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Biomedical subjects

H Tateishi

Publications and source records attributed to H Tateishi.

At least 73 records · Page 4Linked to original sources
PubMed1993

Clinical experience of ceramic cementless total knee arthroplasty in RA and a histological study of the bone-ceramic interface in revision cases.

The Kyoto total knee cementless prosthesis (KC-1) was used in 23 patients with rheumatoid arthritis. Its femoral component is made of alumina ceramics which articulated with a HDP plate supported by a ceramic plate. Although the followup period is short, the postoperative result is not satisfactory, because remarkable sinking of the tibial component was noticed in those patients who have bone atrophy. We had 6 cases of revision so far. Since 1986, we have been using bone cement in all cases of RA in doing TKA.

Adult↗
PubMed1993

[Studies on combination therapy with TAE and percutaneous ethanol injection therapy for unresectable hepatocellular carcinoma].

We studied and analysed the effects of combination therapy with TAE and PEIT for unresectable HCC. The subjects were 28 patients (21 males, 7 females) with 31 tumors treated in the Department of Surgery, Osaka Teishin Hospital. The patients were divided into four groups on the basis of the tumor size (< 3 cm, 3-5 cm, 5-8 cm, > 8 cm). The therapeutic effect on the tumors was evaluated on the basis of the maximum reduction rate within 3 months after TAE and PEIT. The response rates after treatment were 87.5%, 60.0%, 25.0% and 0% for < 3 cm, 3-5 cm, 5-8 cm, and > 8 cm tumor size, respectively. The 50% survival period was 50.9 months. The 1-, 2-, 3- and 5-year survival rates were 92%, 76%, 52% and 32%, respectively. In the cases of over 8 cm, this combination therapy had no effects on the survival period. The findings of the present study suggest that the combination therapy was useful for the unresectable HCC of under 5 cm in diameter.

Carcinoma, Hepatocellular↗
PubMed1992

Physical parameters in Japanese newborns.

A total of 19 physical parameters of the head, face, chest, and the fingers were examined in Japanese 50 male and 50 female newborns, measured 8 to 64 hr after birth. Exceptional values were excluded referring to the estimated mean and standard deviations. Normal values are presented as mean +/- 2 S.D. for each sex. As compared with Caucasian newborns, the Japanese newborns showed longer inner canthal and shorter outer canthal distances, shorter ear lengths, and longer palm and middle finger lengths.

Anthropometry↗
PubMed1992

Reverse flow in the intracranial arteries--the possible significance of comparative flow in the anterior cerebral and the basilar arteries.

Four infants with reverse flow patterns of the intracranial arteries are reported. Two with severe brain damage, had a reverse flow pattern in the anterior cerebral artery, which was recorded during the recovery stage from cardiac arrest. The other two patients showed a reverse flow pattern in the basilar artery and had a good prognosis. Reverse flow in the anterior cerebral artery suggests severe brain damage, but that in the basilar artery does not.

Basilar Artery↗
PubMed1992

Effects of intraaortic balloon pumping on coronary hemodynamics after coronary angioplasty in patients with acute myocardial infarction.

It has been reported that intraaortic balloon pumping can prevent reocclusion after coronary angioplasty for acute myocardial infarction. The speculated mechanism has been the production of markedly enhanced diastolic coronary perfusion pressure; however, most studies have reported that intraaortic balloon pumping has little effect on coronary blood flow. To assess the effectiveness of this procedure, we studied 12 patients with acute anterior myocardial infarction who were undergoing coronary angioplasty and intraaortic balloon pumping. After successful angioplasty, coronary blood flow velocity was measured with a coronary Doppler catheter before and during intraaortic balloon pumping. Although mean coronary blood flow velocity was unchanged, intraaortic balloon pumping increased peak coronary blood flow velocity from 34.6 +/- 5.0 cm/sec (mean +/- SEM) to 46.7 +/- 5.8 cm/sec (p < 0.005). Such an increase in peak coronary blood flow velocity seemed to be a mechanism by which intraaortic balloon pumping could prevent reocclusion after coronary angioplasty for acute myocardial infarction.

Angioplasty, Balloon, Coronary↗
PubMed1992

Siblings of 21-hydroxylase deficiency (non-salt-losing) with aldosterone hypersecretion.

We describe siblings with the non-salt-losing form of 21-hydroxylase deficiency who had hypersecretion of aldosterone and plasma renin activity (PRA). Blood pressure and serum electrolytes in both cases were normal despite the aldosterone hypersecretion. Aldosterone secretion was elevated markedly with ACTH administration and with sodium deprivation and/or volume depletion during ACTH suppression by dexamethasone. With suppression by dexamethasone, aldosterone hypersecretion was decreased with lowering of the steroids proximal to the block in the biosynthetic pathway. However, urinary sodium excretion was decreased. These results suggest that the biosynthetic pathway for aldosterone production was preserved. Furthermore, aldosterone hypersecretion and high PRA may serve to compensate for the sodium loss which results in turn from the overproduction of the sodium-losing steroids, such as progesterone and 17 alpha-hydroxyprogesterone which are aldosterone antagonists.

Adolescent↗
PubMed1992

[Complications of emergency coronary angioplasty for acute myocardial infarction].

To assess the incidence and consequences of complications occurring during emergency percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI), we studied 347 patients who underwent PTCA within 24 hours after the onset of AMI. Acute occlusion occurred in 29 patients (8.4%), of whom 16 patients underwent successful repeat PTCA. All of them survived until hospital discharge. The in-hospital reocclusion rates of these 16 patients were comparable to those of patients who had not experienced acute occlusion (18.8 vs 12.8%, ns). In the remaining 13 patients, reperfusion were not successful after acute occlusion, and 6 died. Side branch occlusion occurred in 21 patients (6.1%). Left circumflex artery occlusion occurring during PTCA for the proximal left anterior descending artery was fatal in 3 patients. Right ventricular branch occlusion during PTCA for the middle of the right coronary artery resulted in intractable right ventricular infarction in one patient, and he died. Among 14 patients who underwent repeat angiography, 13 had a patent side branch which had been occluded during PTCA. One patient had coronary rupture and died. During PTCA of the proximal left anterior descending artery, acute occlusion of the artery without reperfusion or occlusion of the left circumflex artery was often fatal. However, the prognosis of acute occlusion was relatively good, if repeat PTCA was successful and most of the occluded side branches remained patent in the chronic state.

Aged↗
PubMed1992

Pathologic fracture associated with amyloid deposition in the bone of a chronic hemodialysis patient. A case report.

A 63-year-old male who had been on hemodialysis for 14 years developed extensive amyloid deposition in the femoral head and neck that, after a fall, resulted in a femoral neck fracture. The plasma level of beta 2-microglobulin in this patient was elevated, and bone specimens from the fracture site demonstrated positive Congo-red staining, suggesting an association with amyloid deposition.

Amyloidosis↗
PubMed1991

Intraaortic balloon pumping as the postangioplasty strategy in acute myocardial infarction.

To assess the usefulness of intraaortic balloon pumping (IABP) in acute myocardial infarction (AMI), 114 patients with anterior AMI undergoing emergency percutaneous transluminal coronary angioplasty (PTCA) for total occlusion of the left anterior descending artery were studied. After successful PTCA 66 patients were treated with conventional therapy (group I), and 48 patients were treated with IABP for 25 +/- 8 hours (group II). The reocclusion rate was significantly lower in group II (2.4% vs 17.7% p less than 0.05). An increase in ejection fraction in group II compared with group I was marginally significant (4.5 +/- 12.2% vs 9.2 +/- 13.0%, p = 0.08). Vascular complications occurred in two patients, but there were no deaths from IABP. These results suggest that after successful PTCA for acute myocardial infarction, IABP prevents reocclusion and may add strength to reperfusion in the improvement of left ventricular function.

Angioplasty, Balloon, Coronary↗
PubMed1991

A long-term follow-up study of unicompartmental replacement with a Marmor knee prosthesis and the introduction of a new ceramic prosthesis.

Unicompartmental replacement with a Marmor knee prosthesis was performed in 53 patients with unicompartmental osteoarthritis (OA). A five year or longer follow-up study of 15 joints in 13 of these patients was possible, three of which are now more than 10 years post-operative. All 13 patients reported absence of pain on weight-bearing and were able to flex the replaced knee more than 105 degrees. However, the postoperative femorotibial angle (FTA) appeared to be worsening with time, especially in those cases with an immediate postoperative FTA of more than 180 degrees. Since the needed size of the Marmor prosthesis is no longer available, we began using a ceramic prosthesis recently which we are introducing in this article.

Aged↗
PubMed1991

[Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases].

Five patients with typical myocardial stunning were presented. They had chest pain and had electrocardiographic abnormalities matching the symptoms of acute myocardial infarction (AMI) but had no coronary artery stenoses on angiogram (CAG). The prevalence of cases with these clinical manifestations was 1.2% among 415 consecutive AMI patients who were examined invasively. The electrocardiographic abnormalities varied; ST elevations were observed in 4 patients, R waves decreased transiently in one, and Q waves developed in one patient. Typical left ventriculogram (LVG) was akinesis in the apical, diaphragmatic and/or anterolateral segments, but hyperkinesis in the basal segments. This akinesis was transient and resolved in 7 days. CAG revealed diffuse multi-vessel spasms in 2 patients, which were also observed in additional 2 patients after ergonovine administration. The intracoronary administration of nitroglycerin disclosed no coronary artery stenoses in any of the patients.

Aged↗
PubMed1991

[Long-term prognosis after reperfusion therapy with emergency coronary angioplasty for acute myocardial infarction].

The influence of emergency coronary angioplasty (PTCA) for acute myocardial infarction on long-term survival was investigated. We followed 141 patients treated with emergency PTCA and 202 patients treated with thrombolytic therapy alone for a median of 1,157 days and a median of 2,133 days, respectively. All were initially completely occluded at the infarct-related coronary artery (IRCA). Actuarial survival curves were compared and independent predictors of late cardiac death were determined using Cox's proportional hazard model between overall patients and patients whose IRCA was at the proximal site of the left anterior descending artery (LAD). 1. Actuarial survival curves were similar in 2 groups. 2. Independent predictors of late cardiac death in overall follow-up patients were advanced age over 65 years (p < 0.03), a history of previous myocardial infarction (p < 0.03), severer stage of the Killip class on admission (p < 0.003), and the infarct-related proximal LAD (p < 0.01). 3. Among patients with the proximal LAD, the actuarial survival curve was better in those treated with emergency PTCA than in those treated with thrombolytic therapy alone (p < 0.01). 4. Among patients with the proximal LAD, independent predictors of late cardiac death were advanced age over 65 years (p < 0.03), treatment with thrombolytic therapy alone (p < 0.03), left ventricular ejection fraction < or = 40% (p < 0.06), and occluded IRCA on predischarge angiograms (p < 0.08). Among patients with the occluded proximal LAD, those treated with emergency PTCA showed better long-term survival rate than did patients with thrombolytic therapy alone, and this may be explained by higher successful reperfusion rates in the former than in the latter.

Aged↗
PubMed1991

[Prediction and prevention of reocclusion after coronary thrombolysis for acute myocardial infarction based on analysis of the coronary morphology with angiography].

Morphology of the affected coronary artery in acute myocardial infarction was qualitatively analyzed to predict the incidence of reocclusion after intracoronary thrombolysis. In 274 patients with 75% or more residual stenosis after successful thrombolysis, the morphology of the stenosis underlying the acute thrombus was graded as 75% or more (type A, n = 195), or less than 75% (type B, n = 79). Eighty-one patients with type A stenosis and 39 of 79 patients with type B stenosis were treated with immediate PTCA following thrombolysis. In 154 patients treated without PTCA, the severity of type A stenosis on chronic angiography remained unchanged after thrombolysis (87 +/- 7%-->86 +/- 14%); whereas, regression of the stenosis was noted in patients with type B stenosis (85 +/- 6%-->53 +/- 32%, p < 0.001). After thrombolysis, reocclusion occurred in 31 of 117 patients with type A stenosis, but in only 2 of 40 patients with type B stenosis (26.5% vs 5.0%, p < 0.02). Reocclusion was prevented by PTCA in patients with type A stenosis (26.5% vs 8.6%, p < 0.01), but not in patients with type B stenosis (5.0% vs 10.3%, p = ns). Qualitative analysis of coronary morphology after thrombolysis can facilitate the prediction of the occurrence of reocclusion and may provide a framework for selection of therapy.

Angioplasty, Balloon, Coronary↗
PubMed1991

[Quantitative evaluation of right ventricular function by transesophageal echocardiography: report of a case with classical right ventricular infarction].

We were able to diagnose right ventricular infarction (RVI) by transesophageal echocardiography (TEE) in a patient with acute inferior infarction, and it was confirmed by cardiac catheterization. To evaluate right ventricular (RV) function quantitatively, area shortening (AS) and regional AS (rAS) were measured from RV images obtained by TEE. The AS correlated with RV ejection fraction obtained by radionuclide angiography (r = 0.72). The patient with RVI showed depressed RV function by AS measurement with decreased rASs of all regions in the acute phase. In the chronic phase, RV function of the patient improved, especially in the region of the ventricular septum and apex regions. These results indicate availability of TEE and that RV function can be evaluated by TEE.

Aged↗
PubMed1991

[A clinical study of the relation between time to reperfusion and infarct size].

Observations made in animal models of reperfusion in acute myocardial infarction have shown that early reperfusion results in myocardial salvage. But the relation between the time of reperfusion and myocardial salvage is not clear in human patients. If earlier reperfusion provides smaller infarct size, reperfusion therapy initiated in the first 1 hour should be the most beneficial. In this study, we compared the results of therapy initiated in the first 1 hour (group A, n = 19) with treatment started 1 to 24 hours after the onset of chest pain (group B, n = 652). The infarct location, development of collateral vessels, number of diseased vessels and reperfusion rate of thrombolysis in the two groups didn't differ. There was a statistically insignificant trend towards total occlusion of the infarct artery in group A (89.5% vs 69.7%, p less than 0.1). Peak CPK and changes in left ventricular ejection fraction (delta EF) were assessed in patients with total occlusion of the left anterior descending artery and successful reperfusion (n = 8 in group A, n = 120 in group B). There was no difference in peak CPK (3281 +/- 2192Iu/l vs 3490 +/- 1811Iu/l) and delta EF (6.3 +/- 17.1% vs 5.8 +/- 11.9%). These findings suggest that there is no relation between the time of reperfusion and myocardial salvage in human patients.

Coronary Angiography↗
PubMed1990

[Acute myocardial infarction with patent infarct-related artery: selection of treatment based on qualitative analysis of coronary angiograms during the acute phase].

To evaluate the benefit of emergency coronary angioplasty (PTCA) among patients with acute myocardial infarction having patent infarct-related arteries, we investigated 104 patients who received thrombolysis and/or PTCA within 24 hrs after onset of symptoms. The morphology of coronary artery lesions was qualitatively assessed by angiography and categorized as symmetrical or asymmetrical narrowing with smooth margins (S-group, 72 cases) and asymmetrical narrowing in the form of convex intraluminal obstruction representing a thrombus (T-group, 32 cases). Soon after intervention, angiographic success (residual stenosis less than 75%) was achieved in 85% with PTCA (92% in the T-group vs 82% in the S-group) and in 29% without PTCA (53% vs 16%). At hospital discharge, the figures were 82% with PTCA (75% vs 87%) and 43% without PTCA (73% vs 30%). The incidence of re-infarction and/or total occlusion of the infarct-related artery was 9% with PTCA in both the T- and S-groups but 26% in those without PTCA (6% in the T-group vs 31% in the S-group). These data suggest that in patients with patient infarct-related arteries and severe original stenosis, PTCA has an advantage over thrombolysis alone. Qualitative analysis of coronary morphology by angiography provides a framework for selecting adequate therapy.

Adult↗
PubMed1990

[Distinctive response of coronary artery compared acute myocardial infarction with angina pectoris associated with angioplasty].

There has been much controversy over the mechanism of successful percutaneous transluminal coronary angioplasty (PTCA). To examine clinical and angiographic factors that might be related to a successful PTCA, we assessed 224 branches treated with emergent or elective angioplasty in evolving acute myocardial infarction (AMI) and angina pectoris (AP). The patients were divided into three groups; group 1 (G1): AP (n = 113), group 2 (G2): AMI with complete obstruction of infarct-related artery (IRA) (n = 79), group 3 (G3): AMI with incomplete obstruction of IRA (n = 32). The morphology of stenotic lesion was classified into smooth type and irregular type. The former shows concentric smooth border, the latter shows eccentric irregular border and multiple irregular border according to the Ambrose classification. Regarding the severity of the stenosis immediately after successful PTCA, there was no significant differences between G2 and G3, however in G1 it was significantly higher than in other groups (G1 vs G2 vs G3, 56% vs 81% vs 78%, p less than 0.001). Irregular type at stenotic lesions before PTCA were present in 72 of 113 branches in G1 vs 60 of 69 in G2 and G3. Regarding the incidence of acute coronary obstruction during PTCA, there was no significant differences between G1 and G2. However, in G3 it was significantly higher than in other groups (G1 vs G2 vs G3, 8% vs 9% vs 38%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗