Biomedical subjects

H Kitahara

Publications and source records attributed to H Kitahara.

At least 55 records · Page 3Linked to original sources

PubMed1997

Clinical usefulness of the effective regurgitant orifice area determined by transesophageal echocardiography in patients with eccentric aortic regurgitation.

BACKGROUND AND AIMS OF THE STUDY: The aortic regurgitant jet is frequently eccentric, and Doppler color flow mapping techniques of the distal jet is influenced by this eccentricity. The aim of the present study was to determine whether the effective regurgitant orifice area (EROA), determined by the proximal isovelocity surface area (PISA) method using multiplane transesophageal echocardiography (m-TEE), could be used to evaluate the severity of aortic regurgitation (AR) in patients with an eccentric jet. METHODS: Forty-eight patients with eccentric AR were studied. Values of EROA determined by the PISA method were compared with results from cross-sectional area (CSA), vena contracta (VC) width, aortic angiography, and regurgitant fraction. RESULTS: Values of EROA correlated well with results from CSA (r = 0.73, p < 0.001), VC (r = 0.74, p < 0.001), angiographic grade (rs = 0.90 p < 0.001), and regurgitant fraction (r = 0.84, p < 0.001) in patients with eccentric aortic regurgitation. Values of EROA > 0.27 cm2 were always associated with a regurgitant fraction > 0.4, while EROA values < 0.27 cm2 were always associated with a regurgitant fraction < 0.4. CONCLUSIONS: We conclude that, in patients with an eccentric jet, measurement of EROA values by the PISA method using m-TEE is a reliable method of assessing the severity of AR.

Aorta, Thoracic↗

PubMed1996

Enantiomer separation by gas and high-performance liquid chromatography with tripeptide derivatives as chiral stationary phases.

Excellent enantiomer separation of a variety of racemic compounds, including alcohols, amines, amino alcohols, carboxylic acids, hydroxy acids and amino acids, was achieved by GC and HPLC with tripeptide derivatives, containing L-valyl-L-valyl-L-valine isopropyl ester as a chiral selector, bonded to amino silicone oil (CSP-3) and N-(2-aminoethyl)-3-aminopropyl silica gel (CSP-4) via a triazine ring, respectively. These results show that the hydrogen bonding association between solutes and chiral stationary phases (CSPs) can play an important role in chiral recognition in both GC and HPLC. The joint use of two CSPs is promising for the direct separation of racemic compounds.

Amino Acid Sequence↗

PubMed1996

Vesicle formation in dermatomyositis associated with gynecologic malignancies.

Vesicle formation in dermatomyositis is rare. We describe two women with dermatomyositis and vesicle formation on their extremities. Both had an ovarian cancer and histologic examinations revealing subepidermal vesicles. In both patients, direct immunofluorescence did not reveal deposition of immunoglobulin in the basement membrane zone. Of our two patients and the 17 previously reported to have dermatomyositis with vesicle formation, 10 had an internal malignant disease. Of these 10 patients, eight women had gynecologic malignant disease and two men had gastric cancer and lung cancer, respectively. Vesicle formation in dermatomyositis is strongly related to the presence of an internal malignant process, especially gynecologic malignant disease in female patients.

Dermatomyositis↗

PubMed1996

[111In-labeled leukocyte scintigraphy in patients with inflammation of unknown focus].

This study evaluates the usefulness of 111In-labeled leukocyte scintigraphy to localize inflammatory foci that cannot be determined by clinical symptoms and other imaging studies. Patients with persistent fever following abdominal surgery (n = 20), suspected post-traumatic osteomyelitis associated with multiple fractures (n = 5), and fever of unknown origin (n = 22) were recruited. In all patients, the exact location of inflammatory foci could not be determined by clinical symptoms and conventional imaging studies. In patients with post-surgical fever, leukocyte scintigraphy localized responsible foci in 65% of patients and provided clinically useful information for the treatment. In patients with multiple fractures, the location of osteomyelitis was diagnosed confidently in only one case (20%). In patients with fever of unknown origin, responsible foci were detected in 18% of patients. Although in those patients positive leukocyte studies provided clinically useful information, overall usefulness seemed to be limited. Leukocyte scintigraphy is able to detect inflammatory foci in patients with post-surgical fever, but less likely to localize responsible foci for post-traumatic osteomyelitis or fever of unknown origin when patients have been examined carefully by clinical symptoms and conventional imaging studies.

Abdominal Abscess↗

PubMed1996

[A case report of total cavopulmonary connection following total cavopulmonary shunt].

A 20-year-old man underwent total cavopulmonary shunt for univentricular heart type A (A.L.L.) with hemiazygos connection six years ago. Four years later, his condition deteriorated with easy fatigue and cyanosis. Cardiac catheterization showed recanalization of ligated SVC. Chest CT showed tight adhesion between the chest wall and the ascending aorta. We approached the heart through left anterolateral thoracotomy in order to avoid injury of the aorta and the ventricle during redo median sternotomy. Total cavopulmonary connection with intraatrial conduit was performed under circulatory arrest and retrograde cardioplegia without aortic cross clamp. His postoperative course was satisfactory. Left thoracotomy was useful for total cavopulmonary connection following total cavopulmonary shunt associated with postoperative adhesion.

Adult↗

PubMed1994

The urodynamic status during psychogenic erection in a patient with a conus medullaris injury. Case report.

The urodynamic status of a 24 year old male patient with psychogenic erection who sustained a conus medullaris lesion from a burst fracture of the first lumbar vertebra is reported. During the initial measurement the external urinary sphincter pressure began to rise from the base pressure of 35 cm H2O 5 seconds after the beginning of audiovisual sexual stimulation and reached the peak of 110 cm H2O. In parallel, the bladder neck pressure gradually rose from its base pressure of 5 cm H2O to a maximal pressure of 115 cm H2O and then ejaculation occurred. The difference is no more than 5 cm H2O and this small difference in pressure inhibits retrograde ejaculation.

Adult↗

PubMed1994

Eosinophil cationic protein in the sera of patients with Mycoplasma pneumonia.

In 1985 we reported that eosinophilia was found in many children with Mycoplasma pneumonia. We measured the serum concentrations of eosinophil cationic protein (ECP) produced by eosinophils in 25 children with Mycoplasma pneumonia, 25 with asthma and 11 with no disease (normal controls). The mean concentrations (+/- SD) of serum ECP in children with Mycoplasma pneumonia, with asthma and the normal controls were 18.7 +/- 12.6, 23.7 +/- 12.2 and 6.5 +/- 1.4 micrograms/ml, respectively. When compared with those of normal controls, these higher serum concentrations of ECP in children with Mycoplasma pneumonia and asthma were statistically significant (P < 0.001). The data were directly correlated with the presence of eosinophilia (r = 0.349). There was no relationship between the amount of ECP and the age of children with Mycoplasma pneumonia. These results suggest that ECP may work as a factor causing a persistent cough similar to asthma in children with Mycoplasma pneumonia.

Adolescent↗

PubMed1994

[Deterioration of liver function following endoscopic injection sclerotherapy of esophageal varices--significance of a new index for liver function "delta TB"].

Changes of liver functions associated with endoscopic injection sclerotherapy (EIS) in which less than 6 ml of 5% ethanolamin oleate was used were investigated in 50 patients with remarkable esophageal varices. The index used for evaluating hepatic reserve was the difference of total bilirubin in serum between immediately and 15 hours after EIS and was tentatively named as "delta TB" (normal range < or = 0.1). In the patients classified as Child-Pugh A (n = 25), Child-Pugh B (n = 19) and Child-Pugh C (n = 6), delta TB was 0.04 +/- 0.30, 0.23 +/- 0.41, and 0.54 +/- 0.21, respectively. One month after the entire sessions of EIS, the changes of liver function tests before and after EIS were compared in 45 cases. It was disclosed that delta TB was elevated in parallel with the severity of their liver dysfunction before EIS. Also, delta TB seems to reflect the prognosis of the patients treated by EIS for some extent, since the survival period of the cases treated by EIS were correlative with delta TB (r = -0.734, p < 0.01), and delta TB of 20 cases who survived for longer than 5 years after EIS was 0.04 +/- 0.32. Therefore, delta TB seems to be a useful marker for estimating the influence of EIS on liver function.

Adult↗

PubMed1994

[Complete eradication by endoscopic injection sclerotherapy reduces the recurrence of esophageal varices].

Endoscopic intravariceal injection sclerotherapy (EIS) using sclerosant mixed with contrast medium was done in 100 patients without hepatocellular carcinoma. They were followed longer than 12 months (mean; 58 +/- 29 months) after EIS. The recurrence rate of esophageal varices in cases with complete eradication (n = 79) and cases with incomplete eradication of (n = 21) was 8.9% and 85.7%, respectively (p < 0.01). In 21 cases, complete eradication was achieved by intravariceal injection and additional therapy using paravariceal injection was not performed. The recurrence rate of this group was only 4.8%. Endoscopic varicealography during injection sclerotherapy were evaluated in 91 cases. At final session of EIS, narrowing of diameter (less than 1 mm) and irregularity of vessel walls were observed in small vessels (devastated vessels). Appearance rate of devastated vessel in 75 cases with completely eradicated esophageal varices was 65.3%. In contrast, among 16 cases with incomplete eradication of varices, devastated vessels were seen only in 6.3% (p < 0.01). It is concluded that the important point in preventing the recurrence of esophageal varices after EIS was the complete eradication of esophageal varices by intravariceal injection sclerotherapy resulting in the eradication of the routes to esophageal varices from port-splenic venous system. For the sake of accomplishment of this treatment, appearance of devastated vessel is very useful.

Adult↗

PubMed1994

Vertebral bone-marrow changes in degenerative lumbar disc disease. An MRI study of 74 patients with low back pain.

We carried out MRI studies of 74 patients with end-plate and vertebral bone-marrow changes associated with degenerative lumbar disc disease. Abnormalities were classified into type A, with decreased signal intensities, and type B, with increased signal intensities on T1-weighted spin-echo images. Twenty-seven (73%) of the 37 patients with type-A changes had low back pain, in contrast to only four (11%) of the 37 patients with type-B changes. Lateral flexion-extension radiographs showed hypermobility in 26 patients (70%) with type-A changes, and in only six (16%) with type-B changes. Type-A changes correlated with segmental hypermobility and low back pain, while type-B changes were more common in patients with stable degenerative disc disease.

Adolescent↗

PubMed1994

[Deterioration of liver function following endoscopic injection sclerotherapy of esophageal varices--significance of the new liver function test "intravariceal injection (I.I.) index"].

Changes of liver functions associated with endoscopic injection sclerotherapy (EIS) were investigated in 143 patients with remarkable esophageal varices. The index used for evaluating hepatic reserve was the ratio between the increase of total bilirubin and the increase of LDH after EIS [I.I. index = (delta T.Bil./delta LDH) x 100] in cases treated by intravariceal injection of 5% ethanolamine oleate. I.I. index value caused by hemolysis was stable and always below 0.2, while the elevation of I.I. index above 0.2 was regarded as the reflection of the deterioration of liver function. After the entire sessions of EIS, the changes of liver function tests before and after EIS were estimated in 104 cases using 3 factors as follows; (1) delta T.Bil.; increase of total bilirubin more than 0.5 mg/dl (2) delta PT; decrease of prothrombin time more than 5% (3) delta ICG R15; increase of ICG R15 more than 5%. I.I. index of group I (without any changes of 3 factors mentioned above; n = 66) was 0.22 +/- 0.16, approximately within normal range. However, in group II (with 1 factor; n = 29), group III (with 2 factors; n = 5), group IV (with all factors; n = 4), I.I. index was elevated according to the severity of their liver dysfunction. The cases whose I.I. index value increased gradually during the course of EIS, were apt to deteriorate the liver functions and therefore, should be carefully observed. Also, I.I. index seems to reflect the prognosis of the patients treated by EIS for some extent, since the survival period of the cases treated by EIS were correlative with the value of I.I. index (r = -0.542, p < 0.01), and I.I. index of 32 cases who survived for longer than 5 years after EIS was almost normal (0.22 +/- 0.15).

Adult↗

PubMed1993

Anterior surgery in four consecutive technical phases for cervical spondylotic myelopathy.

Between 1960 and 1990, 175 patients having anterior operations for cervical spondylotic myelopathy were evaluated during the course of four operative phases. Specific attention was paid to spine and spinal cord morphologic changes occurring in 52 patients, who were followed up for more than 12 years. Although overall outcomes were satisfactory, a disturbing incidence of neurologic deterioration caused by spondylolisthesis at levels adjacent to fused segments, kyphosis, and altered cord morphology was noted 10 years after surgery. These changes, observed in patients with multilevel pathology and a narrowed spinal canal, promoted the adoption of more stringent operative criteria, including ultrasonically confirmed 16-mm or greater anterior trough decompressions and the performance of long fusions with vascularized fibular struts.

Cervical Vertebrae↗

PubMed1993

Scoliosis associated with syringomyelia.

From January 1986 to December 1991, 1,059 patients with scoliosis of 20 degrees or more were reviewed. By magnetic resonance imaging, 43 patients were found to have syringomyelia. Thirty-eight patients had Chiari type 1 malformation. Twenty-two of the patients were younger than 10 years. Scoliosis was the only presenting symptom in 32 patients. All patients had some neurologic abnormalities. Fifteen patients had left thoracic curves. The incidence of scoliosis with syringomyelia in our outpatient clinic was 4.0%; 18.4% in boys, and 2.6% in girls. Magnetic resonance imaging should be performed in patients who have abnormal neurologic findings.

Adolescent↗

PubMed1993

Visualisation of symptomatic nerve roots. Prospective study of contrast-enhanced MRI in patients with lumbar disc herniation.

We studied the use of gadolinium diethylenetriaminepentaacetic acid-enhanced MRI in the detection of pathological changes in the nerve roots of 25 patients with unilateral sciatica due to lumbar disc herniation. Enhancement was observed in the affected nerve roots within the root sleeve at the caudal edge of the herniation and was classified into three categories: grade 0, none; grade 1, enhancement restricted to a focal region within the sleeve; and grade 2, diffuse and homogeneous. The grade of enhancement correlated well with the severity of the sciatica, and was considered to be due to a disruption of the blood-nerve barrier, leading to oedema.

Adolescent↗

PubMed1993

Long-term follow-up study of anterior surgery for cervical spondylotic myelopathy with special reference to the magnetic resonance imaging findings in 52 cases.

A series of 151 patients with cervical spondylotic myelopathy (CSM) were surgically treated through an anterior approach in the period from 1960 to 1987. Particular attention was given to the results of the 52 patients who were operated on more than 12 years ago. Satisfactory short-term results were obtained in all but the few who had incomplete decompression. In these patients, function deteriorated within five years. A disturbing incidence of progression of myelopathy was noted ten years after surgery. Magnetic resonance imaging identified many of the causes (e.g., newly developed intervertebral disk herniation and progression of spondylosis associated with spinal malalignment in both cephalad and caudal directions). Other adverse changes were hypertrophy of the yellow ligament and ossification of the posterior longitudinal ligament. The new and improved techniques consist of decompression to a width of 16 mm or more with intraoperative ultrasonography in addition to extirpation of the posterior longitudinal ligament. This new measure may reduce the incidence of late neurologic deterioration.

Adult↗

PubMed1992

Purification and characterization of a novel growth factor (FF-GF) synthesized by a rat hepatoma cell line, FF101.

A rat hepatoma cell line, FF101, established in serum-free, protein-free medium, synthesizes a growth factor(FF-GF). FF-GF was purified by gel filtration chromatography, cation-exchange chromatography and isoelectric focusing. Purified FF-GF was revealed as a single band on SDS-gel electrophoresis and its molecular weight was estimated to be 70 KDa. FF-GF stimulated DNA synthesis of various cells from different origins. The growth-promoting activities of FF-GF were abolished by treating with protease, dithiothreitol, acid and heating, whereas its activity was not inhibited by antibodies against acidic and basic fibroblast growth factors. These results indicate that FF-GF is a novel growth factor.

Animals↗

PubMed1992

Micturitional disturbance in tumors of the lumbosacral area.

Neurourological studies were performed on 15 patients with tumors at or below the first lumbar vertebra. Micturitional history revealed that 14 patients (93%) had voiding symptoms. Four patients had incontinence and three had urinary retention. Urodynamic studies revealed that three of six patients tested had abnormal uroflowmetrograms. Urinary residuals greater than 100 ml were observed in 6 of 12 patients. Detrusor hyperreflexia occurred in 3 of 15 patients, 4 of 15 had low-compliance detrusor, and 2 of 15 had detrusor-sphincter dyssynergia. There were no differences in lower-extremity neurological signs in patients with or without incontinence, and patients with or without large residual urine and urinary retention.

Adolescent↗

PubMed1992

Mechanical stability of the pedicle screw fixation systems for the lumbar spine.

Five different pedicle screw systems: AO Fixator Interne, VSP Steffee plate, Luque ISF, modified Zielke, and Chiba-type plate screw system (experimental device), were evaluated for biomechanical strength. A fatigue test for the screw, compressive, and torsional tests for the pedicle screw systems and a pull-out test of the pedicle screw were done. Even the Schanz screw, which showed the highest endurance limit, may be broken under the continuous loading condition in the body. The AO Fixator Interne and Steffee plate system themselves are rigid and are indicated for injuries that need reduction. The Luque ISF, modified Zielke, and Chiba-type plate screw systems, however, are indicated for degenerative lumbar disease requiring in situ fusion. There was a linear positive correlation between the bone mineral density of the vertebral body and the pull-out strength of the pedicle screw (correlation coefficient, 0.68). The fixation strength of the pedicle screw to the bone decreased remarkably in osteoporosis.

Biomechanical Phenomena↗