cases were caused by emepronium bromide and 3 cases, including the present patients, by antibiotics. All cases but one complained of chest pain and/or dysphagia. Although the interval between the onset of the symptoms and the diagnosis varied among cases, the clinical courses were relatively uneventful, without any long-term sequelae. This clinical entity seems to be unfamiliar to pediatricians and is omitted from the differential diagnosis.

Child↗

[MRI of pheochromocytoma].

MRI features of 8 patients were reviewed and correlated with pathological findings. It was characteristic finding that the intensity of pheochromocytoma on T2-weighted image and proton image was very high. The detectability of pheochromocytoma by MRI and CT was almost equal and MRI was also useful for determining aberrant pheochromocytoma. MRI was more helpful for detection of necrotic lesion than CT. We considered that the double ring sign on MRI was characteristic for pheochromocytoma. In the cases which are difficult for diagnosis, other diagnostic studies such as endocrine and other imaging studies are necessary.

Adrenal Gland Neoplasms↗

[A case of retroperitoneal tumor presenting with gross hematuria].

A case of retroperitoneal tumor presenting with gross hematuria is reported. A 62-year-old female consulted our clinic with the chief complaint of gross hematuria. On physical examination, a goose-egg sized tumor was palpable in the left flank region. Drip infusion pyelography and computerized tomographic scan showed left retroperitoneal tumor which deviated the left kidney upwards. Percutaneous needle biopsy of the tumor revealed no malignancy. Total resection of the tumor was performed subsequently. A yellowish solid tumor was macroscopically encapsulated by fibrous tissue, weighed 230 g and 6 x 7 x 10 cm. Histopathological diagnosis was malignant schwannoma. After operation, the hematuria stopped without any treatment and deviation of the left kidney was improved. Soft tissue tumor should be treated by adjuvant chemotherapy with irradiation because of its high frequency of recurrence and metastasis. Combined chemotherapy with VCR, ADR, CPM and DTIC (CYVADIC) was performed and she is in good health at 1 year after operation.

Antineoplastic Combined Chemotherapy Protocols↗

[Tetralogy of Fallot revealed by autopsy in an elderly subject].

A 62-year-old women had a history of cyanosis and easy fatigability from school age but had refused medical examinations. She was admitted to our department with exacerbation of dyspnea at the age of 59. Laboratory tests showed hypoxia complicated with polycythemia with 35 mmHg of PaO2, 8.5 x 10(6) erythrocytes per mm3. The systolic pressure of the right ventricle was 155 mmHg. RI angio demonstrated a high degree of the right-to-left shunt at the ventricular level. The patient was given oxygen therapy at home without diagnosis of tetralogy of Fallot (TOF) and eventually died at the age of 62. Tetralogy of Fallot was diagnosed at autopsy. Pulmonary stenosis of this case was located in infundibulum. The lining of the infundibular inlet was constituted of the thick fibrous tissue which remarkably augmented the pulmonic stenosis. Although the autopsy findings were considered to be relatively mild TOF, the death was presumed to be caused by development of the infundibular stenosis due to formation of fibrous tissue. This is the oldest patient in Japanese medical literature to be identified by cardiac catheterization and autopsy finding as a case of TOF.

Age Factors↗

[Assessment of transient dilation of the left ventricular cavity in patients with hypertrophic cardiomyopathy by exercise thallium-201 scintigraphy].

Exercise Tl scintigraphy (EX-Tl) provides a noninvasive means of identifying myocardial perfusion abnormalities in patients (pts) with hypertrophic cardiomyopathy (HCM). We have noted that some pts with HCM have a pattern of transient dilation of the left ventricle (LV) on the immediate post exercise images as compared with 3 hour redistribution images. We presumed that left ventricular dilation was caused by subendocardial hypoperfusion. So we studied transient dilation of the LV in 50 pts with HCM and 20 controls (C). Initial and delayed conventional short tomographic images were obtained after reconstruction of 30 projections acquired over 180 degrees. Thirty six radii every 10 degrees were generated from the center of the middle myocardial images of the short axis. An area surrounded by the thirty six points of maximal count on each radius was calculated in initial and delayed images. Transient Dilation Index (TDI) as an index of dilation was determined by dividing an area in initial image by an area in delayed image. TDI in pts with HCM was larger than that in C. Pts with HCM were classified into the two groups, Group A: TDI greater than 1.11 (mean + 2 SD in C), 24 pts, Group B: TDI greater than 1.11, 26 pts. Frequency of pts with history of chest pain in Group A was higher than that in Group B, and frequency of pts with positive exercise ECG in Group A was higher than that in Group B. End diastolic volume in Group B did not change 10 minutes after exercise by radionuclide ventriculography. In conclusion, transient dilation of the LV in pts with HCM by EX-Tl is in appearance, and may reflect subendocardial ischemia.

Adult↗

[An analysis of the cellular DNA contents in lung-metastasized stomach cancers].

A study has been conducted of the cellular DNA contents in the primary and metastatic lesions of 30 cases of lung-metastasized stomach cancers, in which each DNA Index (DI) was calculated and analysed comparatively. As a consequence, the rate of the diploid type in the nodular lung metastases was found to be higher than the rate of the others. Further, the DI's of 22 out of 30 (73%) metastatic lymph nodes corresponded with those of the primary lesions. Four lung metastatic lesions out of five differed from their primary lesions, but all five lesions simulated their metastatic lymph nodes. Thus understanding of the properties of the metastatic lymph nodes, rather than their primary lesions, would seen to be helpful in planning the therapy to combat recurrent cancers.

Aneuploidy↗

[Effect of cimetidine on neuromuscular blockade by succinylcholine and pancuronium].

The effect of cimetidine on neuromuscular blockade by succinylcholine and pancuronium was investigated in 54 adult patients scheduled for elective surgery. The neuromuscular blocking properties were estimated with single twitch height (T1) which was obtained by measuring the acceleration of adduction of the thumb in response to the ulnar nerve stimulation under N2O-fentanyl anesthesia. In cimetidine group, cimetidine 200 mg was administered orally on the night before surgery and 90 mins before anesthesia. Succinylcholine 1 mg.kg-1 (n = 14) or 1.5 mg.kg-1 (n = 20) was injected intravenously, and the onset time (from injection to 0% T1), the duration of maximal block (0% T1), and the recovery time from injection to 50% and 75% of control twitch height were evaluated. ED25 and ED50 of pancuronium were calculated from the dose response curve obtained by incremental administration of the drug (n = 20) whose total cumulative dose was 0.1 mg.kg-1. The recovery index of pancuronium was determined by measuring the 25%-75% recovery time. There was no significant difference between cimetidine pretreated patients and non-pretreated patients regarding these parameters of neuromuscular blockade with both succinylcholine and pancuronium. In conclusion, cimetidine has no influence on neuromuscular blockade of succinylcholine and pancuronium under N2O-fentanyl anesthesia.

Adolescent↗

[Anesthetic management of a patient with osteogenesis imperfecta congenita].

We experienced anesthetic management of three cases of osteogenesis imperfecta. Case 1: A 2-year-old boy weighing 8.6 kg was premedicated with chloral hydrate 250 mg intrarectally, but he was very excited on arrival at the operating room. Induction of anesthesia was performed by intramuscular injection of ketamine 40 mg. Case 2: A 4-year-old girl underwent three surgeries (2 osteomies and 1 intramedullary nailing of the tibias) during the past two years. On the second and third procedures, marked hyperthermia (over 39.2 degrees C as rectal temperature) developed during halothane (1-2%) and enflurane (1.5-2.5%) anesthesia. However, on the first surgery, hyperthermia did not occur under combined light halothane (0.3-0.5%) anesthesia with caudal epidural block. Case 3: A 14-year-old female underwent osteotomy of the radius under brachial plexus block without any anesthetic complications. In conclusion, anesthetic considerations for children with this disease are as follows; 1) It is necessary to premedicate to provide good preoperative sedation. 2) Care should be taken to use inhaled anesthetic agents (halothane and enflurane) because of tendency to develop abnormal hyperthermia. 3) It is desirable to use regional anesthesia.

Adolescent↗

[Left ventricular function after Konno procedure for congenital aortic stenosis].

From February, 1984 to September, 1988, eighteen patients with congenital aortic stenosis underwent Konno procedure. There was no operative death, but one late death (5.6%). The annular diameter ranged from 9 mm to 23 mm (mean 15 mm). Preoperative left ventricular ejection fraction (LVEF) measured by cineangiography ranged from 0.59 to 0.92 (mean 0.77) and half of the patients had more than 0.80 of LVEF. Left ventricular function after the operation was evaluated at rest or during exercise by radionuclide ventriculography. Postoperative LVEF ranged from 0.59 to 0.89 (mean 0.75). Although there were no statistically significant changes between preoperative and postoperative LVEF, there was a trend that preoperative supernormal LVEF improved to normal after surgery. The response to exercise also improved in some cases after surgery. We concluded that Konno procedure can be safely undertaken with improvement of left ventricular function.

Adolescent↗

[Effectiveness and limitations of IABP or LVAD in right ventricular dysfunction].

IABP and well functioning left ventricular assist device for a failing left ventricle have potential for altering the loading condition of the right heart. Depending on the extent of myocardial damage and the pulmonary vascular resistance, IABP and LVAD can have different degree of hemodynamic effect on the right ventricle. We examined 20 clinical cases who required IABP support to wean from cardiopulmonary bypass. In 10 cases (group I), CVP rose up above 20 cmH2O within 12 hrs of post operative period. In another 10 cases (group II), CVP rose less than 20 cm H2O. Then we compared hemodynamic change (m-PAP, PVR, CVP, PAWP, CI and RVSWI) between two groups until 72 hrs of post operative period. No significant differences were noted in PVR and CI between two groups, but CVP, m-PAP, PAWP and RVSWI were markedly higher in I group. Reduction of RV afterload produced with an IABP may probably be due to degree of recovery of failing left ventricular function. It is though that IABP has less favorable effect on right ventricular in the cases whose CVP elevate above 20 mmH2O within 12 hrs after operation than in those with CVP below 20 cmH2O. Clinical studies were made on 4 cases with biventricular failure in our experiences of 8 LVAD cases (LV aneurysmectomy + VSP closure, MVR + AVR + CABG + LV aneurysmectomy, CABG + LV aneurysmectomy and MVR + CABG). LVAD seems to have more beneficial effect on RV afterload, than IABP right ventricular dysfunction, however, is likely to continue in the cases whose CVP elevates above 30 mmH2O even if LVAD is used.

Adult↗