Biomedical subjects
Publications and source records attributed to E Ishiyama.
A case of idiopathic adrenal hemorrhage is reported. A 76-year-old woman exhibited a left adrenal tumor, 3 cm in diameter, on abdominal computed tomography. The patient was receiving aspirin medication for atrial fibrillation. There was no evidence of increased adrenal hormones. The mass enlarged to 6 cm in diameter within 18 months, and malignancy was suspected. The mass was diagnosed as adrenal hematoma by operative findings.
Cardiac function and restenosis were evaluated after percutaneous transluminal coronary angioplasty (PTCA) using a Doppler index (the Tei index). Thirty-eight patients, 31 men and 7 women (mean age 57 years) with ischemic heart disease were studied. The underlying heart diseases were angina pectoris without left ventricular asynergy in 16 patients and old myocardial infarction (OMI) with left ventricular asynergy in 22 . Ejection fraction was measured by M-mode echocardiography and deceleration time, and the interval between cessation and onset of the mitral inflow velocity (a), ejection time at aortic valve (b), and the Tei index [(a-b)/b] were measured by M-mode echocardiography performed before and 6 months after PTCA. The ejection fraction, deceleration time and Tei index showed no changes after PTCA in patients with angina pectoris with or without restenosis. In patients with OMI with restenosis, the Tei index increased slightly after PTCA, from 0.56 +/- 0.15 to 0.61 +/- 0.13. The deceleration time changed from 0.23 +/- 0.03 to 0.24 +/- 0.02 msec, and the ejection fraction from 0.46 +/- 0.11 to 0.51 +/- 0.17, neither significantly. However, in patients with OMI without restenosis (15 out of 22 patients), the Tei index significantly improved after PTCA, from 0.55 +/- 0.13 to 0.48 +/- 0.12 (p < 0.05). In patients with left ventricular asynergy due to old myocardial infarction, without restenosis, the Tei index significantly improved after PTCA. The Tei index is useful for evaluating restenosis after PTCA in patients with OMI.
We describe a 42-year old Japanese woman with mixed connective tissue disease (MCTD) who developed fulminant hepatic failure and hepatic encephalopathy. Massive pericardial effusion accompanying cardiac tamponade was shown by echocardiography. The hepatic failure was considered to be caused by a low cardiac output state because of cardiac tamponade, which might be due to cardiac involvement of MCTD. This is a rare case, showing an unusual progressive course in MCTD.
Morphological examination of the sensory hairs of the lower half of the 2nd turn of the organ of Corti of the guinea pig after transtympanic infusion of the aseptic fluids with different osmotic pressure was performed using a scanning electron microscope. Group A fluids (0-315 mosmol/l) did not have any injurious effect on the sensory hairs of the OHCs (outer hair cells) or IHCs (inner hair cells). In contrast, Group B fluids (720, 743 mosmol/l) appeared to cause disarrangement of the stereocilia of the OHCs. Alterations were found to be more extensive and severe in the 3rd row of OHCs. Group C fluids (1224, 1248 mosmol/l) induced total loss of sensory hairs in the 3rd and 2nd row of OHC. The remaining stereocilia in the 1st and 2nd rows showed coalescence of adjacent stereocilia. Based on these findings, the authors concluded that there is a close relationship between osmotic induction/deduction by transtympanic infusion of fluids and high osmotic pressure on the hairs of the organ of Corti.
This study focused on the morphological alteration of the mucous membrane of the middle ear after transtympanic infusion of fluids with different osmotic pressure. Our results suggested that fluids with high osmotic pressure will seriously damage the mucous membrane of the middle ear regardless of whether or not the fluids have ototoxicity. On the other hand, fluids with low osmotic pressure were found to demonstrate minor changes on the mucous membrane. The authors have confirmed through this study that Beriplast-P A (894 mOsm) and B (228 mOsm), fibrinogen-based tissue sealants, may be safely used in the middle ear with minimum injury to the mucous membrane.
The present studies are concerned with the reconfirmation of cryo-effects on the tonsil, such as advantages of cryosurgery on habitual tonsillitis, on expansive growth of tonsillar haemangioma and papilloma, and on malignant lymphoma. The present results revealed that post-operative healing of the wounds was satisfactory with minimum scar formation. Recurrence of habituere tonsillitis within three years after cryosurgery was 17%. Cryosensitivity was extremely high on patients with haemangioma and papilloma, even in cases of malignant lymphoma.
Scanning electron microscopic observation of the transtympanic infusion of 10% xylocain revealed twisting and disorders of outer hairs especially from the 2nd and 3rd rows of the basal to the 2nd turn of the organ of Corti, and adhesion and fusion of the sensory hairs of the crista ampullaris and otolith organ 1 and 4 days after injection. Four percent xylocain however demonstrated very minor alteration of the sensory hairs and no missing sensory hairs were detected from any cases. The authors hypothesized from electron microscopic observation that adhesion and fusion of vestibular sensory hairs or twisting and disorders of the sensory hairs of the organ of Corti might act to intercept harmful circulation of exclusion of abnormal excitement of hair cells and the innovation of electrical discharge of sensory hairs due not only to the pharmacological effects of xylocain but also to osmotic pressure.
A neuro-otological examination was given to 22 patients with paroxysmal positional vertigo within 1 week of head injury. In all cases, reverse rotatory positional nystagmus accompanied by a vertiginous sensation was observed in the positional nystagmus test. No relationship between the affected side and the direction of eye movement in the head-hanging position was found in the positional nystagmus test. From the prognosis and the nystagmus findings, the cause of the vertigo was thought to be partial damage to the inner ear. The clinical course was generally favorable, but recovery was slower in the 11 cases with neuro-otologically demonstrated central nervous system disorders than in the other 11 cases.
The authors were in close contact with children who had indications for tonsillectomy and investigated them in both acute tonsillitis and intermittent periods of tonsil inflammation. The results obtained were as follows: Repeated attacks of acute tonsillitis clearly decreased in number. No secondary diseases due to tonsillitis were observed. When repeated attacks of acute tonsillitis occurred, the symptoms were not as serious as previously.
By use of a chart questionnaire, abnormal sensations of the pharyngo-larynx (ASPL) were analyzed between May 1-October 30, 1984 and followed up uintil 1 year after the first consultation date. Two hundred ninety-one patients from the total were found to suffer from ASPL, the ratio of ASPL to all out-patients being 1.47%. The ratio of sex distinction was 6.2 (males): 10 (females). A significant number of ASPL cases occured between the ages of 30-59 years old. ASPL patients were divided into the following categories: (1) causes originating from the ENT field, (2) internal medicine origin, (3) psychological internal medicine, (4) malignant origin and (5) unknown origin. The authors also conducted an investigation of the relationship between iron deficiency and abnormal sensations of the pharyngo-larynx. ASPL in females aged between 30 to 40 years indicated a significant relation to anemia of latent iron deficiency. The authors also investigated from the psychological internal medicine view and the results revealed sticky sensations of the pharyngo-larynx and autonomic imbalances with position reaction to psychosomatic and neurotic symptoms.
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