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Biomedical subjects

Y Hashimoto

Publications and source records attributed to Y Hashimoto.

At least 649 records · Page 36Linked to original sources
PubMed1996

A very small juxtaglomerular cell tumor preoperatively identified by magnetic resonance imaging.

We describe a 31-year-old man. Although the plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were elevated, computed tomography and rapid sequence pyelography disclosed no abnormality. However, based on the findings of the small tumor (8 x 8 mm) in the kidney visualized by magnetic resonance imaging (MRI) and excessive PRA in the right renal vein, tumor resection was performed. The positive immunohistochemical staining of renin and the visualization of renin mRNA by in situ hybridization provided evidence supporting the diagnosis of juxtaglomerular cell tumor. Blood pressure, PRA, and PAC were normalized after the surgery. The observations suggest that MRI is a powerful diagnostic procedure in small juxtaglomerular cell tumor.

Adenocarcinoma↗
PubMed1996

Visceral leishmaniasis misdiagnosed as malignant lymphoma.

Visceral leishmaniasis is a chronic infectious disease caused by a protozoan parasite of the genus Leishmania, characterized by intermittent fever, monocytosis, hepatosplenomegaly and hypergammaglobulinemia. This morbid condition is rather difficult to diagnose correctly, especially at its early stage, because it is rarely encountered in Japan. Recently we treated a case of visceral leishmaniasis in which the patient was misdiagnosed as malignant lymphoma, and went through splenectomy and steroid administration, which made the diagnosis more difficult.

Adult↗
PubMed1996

Carotid artery disease in patients with retinal artery occlusion.

Embolization from the carotid bifurcation has been proposed as the most common cause of central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). The purpose of this study was to evaluate carotid artery disease in patients with CRAO and BRAO. Using carotid ultrasonography, 17 patients (13 males, 4 females, mean age 68.7 +/- 7.1 years) with CRAO and BRAO were examined for stenotic findings and plaque morphology (homogeneous or heterogeneous) within 7 days after onset. The internal carotid artery (ICA) ipsilateral to the affected side showed a significantly higher incidence of severe carotid stenosis as compared to the non-affected side. The occurrence of heterogeneous plaques in the ICA did not differ between the affected and the non-important affected side. We suspect that severe carotid stenosis in addition to heterogeneous plaques plays an important role in retinal artery occlusion.

Aged↗
PubMed1996

[Dysphagia following lateral medullary infarction].

We studied 10 patients with lateral medullary infarction. Six patients had severe dysphagia from the onset, and needed tube feeding or intravenous hyperalimentation. Three of these 6 patients resolved dysphagia within 3.5 months. Pharyngoesophagography showed aspiration and pooling in the pharynx in other three patients who showed persisting dysphagia for more than 6 months. The cause of dysphagia was not unilateral paralysis of the pharynx and the larynx. Because there were decreased functions of elevation of the larynx, closure of the vocal cord and the pharyngeal movement, the dysphagia of our patients may be due to disturbance of the neurogenic swallowing control. Persistent dysphagia was associated with anterolateral extension of the infarction in the medulla. Two patients with laryngectomy and permanent tracheostomy were able to be discharged to home. We conclude that surgical treatment is a choice in patients with dysphagia which persists for more than 6 months.

Aged↗
PubMed1996

[A case of left atrial myxoma with repeated ischemia of left anterior cerebral artery territory].

A 52-year-old woman was admitted to our hospital because of paralysis of her right lower limb and dysarthria. After admission, she had exacerbations of paralysis of the right lower limb twice. Brain CT scan revealed a low density area in the left anterior cerebral artery territory. MRI disclosed the lesion of the body of the corpus callosum. On the fifth day, trans-esophageal echocardiography detected a mass lesion in the left atrium. There was no recurrence after treatment with heparin. On the 23rd day, the left atrial mass was removed surgically, which was elastic and soft and was confirmed to be myxoma pathologically. It was suggested that the embolic material originated from an adherent thrombus on the surface of the myxoma, since heparin was effective. She showed unique movements of her right hand like diagonistic dyspraxia. The right hand with mild paresis took away an object held in the left hand. The patient was able to move the right hand voluntarily and to imitate with it. She did not show grasping reflex, instinctive grasp reaction and apraxia of the left hand. The lesion of the body of corpus callosum may be responsible for this peculiar neurological symptom.

Brain Ischemia↗
PubMed1996

Application of the Triage panel for drugs of abuse to forensic blood samples.

A simple and rapid screening procedure with Triage has been developed to detect 7 classes of drugs of abuse, phencyclidine (PCP), benzodiazepines (BZO), cocaine metabolite (COC), amphetamines (AMP), cannabinoids (THC), opiates (OPI), and barbiturates (BAR), in hemolyzed blood. A clear supernatant was obtained by mixing the blood with sulfosalicylic acid. The supernatant was neutralized with ammonium acetate and then screened using Triage. The lower limits of detection of the Triage screening method for PCP, diazepam, benzolyecgonine, methamphetamine, morphine, 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), phenobarbital, and secobarbital were 50 ng/mL, 900 ng/mL, 1,000 ng/mL, 600 ng/mL, 900 ng/mL, and 900 ng/mL, respectively. The sensitivity of Triage for THC-COOH in deproteinized blood samples was much lower than that in urine samples. No false positive reactions were observed for the 6 classes of the drugs of abuse with the exception of AMP when the blood was decomposed. Phenethylamine, a putrefactive amine, gave positive results for AMP at concentrations over 5,000 ng/mL. The method was applied to 9 hemolyzed blood samples and 3 turbid urine samples from 12 forensic autopsy cases suspected of drug misuse. Among these, 5 were positive for AMP, 1 for OPI, and 4 for BAR. The presence of methamphetamine is only one of the 5, codeine in 1, and phenobarbital in 4 was confirmed by gas chromatography. All 4 samples which were false positive for AMP contained phenethylamine at relatively high concentrations because of moderate to heavy putrefaction. This method, although disadvantageous to test for AMP and THC, is helpful for the forensic toxicologist because any kind of bloody fluid can be tested rapidly with Triage to detect toxic levels of PCP, BZO, COC, OPI, and BAR.

Adult↗
PubMed1996

[Postoperative analgesic requirements after various operations].

The difference in postoperative analgesic requirements for operations involving 11 sites was assessed in 1100 patients. Pain relief was mainly attained by epidural administration of bupivacaine 0.25% on demand. Postoperative analgesic was required most frequently after thoracotomy, followed by gastrectomy with left diagonal approach, gastrectomy with median approach, operation for colon cancer, cholecystectomy and hysterectomy. After hip operation, periproctal operation, radical mastectomy, appendectomy and herniorrhephies, total analgesic requirement was similar and the minimum amount required. In conclusion, there was a high degree of correlation between the severity of the pain and the site of the operation.

Analgesics↗
PubMed1996

Diagnosis of middle cerebral artery occlusion with transcranial color-coded real-time sonography.

PURPOSE: To determine the usefulness of transcranial color-coded real-time sonography in detecting occlusion of the horizontal portion of the middle cerebral artery. METHODS: Using transcranial color-coded real-time sonography, we measured the end-diastolic flow velocity with incident angle correction and the side-to-side ratio of the end-diastolic flow velocity (the end-diastolic ratio) in both middle cerebral arteries in 44 patients with or without occlusive disease. Cerebral angiography was carried out in all patients before or within 1 week after sonography. The subjects included 4 patients with unilateral stenosis of the extracranial internal carotid artery > or = 75%; ICS group), 6 with unilateral occlusion of the extracranial internal carotid (ICO group), 6 with occlusion of the horizontal portion of the middle cerebral artery (M1 group), and 28 without stenotic (< 75%) lesions in the internal carotid artery (control group). RESULTS: In the control group, the end-diastolic flow velocity was 40.4 +/- 16.8 cm/s (mean +/- SD) and the end-diastolic ratio was 1.28 +/- 0.27. In the ICS and ICO groups, the end-diastolic flow velocities on the affected side and the end-diastolic ratios were 33.4 +/- 9.0 cm/s and 1.35 +/- 0.24, and 29.6 +/- 10.2 cm/s and 1.67 +/- 0.58, respectively. In the M1 group, the end-diastolic flow velocity (16.7 +/- 4.29 cm/s) on the occluded side was significantly lower than that in the other groups. The end-diastolic ratio (3.53 +/- 1.47) in the M1 group was significantly higher than that in the other groups. CONCLUSION: The M1 group could be easily distinguished from the other groups on the basis of the end-diastolic ratio. Measurement of the end-diastolic flow velocity and the end-diastolic ratios in the middle cerebral artery by means of transcranial color-coded real-time sonography may help to identify an occlusion in the horizontal portion of the middle cerebral artery.

Arterial Occlusive Diseases↗
PubMed1996

[A case of cerebral infarction due to dissection in a branch of the middle cerebral artery].

A 65-year-old man developed left drop hand, dysarthria and emotional incontinence. Brain CT and MRI revealed multiple cerebral infarctions in the cortex and subcortical white matter of the right temporal and parietal lobes which were in the distribution of the right middle cerebral artery. Cerebral angiography disclosed segmental narrowing (string sign) and two pseudoaneurysms in the right angular artery which were diagnosed as dissecting aneurysm of a branch of the middle cerebral artery. In this case, cerebral angiography was more useful than MRI in diagnosis of dissecting aneurysm of a branch of the middle cerebral artery. This was a very rare case of dissecting aneurysm of the middle cerebral artery localized in one of its branches.

Aged↗
PubMed1996

[A case report of thoracic aortic and common carotid artery dissecting aneurysm diagnosed by duplex ultrasound examination].

A 61-year-old man was admitted to our hospital because of sudden consciousness disturbance, aphasia and right-side hemiparesis. On admission his blood pressure was 124/74mmHg, and his pulse was a regular rate of 46 beats per minute. Electrocardiogram was normal. Thirty minutes after the onset brain computed tomographic (CT) scan showed no abnormality. Fifty minutes after the onset cervical ultrasound examination with color-coded Doppler demonstrated a subintimal dissection with a false channel of the left common carotid artery. Eighty minutes after the onset thoracic CT scan demonstrated the false lumen in ascending and descending thoracic aortic artery. Cervical CT scan showed a dissection with a false channel of the left common carotid artery. We could diagnose him as cerebral infarction due to thoracic aortic and common carotid artery dissection by means of ultrasound examination within 80 minutes after the onset. He spontaneously and fully recovered three days later. We emphasize the usefulness of noninvasive technique such as cervical ultrasound examination with color-coded Doppler in the diagnosis and follow-up of common carotid artery dissection.

Aortic Dissection↗
PubMed1996

[Re-operation for Budd-Chiari syndrome].

A 42-year-old man, who underwent a radical operation for Budd-Chiari syndrome under femoro-femoral bypass in our hospital 5 years ago, was re-admitted for evaluation of progressive liver dysfunction and dilatation of superficial veins of scrotum and lower extremities. Cavography revealed complete obstruction at the portion of previous patch dilatation. We performed re-do operation by the same method except we chose this time the heparin-coated circulatory system including centrifugal pump and ringed ePTFE graft as a material of patch dilatation. Cavography after the re-do operation revealed widely patent IVC-RA junction and he has been doing well.

Adult↗
PubMed1996

Postmortem stability of cocaine and cocaethylene in blood and tissues of humans and rabbits.

A study was conducted to examine the postmortem stability of cocaine and cocaethylene in rabbit blood and tissues, and to determine whether cocaethylene is produced in decomposed human specimens containing cocaine and endogenous ethanol. Heart blood, liver, brain and femoral muscle taken from rabbits 20 min after oral administration of 20 mg/kg cocaine together with 2 g/kg ethanol were kept at 20-25 degrees C for 5 days. Cocaine and cocaethylene concentrations were in the order brain > liver > muscle > blood, and showed very large intersubject variations at the time of death. Cocaine was degraded rapidly in the blood and liver. However, 12.0 +/- 8.5% and 26.2% +/- 19.4% of the original cocaine was still detectable in the brain and muscle, respectively. Cocaethylene was degraded more slowly than cocaine in all of the specimens. The pH of the blood remained around 7.4 during a 5-day period; all the other specimens showed pH values of 6.2-6.7 on and after the first day postmortem. When 10,000 ng/g cocaine was incubated with decomposed human blood, liver, brain and muscle homogenates containing 0.29-0.60 mg/g endogenous ethanol at 20-25 degrees C and 37 degrees C, no change in cocaine concentration was observed during the study period of 24 h, and no cocaethylene was detected. The pH values of the homogenates were within the range 4.2 to 5.2 at the beginning of the experiment. It was found that: 1) cocaethylene was more stable in postmortem specimens than cocaine; 2) muscle as well as brain was specimen of choice for detecting cocaine and cocaethylene postmortem; 3) cocaine was resistant to decomposition under acidic conditions; and 4) putrefactive bacteria had no ability to produce cocaethylene even in the presence of cocaine and endogenous ethanol.

Animals↗
PubMed1996

Endogenous ethanol production in trauma victims associated with medical treatment.

Four cases of trauma, where endogenous ethanol production was suspected to have been occurred in association with medical treatment, are reported. To discriminate endogenous ethanol produced de novo by bacteria from exogenous ethanol by drinking, various tissues and body fluids, such as brain and cerebrospinal fluid, together with blood obtained from various locations, were subjected to analysis for both ethanol and n-propanol. The first individual was a 40-year-old man who had been stabbed in the abdomen with a knife and had died of bleeding about 12 h after peritoneotomy, and autopsied 12 h later. In the heart blood, 0.44 mg/g ethanol and 0.005 mg/g n-propanol were detected. Ethanol levels in the cerebrospinal fluid, vitreous humor and brain, reflecting exogenous ethanol levels, were 0.08-0.16 mg/g, and no n-propanol was detected in any of the specimens. The second individual was a 45-year-old man who had been punched hard in the head and face and had died of traumatic shock about 12 h after hospitalization, and autopsied 12 h later. The heart blood concentrations of ethanol and n-propanol were 0.15 and 0.008 mg/g respectively, and a subdural hematoma contained only 0.05 mg/g ethanol and non n-propanol. The third individual was a 34-year-old man who suffered incised wounds of the left arm and head with a sickle and had died of hemorrhagic shock. In the heart blood, 0.30 mg/g ethanol and 0.026 mg/g n-propanol were detected; there was 0.04 mg/g ethanol and no n-propanol in the brain. The fourth individual was a 76-year-old woman who had been hit by a motorcycle and had died of liver rupture about 1 h after admission to a hospital. The heart blood contained 0.22 mg/g ethanol and 0.002 mg/g n-propanol. Only a trace of ethanol and no n-propanol were detected in the pericardial sac fluid and cerebrospinal fluid.

1-Propanol↗
PubMed1996

[The effect of preoperative oral fluid intake on the volume and pH of gastric contents in elective surgical patients--a comparison of tea with apple juice].

This study aimed to investigate the effect of 150 ml of either tea or apple juice on the volume and pH of gastric contents in 40 elective surgical patients, ranging in age from 18 to 70 years. They were given diazepam 5 approximately 10 mg and roxatidine 75 mg orally 2 hours before the start of isoflurane anesthesia or modified neuroleptic anesthesia. Immediately following the induction of anesthesia with thiopental and vecuronium, a nasogastric tube was placed to aspirate the gastric content to measure its volume and pH. The volume and pH of gastric contents were 6.4 +/- 8.5 ml, 6.0 +/- 2.2 in tea group and 17.1 +/- 18.4 ml, 4.4 +/- 2.6 in apple juice group, respectively. There was a significant difference in the gastric volume between the two groups (P < 0.05), while no significant difference in gastric pH was observed. This result suggests that apple juice is not appropriate as preoperative drink because apple juice increases gastric contents, and may cause aspiration pneumonia.

Adolescent↗
PubMed1996

[Video-assisted right pneumonectomy for small cell carcinoma].

We presented a case of video-assisted right pneumonectomy for small cell carcinoma. A 54-year-old male was admitted because of an abnormal shadow on a chest rentogenogram occasionally. The bronchoscopic biopsy revealed squamous cell carcinoma at the right intermediate bronchus. His magnetic resonance imaging demonstrated a 5-cm right hilar mass involving with right pulmonary artery. The operation was carried out by video-assisted thoracotomy with small lateral thoracotomy. Pathological findings revealed oat cell carcinoma with a subcarinal node involvement postoperatively. His postoperative course was uneventful. He received adjuvant chemotherapy and 60 Gy radiation in the mediastinum. He is alive 12 months after surgery without any evidence of recurrence. The advantages of the video-assisted thoracotomy were reported less postoperative pain and discharged earlier than the standard thoracotomy. Video-assisted pneumonectomy had not disturbed him in the adjuvant therapy for oat cell carcinoma.

Carcinoma, Small Cell↗
PubMed1996

Effects of anti-intercellular adhesion molecule-1 and anti-lymphocyte-function-associated antigen-1 monoclonal antibodies on the metastasis of murine tumors.

Anti-intercellular adhesion molecule-1 (anti-ICAM-1) and anti-lymphocyte-function-associated antigen-1 (anti-LFA-1) monoclonal antibodies (mAbs) were injected into mice and their effects on tumor metastasis were investigated using two murine models. Depending on the dose, the anti-ICAM-1 mAb (KAT-1) expressed both inhibitory and promoting effects on liver metastases of ICAM-1 + LFA-1 + P815 mastocytoma cells, whereas it enhanced lung metastases of the ICAM-1-LFA-1-Meth-A fibrosarcoma cells at any doses. In contrast, anti-LFA-1 mAb (KBA) showed promoting effects only on the metastases of both tumor lines. Treatment of mice with either mAb enhanced metastases of P815 mastocytoma cells in the spleen.

Animals↗
PubMed1996

[A fluoroscopic analysis of the catheters abnormally placed in the epidural space].

In order to know how the catheters are placed abnormally in the epidural space, we inserted the epidural catheters under fluoroscopy. The catheter was placed straightly upward when the epidural puncture was done in the center of epidural space. When the puncture site was nearly close to the side wall of epidural space, we could not insert catheter at all. When the tip of the needle was near the side wall and the inserting catheter slipped upward, catheter was placed straight. When the catheter wedged at the side wall, it made loop and curled or kinked. We thought that the cause of abnormal location of the catheters in epidural space is the right angle between the wall of the epidural space and the direction of catheter.

Adult↗