Biomedical subjects

Y Miyamoto

Publications and source records attributed to Y Miyamoto.

At least 307 records · Page 17Linked to original sources

PubMed1996

[Clinical features and prognosis of facial palsy and hearing loss in patients with Ramsay Hunt syndrome].

Clinical studies were performed on 325 patients with Ramsay Hunt syndrome who were treated in the Facial Nerve Clinic at Ehime University Hospital between 1976 and 1995. The clinical manifestations of Ramsay Hunt syndrome were various. Three major symptoms, auricular vesicles, facial paralysis and vestibulo-cochlear dysfunction, were found in 57.6% of the patients although these symptoms did not always appear simultaneously. Auricular vesicles appeared before (19.3%), during (46.5%), or after (34.2%) the onset of facial paralysis. Hearing loss was observed subjectively in only 20% but objectively in 48.2% of the patients. Hearing loss appeared before (34.3%), during (34.3%), or after (31.3%) the onset of facial paralysis. Complete recovery from facial paralysis was achieved in 52.4% of the patients. Good recovery of the facial nerve function was achieved in patients who had zoster vesicles or vestibulo-cochlear dysfunction preceding the development of facial paralysis. Complete recovery of hearing was also achieved in 45.4% of the patients, and the recovery was better in patients having light hearing loss, less than 35dB. The patients younger than 16 years old showed better recovery from both facial paralysis and hearing loss than the patients older than 60 years. Glossopharyngeal nerve or vagal nerve paralysis concomitant with facial paralysis was found in 8 (2.5%) patients. The outcome of glossopharyngeal nerve paralysis was good but that of the vagal nerve was poor.

Adolescent↗

PubMed1996

[Clinicopathological study on primary lung cancer--immunohistochemical expression of p53 suppressor gene and bcl-2 oncogene in relation to prognosis].

Two hundred and eleven surgically resected primary lung tumors were studied immunohistochemically. According to histologic type, they were 129 adenocarcinomas, 56 squamous cell carcinomas, 4 small cell carcinomas, 8 large cell carcinomas, 8 adenosquamous cell carcinomas, 5 so-called carcinosarcomas and 2 other tumors. Immunohistochemical expression of p53 and bcl-2 was studied in relation to the disease-free survival. Among the 211 patients with lung cancer, 109 were positive for p53 expression, and there was no significant relationship between p53 expression and sex, or clinicopathological stage and size of the tumor, although the patients with squamous cell carcinoma had a significantly higher frequency of p53 expression than those with adenocarcinomas. The frequency of p53 expression was significantly higher in the patients with poorly differentiated adenocarcinomas than in those with other histologic types. Seventy four of the 211 patients were positive for bcl-2 expression and bcl-2 expression was higher in the stage I patients and patients with small lung tumors 2cm or less in diameter than in the other patients. The patients with adenocarcinoma had a higher frequency of expression than those with squamous cell carcinoma but no difference was found in the histological differentiation of the tumor. The 5-year survival of patients positive for p53 expression was poorer than that of those with negative expression and the survival rate was higher in the patients positive for bcl-2 expression than in those with negative expression. These findings suggested that the expression of p53 and bcl-2 is a useful marker of follow-up and prognosis, but will require more data concerning the mechanism of carcinogenesis. Seven cases of primary lung cancer were examined for genetic abnormality of the p53 gene. cDNA was synthesized from total RNA of primary tissues of lung cancer using oligo (dT) primer and reverse transcriptase and polymerase chain reaction (RT-PCR), and PCR-single strand conformation polymorphism (SSCP) analysis were performed. Five patients gave a positive result upon PCR-SSCP analysis of the p53 gene. To confirm the results of PCR-SSCP analysis, their nucleotide sequences were further analyzed and four of them had point mutations at different codons (154, 176, 207, 236) and one had deletion of one nucleotide (245) in exon 5 and 8. Fifteen percent of 26 patients with small peripheral lung adenocarcinomas less than 2cm in diameter were already advanced in stage and various factors such as vascular invasion, pleural involvement and degree of scar grade were higher than in patients with clinicopathological stage I. In advanced cases, the frequencies of p53 expression was higher than in stage I cases. Concerning the relationship of the degree of scar grade to PDGF-B expression, we demonstrated the production of PDGF-B protein immunohistochemically and the expression of PDGF-B-mRNA by In situ hybridization in the adenocarcinoma cells and macrophages of the lung tumors. However, no significant correlation was observed between the degree of PDGF-B expression and collagen production in the fibrotic focus.

Adenocarcinoma↗

PubMed1996

[Dextran-induced anaphylactoid reactions in two patients with gastrointestinal cancer].

We report dextran-induced anaphylactoid reactions (DIAR) subsequent to rapid infusion of Rheomacrodex (dextran 40) in two patients, a 67 year old man with gastric cancer undergoing distal gastrectomy and a 47 year old man with transverse colon cancer undergoing colectomy. Both showed sudden tachycardia, hypotension and skin flush, which were treated with epinephrine or etilephrine administration. Most cases of severe DIAR are immune complex anaphylaxis mediated by dextran-reactive antibodies (DRA) of the IgG class, which are considered to arise mainly in response to immunization with dextran-cross-reactive bacterial polysaccharides in the gastrointestinal tract. High titers of DRA have previously been reported in gastric ulcer patients with pyloric stenosis, suggesting bacterial polysaccharides permeation through the luminal wall which may easily occur in the presence of local inflammation or ulcer. Although serum DRA titers in our patients have not been examined, inflammation or ulcer around the tumor might have played a role in producing high titers of DRA. In patients suspected of gastrointestinal ulcer or inflammation, including cancer, dextran administration is not preferable or should be avoided, unless hapten-dextran preparation is used for the prophylaxis of severe DIAR.

Aged↗

PubMed1996

[Coronary artery bypass grafting under bradycardia induced by ultra-short acting beta blocker].

From Dec. 1993 to May, 1994, coronary artery bypass grafting (CABG) was performed in 7 patients under bradycardia induced by an ultra-short acting beta blocker (esmolol). The ages ranged from 51 to 68 years. There was one patient with low ejection fraction (EF = 31%) and two patients with porcelain aorta. A tepid temperature was maintained during cardiopulmonary bypass (CPB). A high flow rate of 2.2-2.6 liter/min/m2 was applied to control perfusion pressure above 50 mmHg during CPB. After CPB was started, a high dose of esomolol was added (10-30 mg/kg intravenous bolus followed by a continuous infusion of 1-4 mg/kg/min). Severe bradycardia was achieved by the initial loading of esmolol. The mean heart rate was significantly (p < 0.01) decreased from 78 +/- 12 bpm to 49 +/- 7 bpm by the loading. Altogether, 25 anastomoses (11 ITA, 6 GEA, 8 SVG) were performed to LAD (10), Cx (7) and RCA (8), with an average of 3.6 +/- 0.9 anastomoses/patient. IABP was required for 2 patients postoperatively. There was no operative death, but one hospital death due to aspiration pneumonia 3 months later. Postoperative max CPK-MB was low (17.4 +/- 9.7 IU/L) in 6 patients. The postoperative angiography was performed in all patients with a patency rate of 88%. It was considered that esmolol facilitated CABG under beating heart and this technique is suitable for patients with severe atheromatous disease of the ascending aorta or patients with a low ejection fraction to avoid aortic cross-clamping.

Adrenergic beta-Antagonists↗

PubMed1996

[Prognostic factors of resected pulmonary metastases of osteogenic sarcoma].

From December 1979 to December 1994, 22 patients with osteogenic sarcoma underwent a total of 34 thoracotomies for resection of pulmonary metastases in our department. We did a retrospective study to identify prognostic factors. The tumor doubling time (TDT) calculated for 21 patients before the first (if multiple) resection was not correlated with days of survival after resection of the primary tumor, nor was it correlated with days of survival after the first (if multiple) resection of the pulmonary metastatic tumors. Of the nine patients who underwent at least two thoracotomies, the TDT calculated from X-ray films taken before the second (or later) thoracotomy was significantly shorter than the TDT calculated before the preceding thoracotomy (p < 0.05). The disease-free interval (DFI) after resection of the primary tumor was correlated with the days of survival after that resection (p < 0.001) and also with survival after resection of the pulmonary metastatic tumors (p < 0.01). This DFI of patients who survived at least 2 years from the date of the resection of the primary tumor was significantly longer than in patients who survived less than 2 years from that date (p < 0.05). The most significant prognostic factor was this DFI. The cumulative survival rate was 42.4% at three years and 33.9% at five years, with an operative mortality of 0%.

Adolescent↗

PubMed1996

[HELP syndrome and anesthetic management].

From January 1990 to December 1994, 24 parturients were diagnosed as having HELLP syndrome alone or combined with preeclampsia/eclampsia among 8,224 patients who were delivered at our institution. They consisted of 14 primiparous and 10 multiparous patients. Mean maternal age was 28.9 +/- 3.3 and gestational age was 34.8 +/- 5.6 weeks. Of 24 parturients, 8 had vaginal delivery and the remaining 16 were delivered by caesarean section. Serious maternal morbidity included eclampsia (n = 3), preeclampsia (n = 18), renal failure (n = 5), hydrothorax (n = 4), and DIC (n = 1). There was no maternal death. There were 3 intrauterine fetal deaths and two neonatal deaths. Perinatal deaths were 2 (0.9%, 2/26). Three caesarean sections were performed under general anesthesia, and 13 under spinal anesthesia. In cases with apparent bleeding tendency, spinal and epidural anesthesia should be avoided. In providing general anesthesia, hypertension should be controlled, and the uterus is preferably dilated before the delivery and contracted there-after.

Adult↗

PubMed1996

[The usefulness of mediastinoscopy for primary lung cancer].

The usefulness of mediastinoscopy for lung cancer was retrospectively evaluated for the aspect of prognosis. The subjects were 421 patients with primary lung cancer except exploratory thoracotomy. In the MD(+) group, there was no difference in prognosis between right and left sided thoracotomies, but in the MD(-) group there was a tendency for poorer prognosis in the left-sided thoracotomy (p < 0.1). In the right-sided thoracotomy, there was no difference of prognosis between the MD(+) group and MD(-) group. On the contrary, in the left-sided thoracotomy there was a statistically better prognosis in the MD(+) group than in the MD(-) group (p < 0.05). In the left-sided thoracotomy group, there was a statistically better prognosis in the MD +) group than in the MD(-) group in the pN 0 or pN 1 group (p < 0.01), but there was no difference of prognosis in the pN 2 group. In lung cancer of the left side, the mediastinal lymph node dissection would be more incomplete because of the presence of the aorta and the mediastinal lymph node metastasis would tend to be missed. Mediastinoscopy gives the right diagnosis of mediastinal lymph node metastasis and an accurate staging of lung cancer. Mediastinoscopy is very useful especially in the left-sided lung cancer.

Adult↗

PubMed1996

[Complicated bronchoplasty for lung cancer--its significance in salvaging a few segments of lung].

We performed bronchial reconstruction by several unusual procedures and succeeded in preserving lung function, which was proven with spirometry and treadmill exercise test. Type 1 (n = 2): Anastomosis between the left main bronchus and upper segmental bronchus with lower lobectomy and lingulectomy. Type 2 (n = 2): Anatomosis between the left main bronchus and basal segmental bronchus with upper lobectomy and superior segmentectomy acompanied by vascular reconstruction. Type 3 (n = 4): Anastomosis between the right main bronchus and lower bronchus with upper and middle lobectomy, accompanied by vascular reconstruction in 2 cases. One patient required completion pneumonectomy but the others had uneventful postoperative courses and maintained better lung function than expected, although the amount of preserved lung tissue was limited. There may be a great difference in the postoperative quality of life if pneumonectomy can be avoided, even though the preserved segments are few. Surgeons should reconsider the choice of pneumonectomy for interlobar tumors invading another lobe, especially in the case of N0 or N1 squamous cell carcinoma.

Aged↗

PubMed1996

+Gz acceleration affects the trace minerals zinc, copper, and chromium in serum and urine of humans.

BACKGROUND: Research investigating the relationship between physical training and trace mineral concentrations has primarily focused on athletes. Few investigations, however, have specifically examined the alterations of trace mineral concentrations occurring in humans exposed to +Gz acceleration. Exercise alters mineral content; G-exposure is a form of exercise; therefore, G-exposure may elicit changes in mineral content. HYPOTHESIS: Exposure to +Gz acceleration may affect the concentrations of the trace minerals zinc, copper, and chromium in human serum and urine. METHODS: Blood samples were obtained from 7 men and 3 women, before and immediately after +Gz acceleration. Urine samples were obtained before, 30 min after, and 2 h after +Gz acceleration. RESULTS: The serum zinc concentration was significantly different after +Gz acceleration, decreasing from 90.6 +/- 21.0 micrograms.dl-1 to 80.8 +/- 14.4 micrograms.dl-1. The serum copper concentration was also significantly altered immediately after +Gz acceleration, decreasing from 111.7 +/- 27.5 micrograms.dl-1 to 98.5 +/- 35.2 micrograms.dl-1. The urinary zinc and copper concentrations, and the serum chromium concentration were not significantly affected by +Gz acceleration. CONCLUSIONS: The circulating levels of these minerals presumably change as they are transported to the tissues requiring greater amounts due to the increased physiological work associated with +Gz acceleration.

Acceleration↗

PubMed1995