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Biomedical subjects

Y Yamaguchi

Publications and source records attributed to Y Yamaguchi.

At least 487 records · Page 27Linked to original sources
PubMed1997

[Swallowing rehabilitation in an elderly patient with Wallenberg's syndrome--role of videofluorography and the swallowing provocation test].

A 65-year-old man was admitted to our department due to severe dysphagia, dysarthria, and aspiration pneumonia. Dysphagia and dysarthria were caused by lateral medullary infarction (Wallenberg' s syndrome). After the patient recovered from pneumonia, the abnormality of swallowing was assessed by a swallowing provocation test and videofluorography. Two months after the start of swallowing training, a swallowing provocation test showed that the swallowing reflex had improved and videofluorography showed that the magnitude of aspiration to the trachea had decreased. The patient began taking food by mouth. These tests are useful for quantitative assessment of dysphagia and for deciding when to start oral intake in elderly patients.

Aged↗
PubMed1997

Identification of rat and human cytochrome P450 forms involved in the metabolism of the thromboxane A2 receptor antagonist (+)-S-145.

(+)-S-145 [5-(+)-(Z)-7-[(1R, 2S, 3S, 4S)-3-phenylsulfonylaminobicyclo[2.2.1]hept-2-yl]-heptenoic acid] and its beta-oxidized metabolites [two [bisnor or dihydro (DH)-bisnor] or four (tetranor) carbon-shortened products at the carboxyl side chain] are hydroxylated at the C-5 or C-6 position of the bicyclo ring by microsomal monooxygenases. We investigated the oxidative metabolism of (+)-S-145 and its beta-oxidized metabolites with liver microsomes from rats and humans to identify which cytochrome P450 (P450) forms are involved in these reactions. In rats, phenobarbital or dexamethasone treatment significantly increased 5- and 6-hydroxylation activities toward (+)-S-145 and its beta-oxidized metabolites, suggesting the involvement of P4503A forms. Immunoinhibition studies suggested that P4503A2 was mainly responsible for the 5-hydroxylation of (+)-S-145, bisnor, and DH-bisnor and the 6-hydroxylation of bisnor and tetranor. Furthermore, P4502C6, a phenobarbital-inducible 2C form in the rat, was involved in the 6-hydroxylation of (+)-S-145, bisnor, and DH-bisnor. P4502C11, the major constitutive form (male rats), was partly involved in the 5-hydroxylation of DH-bisnor and the 6-hydroxylation of bisnor and DH-bisnor. Reconstitution studies with purified human enzymes and immunoinhibition studies suggest that P4503A4 is primarily involved in the 5-hydroxylation of (+)-S-145 and bisnor and the 6-hydroxylation of tetranor; P4502C9/10 mainly catalyzed the 5-hydroxylation of tetranor and the 6-hydroxylation of (+)-S-145. Results of the present study indicated that the same subfamily P450 forms are responsible for the oxidative metabolism of (+)-S-145 in rats and humans. P4503A enzymes were shown to be involved in the formation of 6-hydroxy tetranor, the main metabolite of S-1452 in vivo.

Animals↗
PubMed1997

[Heavy ion radiotherapy for lung cancer].

In our institute, heavy ion medical accelerator in Chiba (HIMAC) completed to be constructed October, 1994. Next year, we started to treat head & neck cancer firstly as a pilot study using carbon beam. Following the observation on the expected reaction of skin and mucosa membrane, we opened the protocol for lung cancer entitled "A phase I/II and II clinical trials of heavy iron particle radiotherapy for non-small cell carcinoma of the lung". Since then, Cabon beam possessing the well-balanced dual actions on cancer: efficient dose-localization and high RBE was given to 25 inoperable patients with stage 1 and 3 patients with stage IIIA as preoperative radiotherapy. The dose was raising from 59.4GyE, 64.5GyE and 72GyE by 10%. Tumor control of the patients who elapsed more than 6 months was evaluated in two of 4 patients (50%) given 59.4GyE, one of 4 (75%) given 64.5GyE and all of 17 (100%) given 72GyE. It appeared to be dose dependent. On the other hand, two of 28 patients (7%) showed acute radiation pneumonia treated with steroid hormone. However, the late effect of the lung was weaken with slight radiographic changes and with no manifestations. Now that heavy ion particle radiotherapy for lung cancer was revealed to be safe, we intend to attain the tumor control compatible with that of surgery.

Humans↗
PubMed1997

[Surgical emergency induced by chest tumors].

Mechanisms and therapeutic procedures for emergencies induced by chest tumors are reviewed. 1) Carcinomatous pleuritis is the most frequently encountered situation for clinicians. At first, pleural effusion should be punctured for diagnosis and chest drainage should be performed consequently. Intrathoracic chemotherapy and pleurodasis (OK-432 is usually used) are then used if necessary. 2) Airway stenosis is the most critical state. Conventionally, violent incubation throughout the stenotic portion of the airway has been used with poor results. Recently, however, irradiation of Nd:YAG laser can be utilized, and the prognosis of the airway stenosis is much improved. Another effective procedure is the insertion of several kinds of airway stent. Silicon stents like T-tube, Dumon tube and Dynamic stent or metallic stents like EMS (Expandable Metallic Stent) are generally used. The advantages of EMS are easy installation and little disturbance of sputum excretion. The disadvantages of EMS are difficult removal and re-stenosis of the airway. On the other hand, silicon tubes are easy to be removed, re-insertion is possible and re-stenosis is rare, but the insertion should be performed under general anesthesia and sputum excretion may pose problems. A case of laser irradiation and two cases of stent insertion are presented. 3) Airway bleeding is also emergent. Bronchofiberscopic ethanol injection (BEI) is effective against continuous bleeding of the central airway. We performed BEI for 33 lung cancer cases, and the method was effective for all cases. 4) Cardiac tamponade, SVC syndrome, esophago-bronchial fistula, bronchial stump fistula are also important emergencies induced by chest tumors. Standard therapeutic procedures are explained for all oncology surgeons and physicians.

Bronchial Fistula↗
PubMed1997

[Evaluation of intrapulmonary nodules by thoracoscopic ultrasonography].

We evaluated the usefulness of thoracoscopic ultrasonography for diagnosing intrapulmonary nodules. We studied 7 patients undergoing thoracoscopic operations. Three had benign lung tumors, one had metastatic lung tumors from a renal cell cancer, and three had primary lung cancers. During thoracoscopy three benign tumors were seen as masses protruding from the visceral pleura in to the pleural space, and two primary lung cancers were seen as pleural indentations. However, the presence of one metastatic lung tumor and one primary lung cancer could not be confirmed by thoracoscopy because of the lack of pleural changes. Furthermore, intrapulmonary spread of malignant tumors in four cases could not be seen by thoracoscopy. All tumors were seen clearly and their characteristics were identified by thoracoscopic ultrasonography. Partial lung resection during thoracoscopy was successful in all patients. We found thoracoscopic ultrasonography to be useful for confirming the presence of peripheral solid nodules, and for deciding where to make incisions for partial lung resection.

Adult↗
PubMed1997

[CPE chemotherapy for tongue carcinoma--clinical effects and side effects].

UNLABELLED: Recent advances in chemotherapy have markedly improved the treatment results for oral cancer. Among many chemotherapeutic regimens, the usefulness of multiple combination chemotherapy with cisplatin as the primary drug has been frequently reported. During the past 6-year period, we have performed combination chemotherapy with cisplatin as the primary drug, peplomycin, and etoposide (CPE chemotherapy) as one of the chemotherapeutic regimens for oral cancer. The subjects were 11 patients (7 males and 4 females) with tongue cancer treated by CPE chemotherapy as neoadjuvant chemotherapy at our department between March, 1990 and April, 1995. RESULTS: PR in 8 (73%), and NC in 3 (27%). No patient showed CR and PD. The side effects observed were reversible findings such as transient myelosuppression, nausea-vomiting, and alopecia. No patient showed severe or persistent suppression of hematopoietic function.

Alopecia↗
PubMed1997

[Use of casual plasma glucose levels in community screening for diabetes mellitus].

The aim of this study was to assess the utility of casual plasma glucose as a screening test for diabetes mellitus in lieu of hemoglobin A1c (HbA1c) and urinary glucose. Casual plasma glucose and urinary glucose were measured in 1,024 individuals in a rural community. The individuals were then offered participation in an oral glucose tolerance test (OGTT). A 75 g OGTT based on WHO criteria was performed and HbA1c was measured in 290 respondents. Receiver operating characteristic (ROC) curves for casual plasma glucose and HbA1c were constructed and the areas under ROC curves for the tests were calculated. The area under the ROC curve for HbA1c was significantly higher than that for casual plasma glucose (p < 0.01). The sensitivity and specificity for casual plasma glucose > 140 mg/d/were 61% and 62%, respectively, while the specificity of HbA1c was 93% with a sensitivity of 61%. The sensitivity of urinary glucose was low (only 18%) with a comparable specificity (93%). It is concluded that measurement of casual plasma glucose is inferior to HbA1c as a screening test for diabetes.

Blood Glucose↗
PubMed1997

[Distribution and contrast enhanced CT appearance of abdominal tuberculous lymphadenopathy].

PURPOSE: To clarify the contrast enhanced CT features and anatomic distribution of the disseminated vs non-disseminated tuberculosis (TB) involving abdominal lymph nodes. MATERIALS AND METHODS: The contrast enhanced CT findings of abdominal lymphadenopathy in 25 patients, including disseminated TB associated with miliary TB of the lung (n = 5) and non-disseminated TB (n = 20), were retrospectively evaluated in a blind review to assess our criteria of morphology, density and location of the involved lymphadenopathy. RESULTS: The enhancement patterns of disseminated TB were not different from those of non-disseminated TB. Ninety-six percent of the patients had peripheral rim enhancement, and 60% showed a multilocular appearance. The enlarged lymph nodes of TB were less than 4 cm in diameter. Lymphadenopathy caused by hematogenous dissemination often accompanied splenic involvement showing multiple low-density foci in the spleen. The predominant sites of lymphadenopathy of disseminated TB were hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric, and both upper and lower portions of the retroperitoneal lymph nodes, whereas non-disseminated TB mainly involved hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric and upper retroperitoneal lymph nodes, excluding the lower retroperitoneal lymph nodes. By combining contrast enhancement patterns and the anatomic distribution of lymphadenopathy shown on the contrast enhanced CT images, reviewers made a correct diagnoses of tuberculosis in 94%, of cases, with a specificity of 95% and sensitivity of 92%. CONCLUSION: Contrast enhanced CT patterns correlate well with the pathologic features of tuberculous lymphadenopathy. A different anatomic distribution between disseminated and non-disseminated TB involving the lower retropentoneal lymph nodes was recognized in this study.

Abdomen↗
PubMed1997

[Super selective bronchial artery embolization using metallic coils in the management of hemoptysis].

Hemoptysis is one of the most important clinical problems of cardiopulmonary disease with high mortality rate. Its management is routinely performed with Bronchial Artery Embolization (BAE). However, it was reported that BAE had some disadvantages such as spinal injury and recurrent bleeding. In order to prevent spinal injury, we tried the super selective bronchial artery embolization (ss-BAE). This technique is especially available in the occlusion of the bronchial artery forming the common trunk with the spinal artery. Besides, BAE, considered to be only a palliative treatment, might cause recanalization due to reabsorption of the occlusive agent. So we used metallic coils to prevent this drawback. The ss-BAE with metallic coils was performed in 2 cases who had refractory hemoptysis against conservative therapy. Hemoptysis disappeared in both cases. The ss-BAE with metallic coils was shown to be safer and more effective than ordinary BAE.

Aged↗
PubMed1997

Massive uncomplicated vascular immune complex deposits in the kidney of a patient with systemic lupus erythematosus.

The case of a patient with systemic lupus erythematosus (SLE) is reported which was accompanied by renal dysfunction and massive vascular immune deposits in the kidney without active glomerular lesions. The renal biopsy showed arterioles and small arteries with circumferential periodic acid-Schiff (PAS) and Masson trichrome-positive homogenous material in the subendothelial area in the absence of thrombotic, necrotizing or inflammatory lesions. Immunofluorescence and electron microscopy examination demonstrated immune deposits in the vascular walls. Glomeruli showed only minor abnormalities with a trend to collapse. There was no improvement in renal dysfunction over a 4-year period until the patient's death, despite steroid therapy producing a decrease in disease activity. The autopsy showed similar vascular changes to those seen in the biopsy, however; glomeruli were either sclerotic or showed a trend to collapse. Massive uncomplicated vascular immune complex deposition without active glomerular lesions is rare. The present case indicates that this type of lupus vasculopathy may be a prognostic factor for the loss of renal function in SLE mediated by hemodynamic glomerular injury.

Aged↗
PubMed1997

[Usefulness of percutaneous microwave tissue coagulation therapy for solitary liver cancer].

The possible use of percutaneous transhepatic microwave tissue coagulation therapy (PMCT) using ultra-sonography under local anesthesia for solitary liver cancer was studied. The subjects were 8 patients having primary or metastatic liver cancer with solitary liver tumor less than 4 cm in size, consisting of 2 hepatocellular carcinomas, and 6 metastatic carcinomas. PMCT was performed continuously 3 times at the output of 30 watts for 30 seconds at a time. Tumors less than 3 cm in size were completely coagulated by irradiation from 2 to 5 times judged by enhanced CT. No recurrence of tumor was recognized in the coagulation area. But in some cases, multiple metastases were found at another site in the liver by 3 months after PMCT. Thus, the results suggest that PMCT is a useful therapy for small liver tumor as a local control.

Aged↗
PubMed1997

[A case of advanced hepatocellular carcinoma with portal invasion effectively treated by continuous intra-arterial chemotherapy with 5-fluorouracil].

A 79-year-old male diagnosed as advanced hepatocellular carcinoma with portal invasion was treated by continuous intra-arterial chemotherapy of 5-FU, which was continuously administered for 72 hours at a dose of 333 mg/mm/day every 2 weeks and repeated 12 times. Total dose of 5-FU was 14.4 g. Toxicity of this therapy was not recognized. Levels of AFP were reduced from 4385.6 ng/ml to 11.9 for 6 months. No tumor was recognized on CT scan at 6 months after starting this therapy, after 15 months of this therapy, the patient is alive and disease-free. Given the above results, continuous intra-arterial administration of this 5-FU therapy may be effective for patients with hepatocellular carcinoma.

Aged↗
PubMed1997

Adhesion molecule expression in vascular endothelial cells incubated with cancer cell line supernatant are inhibited by neutrophil elastase inhibitor (ONO-5046.Na).

We investigated the role of a neutrophil elastase (NE) produced by cancer cell lines on intercellular adhesion molecule-1 (ICAM-1) expression in endothelial cells using two human non-small cell lung cancer cell lines, EBC-1 and PC-3. It is known that immuno-reactive NE is produced by EBC-1 cells, but not PC-3. In control study, Northern blot analysis revealed that in vitro ICAM-1 mRNA transcripts in the rat endothelial cell line (WK-5) was increased in the presence of purified NE while a specific neutrophil elastase inhibitor (ONO-5046.Na) inhibited ICAM-1 expression. Similarly, ICAM-1 mRNA levels in WK-5 cells were increased by the culture supernatant obtained from EBC-1, but not from PC-3. In addition, ONO-5046.Na inhibited the increase in ICAM-1 mRNA levels stimulated by immuno-reactive HE from EBC-1. These results suggest that EBC-1 cells produce immunoreactive NE which has biological function of NE to stimulate ICAM-1 expression in the endothelial cells.

Animals↗
PubMed1997

Fully automated measurement of total iron-binding capacity in serum.

We established a method for fully automated measurement of total iron-binding capacity (TIBC) in serum without separation of the unbound excess iron after saturating serum transferrin. After saturation of serum transferrin with an excess amount of iron (first step), the unbound iron was eliminated by formation of a complex with ferrozine, which was used as a chromogenic reagent (second step). For the TIBC assay, iron dissociated from transferrin by shifting the pH to acidic was reacted with ferrozine, and the increase in the absorbance at 570 nm was measured (third step). Because the iron used as a calibrator, which was added to saturate transferrin, reacted completely with ferrozine in the second step (elimination of unbound iron), the change in the absorbance to generate a calibration factor could not be monitored in the third step. To solve this problem, we used N-(2-hydroxyethyl)ethylenediamine-N,N',N'-triacetic acid (HEDTA) to complex with the iron added to saturate transferrin in the second step. This made it possible to form an iron-ferrozine complex at acidic pH because iron was dissociated from HEDTA at acidic pH. The within-run CVs of this method were 0.66-2.43% at 17.7-77.0 mumol/L, and the day-to-day CVs were 1.06-1.57% at 29.9-60.4 mumol/L (n = 10). The correlation between the values obtained with this method (y) and those from the direct TIBC assay, which involved removal of unbound iron by ion-exchange resin (x), was: y = 0.963x + 0.29 mumol/L (r = 0.973, Sy/x = 2.83, n = 59), and with the TIBC values calculated from the serum iron concentrations and the unbound iron-binding capacities measured by a direct colorimetric method (x) was: y = 1.01x - 1.06 mumol/L (r = 0.994, Sy/x = 1.66, n = 51).

Blood Proteins↗
PubMed1997

[A surgical case of aggressive fibromatosis].

A case of "aggressive fibromatosis" which appeared in posterior mediastinum is reported. A 50-year-old woman was admitted to our hospital with right shoulder pain. The tumor surrounded the right vertebral artery and infiltrated into the right sympathetic nerve, brachial plexus and muscle tissue. It was suspected of neurogenic tumor by percutaneous needle biopsy. Removal of the tumor and partial resection of the invaded vertebral artery and brachial plexus were made in Aug. 10, 1996. In postoperative examination, the tumor was 6.2 x 6.5 x 4.5 cm in size and diagnosed pathologically as "aggressive fibromatosis". Postoperative course was uneventful, but Horner's symptoms and motor disturbances of IV, V, fingers of the right hand were slightly occurred. Radiotherapy of 60 Gy was done after operation. There is no recurrence to date 17 months after surgery. As for the character of this disease, it seldom metastasizes, but grows infiltratively and the recurrence after operation is an important problem. In particular, the neck and the head are important because surgical margin is not provided enough, anatomically. Therefore, chemotherapy or radiotherapy after operation is needed. In this case, radiotherapy was done after operation. So, there is not the recurrence and passes to date 17 months after surgery. But, follow-up of long terms is necessary because it may recur after postoperative therapies.

Combined Modality Therapy↗
PubMed1997

[The progress of lung cancer surgery].

Surgery has become one of the major treatments for lung cancer, increasing in number as well. Four times more patients undergo operation for lung cancer compared to 20 years age. The 5-years-survival rate of surgically treated patients this past 9 years was 55.2%. Technological advances in imaging and technical progress of diagnosis has lead to accurate staging prior to surgery. Group examination inables us to discover early lung cancer patients. Post operative adjuvant therapy such as LAK immunotherapy is also effective. The progress of extended surgery, surgical techniques such as bronchoplasty is also important. These factors are all responsible for the improvement of the survival rate for surgically treated patients.

Humans↗