Search PubMed⌕ Search

Biomedical subjects

Y Yoshida

Publications and source records attributed to Y Yoshida.

At least 631 records · Page 35Linked to original sources

[Intrathoracic extramedullary hematopoiesis in a case of hereditary spherocytosis].

A 62-year-old man with a history of hereditary spherocytosis had an abnormal shadow on a chest X-ray film, but the shadow was not examined further. The patient was admitted to our hospital because of severe anemia, multiple gallstones, and splenomegaly. Acute cholecystitis developed due to gallstones. A smear of peripheral blood showed spherocytosis, and the osmotic fragility as measured by Parpart's method was abnormally high. These findings are consistent with hereditary spherocytosis. Splenectomy and cholecystectomy were done. The chest X-ray film, CT scan, and MRI revealed multiple well-demarcatd paravertebral masses. A biopsy of a mediastinal mass was done with an ultrasonically guided needle, and hyperplasic erythroid hemopoietic tissue was obtained. This finding led to the diagnosis of extramedullary hematopoeisis. We think extramedullary hematopoeisis should be included in the differential diagnosis of posterior mediastinal masses.

Hematopoiesis, Extramedullary↗

[Surgery for WPW syndrome with concomitant CABG: a case report].

A 58-year-old man underwent simultaneous surgery for WPW syndrome complicated by frequent attacks of atrial tachyarrhythmia combined with angina pectoris persisting after anterior myocardial infarction. Repeated PTCA of 3 times failed and restenosis occurred with recurrent angina particularly when atrial tachyarrhythmia took place. The preoperative ECG suggested the presence of a left free wall accessory pathway confirmed by an electro-physiolosical study. Coronary bypass grafting (LITA-LAD, SVG-4 PD) and division with cryoalation of the accessory pathway were performed using a transseptal left atrial approach. The patient is doing well now and free from both angina and tachycardia.

Angina Pectoris↗

[Primary myelofibrosis with positive coombs' test responding to prednisolone].

Primary myelofibrosis was diagnosed in a 43-year-old female in 1991, who gradually became transfusion dependent. There was no evidence suggesting connective tissue diseases except for biological false positive STS. Because her direct Coombs' test was positive and serum haptoglobin level was extremely low (< 6mg/dl), intermediate dose (30mg/day) prednisolone therapy was started. Her hemoglobin level and platelet count increased dramatically to a normal level within 3 weeks after the initiation of prednisolone therapy. Bone marrow biopsy performed 6 months later revealed marked recovery of hematopoiesis. Though the effects of corticosteroid therapy in primary myelofibrosis still remain unclear, this therapy might be useful in the treatment of some groups of patients via the correction of immunological aberrations and/or the decrease of bone marrow fiber.

Adult↗

Association between electrocardiographic ischemic abnormalities and ischemic heart disease risk factors in a Japanese population.

This cross-sectional study was undertaken to investigate the association of electrocardiographic (ECG) ischemic abnormalities with ischemic heart disease (IHD) risk factors in a Japanese population. Resting ECGs of 1201 subjects (572 men and 629 women, aged 30 to 89 years), were coded independently by two coders according to the Minnesota Code. Blood pressure (BP) was recorded using a standard sphygmomanometer, and non-fasting serum total cholesterol and high-density lipoprotein cholesterol were measured. Codes 1.1 and 1.2 were classified as myocardial infarction and codes 1.3, 4.1-4.4, 5.1-5.3 and 7.1 were classified as ischemia. Prevalence of ECG with evidence of IHD (IHD ECG) was defined as myocardial infarction and ischemia together. Levels of risk factors were compared between subjects with IHD ECGs and those without IHD ECGs. Multiple logistic regression analysis was used to ascertain the associations between IHD ECG and risk factors. The prevalence of myocardial infarction in the total population was 1.5% and 0.7% in men and women, respectively and the prevalence of IHD ECGs was 10% and 11.3% in men and women, respectively. Systolic blood pressure (SBP) was consistently higher in subjects with IHD ECGs in the total population of both sexes (P < 0.001, P = 0.001 for men and women respectively). Diastolic blood pressure (DBP) was higher only in men with IHD ECGs (P = 0.002). In middle-aged men (aged 30-59 years), total cholesterol was considerably higher in subjects with IHD ECGs, although this relationship was statistically not significant. In multiple logistic regression analysis, SBP was independently associated with IHD ECGs in both sexes (P = 0.001). Associations between IHD ECGs with total cholesterol, alcohol intake and smoking were not statistically significant. This study showed that electro-cardiographic IHD evidences in Japanese are predominantly associated with blood pressure level in both sexes.

Adult↗

Involvement of angiotensin II in glomerulosclerosis of stroke-prone spontaneously hypertensive rats.

Renal plasma flow (RPF), glomerular filtration rate (GFR), glomerular pathology and glomerular TGF-beta gene expression were examined in 12- and 24-week-old stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar Kyoto rats (WKY). These parameters were also examined in SHRSP treated with equihypotensive doses of angiotensin II receptor antagonist (CV-11974:CV) and hydralazine (Hyd) for 12 weeks. Twelve-week-old SHRSP showed a decrease in RPF and GFR, and an increase in filtration fraction (FF) and urinary protein excretion (UP) compared to WKY. CV normalized these parameters, whereas although Hyd showed improved levels they were not to the levels achieved by the WKY. Glomerular TGF-beta expression was increased 2.0-fold in 12- and 24-week-old SHRSP, and CV, but not Hyd, decreased it to the control levels of WKY. At 24 weeks old, SHRSP showed a higher glomerulosclerosis index (GI) than WKY. CV, but not Hyd, lowered the GI to the level of the WKY controls. These data indicate that renal hemodynamic changes are closely associated with an increased TGF-beta expression in SHRSP and that this condition is caused by angiotensin II.

Angiotensin II↗

[Apoptosis in MDS].

We examined the endonuclease activity capable of inducing internucleosomal DNA fragmentation in hematopoietic cells. Mg(2+)-dependent nuclease activity was high in hematopoietic progenitor cells and the activity decreased with myeloid or erythroid differentiation. This was the case in MDS as well as in normal hematopoiesis. In contrast, Ca2+/Mg(2+)-dependent nuclease activity varied widely in the samples from MDS and the possibility was indicated that the activity of Glycophorin A+ cells was related to the degree of anemia. We also investigated DNA strand breaks in bone marrow samples from 16 patients with MDS and 10 with other diseases by an in situ end labeling (ISEL) technique. The reactivity in ISEL tended to increase parallel to disease progression of MDS. The high ISEL-positivity was also observed in some samples from patients with MPD and other diseases. Though ISEL is a useful technique for quantification of apoptosis, our results suggested that MDS cells with ISEL positive staining are not necessarily in the process of apoptosis.

Apoptosis↗

[Efficacy of cefditoren pivoxil in the treatment of acute otitis media due to benzylpenicillin-insensitive Streptococcus pneumoniae].

Clinical and bacteriological studies were carried out on cefditoren pivoxil (CDTR-PI) granule in infantile purulent acute otitis media treated at general practice settings and the following findings were obtained: 1. Two hundred forty eight strains were isolated from 210 patients, almost all of which (81.1%) harbored the following two strains: Streptococcus pneumoniae (42.3%) and Haemophilus influenzae (38.8%). Among S. pneumoniae, benzylpenicillin (PCG)-insensitive S. pneumoniae, (PISP) or PCG-resistant S. pneumoniae (PRSP) was 36.2%, corresponding to 15.3% of all the isolates and found in 18% of all patients. 2. The bacteria in the middle ear discharge and the nasopharyngeal swabs were correlated with conformity rate of more than 80% with regard to Streptococcus pyogenes, S. pneumoniae and H. influenzae but no Staphylococcus aureus was detected simultaneously from the two sources in any of the patients. S. aureus and coagulase-negative staphylococci (CNS) were considered to be contaminants that were originated from the external auditory meatus at the time of sampling. 3. Frequencies of isolation of S. pneumoniae from different age groups were higher in a lower age group between 0 and 4 years and those of PISP or PRSP had the similar tendency. 4. Antibacterial activities were determined for CDTR and related oral antibiotics against the strains of S. pneumoniae and H. influenzae as representative isolates. CDTR had stronger antibacterial activities against both bacteria than the reference antibiotics. CDTR was found to be transferred into the otorrhea at a mean concentration of 0.58 micrograms/ml after single administration of CDTR-PI granule formulation at 3 mg(potency)/kg. 5. As for bacterial eradication efficacies in the middle ear cavity and the nasopharynx, eradication rates were higher than 80% in the middle ear cavity in all cases without large differences among bacterial species but eradication rate of PISP was 30% in the nasopharynx, and it was significantly lower than those of PSSP and other bacteria. 6. In view of clinical effectiveness, the efficacy rate was 89.4% and bacteriological effects was 92.2%; in view of safety, adverse reactions were; observed in 9.5% and the rate of usefulness was 89.4%. 7. From above-stated results, CDTR-PI was considered as a useful oral antibiotic for infantile acute otitis media including PISP infections.

Acute Disease↗

Indirect measurement of tidal volume by multi-lead electrocardiograms: effect of filtering, deep breath, lead and posture.

We examined a new method for estimating tidal volume from the electrocardiogram (ECG) in order to dispense with the need for sensors used exclusively for tidal volume measurement. The direction of the vector loop in the QRS complex (DVL) was defined as the direction of the diagonal line of the rectangle which circumscribed the vector loop obtained from two orthogonal leads. Two leads of the ECG were transformed into the orthogonal leads using Einthoven's triangle. The peak-to-peak change in the direction (the change in the DVL) was highly correlated with tidal volume. Low-pass filtering of the ECG produced a better correlation between tidal volume and the change in the DVL, when the cutoff frequency was set at 20-45 Hz. A tidal volume of less than 1.21 was correlated more highly with the change in the DVL than a tidal volume of more than 1.21 A combination of leads I and III produced the best correlation between tidal volume and the change in the DVL, compared with other combinations. The posture of the subject had some effects on the slope of the linear regression between tidal volume and the change in the DVL.

Electrocardiography↗

A method of evaluating drug efficacy by statistical analysis of healing speed of peptic ulcer.

At present, the evaluation of anti-ulcer drugs is generally accomplished simply by calculating the cumulative healing rate at a certain point of time during treatment, which does not implicate any analysis of the healing speed of the ulcer. If the cumulative healing rate of an ulcer is expressed as a function of drug administration time, t, then it will be possible to calculate parameters concerning the healing speed of ulcers and thus evaluate drug efficacy as the time series analysis of the cumulative healing rate. A new method of evaluating anti-ulcer drugs by a statistical analysis of healing speed is proposed. A non-linear regression analysis was performed between two variables, t (time of drug administration: week) and y (non-healing rate: %), to obtain the exponential function y = Ae-kt. The theoretical values calculated from the exponential equation were in close proximity to the observed values. With this analysis, four parameters concerning the healing speed were defined, namely the healing rate constant, the initiation time of healing, the half-life of non-healing rate and the time necessary for 50% healing. With this method, the efficacy of drugs on peptic ulcer healing was dynamically analysed, the non-healing rate (y) being expressed as an exponential function of length of time (t) of treatment, thus obtaining digital parameters for healing speed.

Anti-Ulcer Agents↗

Dysfunction of immune system and induction of autoantibodies to liver antigens by neonatal thymectomy in mice.

We examined the development of autoantibodies to liver proteins and hepatitis in BALB/c mice thymectomized 2 days after birth and attempted to characterized the immune function of these mice. Autoantibodies to crude liver proteins detected by ELISA were found in 21 (84%) of 25 mice thymectomized 2 days after birth. In these mice, sera of 11 animals showed reactivity with both liver specific proteins (LSP) and the second fraction of crude liver proteins; sera of 3 mice showed reactivity with only the second fraction but sera showed reactivity with only LSP. By Western-immunoblotting, sera of BALB/c mice which showed high autoantibody level to liver proteins detected a strong band around 150kD in the second fraction of crude liver proteins. Still more, hepatic inflammation; mononuclear cell infiltration in the portal area, was induced in mice with apparently high autoantibody level to crude liver proteins. These results in BALB/c mice corresponded with our previous reports which employed C3H/HeN mice. Next, we examined immune functions of mice thymectomized 2 days after birth. In thymectomized mice, the proportion of Thy-1, L3T4 and Lyt-2 positive cells (T cells) decreased and the proportion of B220 positive cells (B cells) increased. The proliferative response of lymph nodes lymphocytes cultured with mitomycin C-treated syngeneic spleen cells was lower, and the total IgG level in the sera was higher when compared with control normal mice. Anti-nuclear antibody (ANA) also appeared in the sera of thymectomized mice 2 days after birth. All these results suggest that the dysfunction of T cell and polyclonal activation of B cell were induced in neonatally thymectomized mice and resulted in the production of ANA and autoantibodies to liver proteins.

Animals↗

[Pulmonary arteriovenous fistula--usefulness of three-dimensional computed tomography].

A 57-year-old woman was admitted to our hospital for examination of an abnormal shadow in the left middle lung field. The lesion was in S4 of the left upper lobe, with dilation of A5 b and V5 b, and was suspected to be a pulmonary arteriovenous fistula. A three dimensional CT scan showed a tortuous and irregularly dilated vessel. Color doppler imaging showed a mosaic pattern of blood flow. These findings indicated that the fistula was attached to the pleura. The patient underwent thoracoscopic partial resection of the lung.

Arteriovenous Fistula↗

Preservation of myocardial function and metabolism at subzero nonfreezing temperature storage of the heart.

BACKGROUND: The hypothermic simple immersion technique has been widely used to preserve the donor heart for transplantation. However, there is still controversy as to which temperature provides the best protection against prolonged ischemia. The low molecular weight solutes within cells depress the freezing point to -0.6 degree C. In practice, however, most cells do not freeze internally unless they are cooled below -10 degrees C. We investigated the effects of subzero nonfreezing storage at -1 degree C on the preservation of myocardial metabolism and function. METHODS: Isolated Wistar rat hearts were subjected to 6 hours of preservation with the intracellular type University of Wisconsin solution; the hearts of the subzero group were preserved at subzero nonfreezing (-1 degree C) temperature, and the hearts of the control group were at 4 degrees C. Recovery of cardiac function, myocardial adenine nucleotides content, and myocardial water content were evaluated after preservation. RESULTS: Subzero group resulted in significantly better aortic flow, cardiac output, and aortic systolic pressure than in the control group. Myocardial adenosine triphosphate, adenosine diphosphate, and total adenine nucleotides at end-storage were significantly better preserved in subzero group when compared with the control group. Myocardial water content at reperfusion significantly increased in the control group compared with the subzero group. CONCLUSIONS: Storage in the intracellular type solution at subzero nonfreezing (-1 degree C) temperature as compared with 4 degrees C appears to prolong myocardial preservation with respect to the enhancement of postischemic functional recovery, preservation of myocardial adenine nucleotides during ischemia, and prevention of myocardial edema at reperfusion.

Adenine Nucleotides↗

Ecabet sodium eradicates Helicobacter pylori infection in gastric ulcer patients.

Ecabet sodium (ecabet), a new agent that has protective effects on the gastric mucosa has anti-Helicobacter pylori effects, binding with urease to inhibit H. pylori activity, and causing the bacterial to become non-viable. Ecabet monotherapy eradicates H. pylori infection in Japanese monkeys. We investigated a new regimen that included ecabet to eradicate H. pylori infection in gastric ulcer patients. Fifty-five H. pylori-positive patients with gastric ulcer were randomly assigned to one of two groups: group 1 received dual therapy with lansoprazole (30 mg o.d.) for 8 weeks plus clarithromycin (200 mg b.i.d.) or amoxicillin (250 mg q.i.d.) for 2 weeks. Group 2 received triple therapy with lansoprazole (30 mg o.d.) and ecabet sodium (1.0 g b.i.d.) for 8 weeks plus clarithromycin (200 mg b.i.d.) or amoxicillin (250 mg q.i.d.) for 2 weeks. Four weeks after the treatment was withdrawn, H. pylori status was evaluated by histological examination, rapid urease test, and culture. The eradication rate was 26% (7 out of 27 patients) in group 1 and 79% (22 out of 28 patients) in group 2. All patients completed the treatment. The addition of ecabet to the regimen increased the eradication rate of H. pylori infection, and there were no associated major side effects.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Endoscopic topical therapy for the treatment of Helicobacter pylori infection.

We modified a novel topical therapeutic method for the treatment of Helicobacter pylori infection to increase its effectiveness and tolerability. Sixty-six patients (with nonulcer dyspepsia, inactive ulcer, or active ulcer) were given lansoprazole (30 mg, h.s.) and pronase (18,000 tyrosine units, b.i.d.) orally for 2 days before the topical therapy. One hundred milliliters of 7% sodium bicarbonate solution containing bismuth subnitrate, amoxicillin, metronidazole (at two different regimens), and pronase was instilled into the stomach through an endoscope. A double-lumen tube with a balloon at the tip was inserted into the duodenum along with the endoscope. The balloon was inflated with 25 ml of air and was lodged postbulbarly. The solution was kept in the stomach for 2 h, and the patient's position was changed every 15 min from the sitting to the supine, prone, and right lateral position, each position being maintained twice, to expose the entire gastric mucosa. The solution was aspirated at the end of the procedure. H. pylori infection was cured in 16/22 (72.7%) of patients with nonulcer dyspepsia, in 21/26 (80.7%) of patients with inactive ulcer, and in 1/18 (5.6%) patients with active ulcer. H. pylori eradication was confirmed 4 weeks after the therapeutic procedure by smear, culture, and histology of antral and corpus biopsy specimens. Side effects (loose stools) were observed in two patients only, and one patient had loss of appetite. These effects were transient. This endoscopic topical therapy for H. pylori infection is a safe, effective, and well tolerated procedure. With further modifications of the drug regimens and the method itself, this procedure could be of interest as anti-H. pylori therapy.

2-Pyridinylmethylsulfinylbenzimidazoles↗

[Prognostic value of acute pulmonary vascular response to oxygen inhalation in patients with chronic obstructive pulmonary disease].

Seventy-two patients with chronic obstructive pulmonary disease (COPD) underwent right heart catheterization when they were clinically stable and the relationship between length of survival and acute pulmonary vascular response to 100% oxygen inhalation was studied. Oxygen inhalation significantly reduced mean pulmonary arterial pressure (PPA), cardiac index (CI), and pulmonary arteriolar resistance (PAR). The percent change in PAR (% delta PAR) was used as an index of the acute pulmonary vascular response to 100% oxygen inhalation. Each patient was classified as a responder (% delta PAR > or = 15%) or a nonresponder (% delta PAR < 15%). The cumulative survival rates of these two groups were compared. Responders survived significantly longer than did nonresponders (mean survival times were 2571 days and 1432 days, respectively). The two groups did not differ significantly in anthropometic data, pulmonary hemodynamics, or blood gas data measured at base line during air inhalation. However, FEV1 and VC were significantly lower in nonresponders than in responders. The % delta PAR was not significantly related to age, PPA, PAR on air inhalation, FEV1, FEV1%, VC or VC%. We conclude that the pulmonary vascular response to oxygen inhalation (% delta PAR) may be an independent prognostic factor in patients with COPD.

Administration, Inhalation↗