Biomedical subjects

H Yoshitomi

Publications and source records attributed to H Yoshitomi.

At least 19 recordsLinked to original sources

PubMed2006

Efficacy of computer-assisted pedicle screw insertion for cervical instability in RA patients.

We evaluated the efficacy of the computer-assisted cervical pedicle screw insertion, compared with those inserted without the help of the system on the cervix of rheumatoid arthritis (RA) patients. Eighty-six cervical pedicle screws were inserted without the help of the system. Of the 86, 59 screws were in non-RA patients with degenerative spine, and 27 were in RA patients. The accuracy of the screw insertions was evaluated by a CT-based method. Then, 25 screws were inserted with the system into the cervical spines between C2 and C6 in RA patients (Navigation group). The efficacy of the system was assessed by the CT-based method, compared with 27 screws inserted without the system (Conventional group). The screws in RA patients tended to be more deviated than those in non-RA patients. In Conventional group, four screws (15%) were placed far laterally, and two (7%), far medially. In contrast, no screw was placed far laterally or medially in Navigation group (P < 0.05).

Adult↗

PubMed2006

[Assessment of surgery for stage IV non-small cell lung cancer].

We assessed the survival of surgery for stage IV non-small cell lung cancer. Forty-two patients were operated on lung cancer for stage IV from 1986 to 2005. Overall median survival time (MST) was 12.3 months and 5-year survival rate was 9.8%. There was significant difference in survival between pulmonary metastasis (pm2) and other sites metastasis (p<0.05). In pm2 patients there was significant difference between ipsilateral metastasis and contralateral metastasis (MST 21.9 months, 2-year survival rate 48.6%, 5-year survival rate 21.6% and MST 12.3 months, 2-year survival rate 0%) [p<0.05], and between complete resection and incomplete resection (MST 36 months, 2-year survival rate 64.8%, 5-year survival rate 28.8% and MST 12.3 months, 2-year survival rate 0%) [p<0.01]. In patients with brain metastasis, surgery of brain metastasis was better prognosis than radiation therapy (MST 12.5 months, 3-year survival rate 33.3% and MST 8.3 months, 2-year survival rate 0%) [NS].

Aged↗

PubMed2006

[A study of high-resolution computed tomography (HRCT) findings of resected small pulmonary nodules 2 cm or less in diameter with reference to the malignant nature].

To identify the characteristics of peripheral small lung mass lesions on high-resolution computed tomography (HRCT) and discriminate between malignant and benign, 223 mass lesions 2 cm or less resected surgically were evaluated about following points. 1) Density : 90.7% of lesions with mixed solid and ground-glass opacity (GGO) components were adenocarcinomas. Pure GGO lesions without scale-down between several months were all adenocarcinomas or atypical adenomatous hyperplasia (AAH). Thereby, patients with these findings are good candidates for surgical resection. 2) Spicular or pleural indentation :75.2% (88 of 117 cases) of adenocarcinomas and all squamous cell carcinomas (18 cases) showed these findings, but 26.6% (41 of 154 cases) of positive cases were benign lesion (non-specific inflammation, mycobacterisis, and so on). Accordingly, they are not peculiar to malignancy. 3) Satellite lesion : all lesions with this one showed benign, therefore it was thought that this finding could exclude malignant lesion. Thus, recognition of certain characteristics at HRCT can be helpful in discrimination between small malignant mass and benign mass.

Adenocarcinoma↗

PubMed2005

[The effect of multimodality induction therapy for locally advanced non-small cell lung cancer].

In this study we analyzed induction therapy for locally advanced non-small cell lung cancer. Eligible patients had mediastinoscopic proven N2 disease and T4 with mediastinal involvement. From January 1997 to May 2005, 56 patients entered the study. They received 2 cycle chemotherapy (platinums based 2 or 3 drugs), in 32 patients with concurrent radiotherapy followed by surgery. Response rates were 57.1%. Fifty-one patients underwent surgery. A radical resection was possible in 39 patients. Complication occurred in 14 patients (27.5%). Overall 5-year survival was 27.5%. In N2 disease, there was no statistically significant difference in survival between the induction group and the historical group. In T4 disease, overall 5-year survival was 30.2% for the induction group and 5.2% for historical group. There was significant difference in survival between the groups (p < 0.05).

Adult↗

PubMed2001

Liver organogenesis promoted by endothelial cells prior to vascular function.

The embryonic role of endothelial cells and nascent vessels in promoting organogenesis, prior to vascular function, is unclear. We find that early endothelial cells in mouse embryos surround newly specified hepatic endoderm and delimit the mesenchymal domain into which the liver bud grows. In flk-1 mutant embryos, which lack endothelial cells, hepatic specification occurs, but liver morphogenesis fails prior to mesenchyme invasion. We developed an embryo tissue explant system that permits liver bud vasculogenesis and show that in the absence of endothelial cells, or when the latter are inhibited, there is a selective defect in hepatic outgrowth. We conclude that vasculogenic endothelial cells and nascent vessels are critical for the earliest stages of organogenesis, prior to blood vessel function.

Animals↗

PubMed2001

Bilateral phrenic nerve palsy as a complication of anterior decompression and fusion for cervical ossification of the posterior longitudinal ligament.

STUDY DESIGN: A case report of bilateral phrenic nerve palsy as a complication of anterior decompression and fusion for cervical ossification of the posterior longitudinal ligament (OPLL). OBJECTIVES: To present a case of a rare and serious complication of cervical spinal surgery and to investigate its cause. SUMMARY OF BACKGROUND DATA: There have been a number of reports of phrenic nerve palsy after cardiac surgery, but the authors have found no previous description of this complication related to spinal surgery. METHODS: The authors describe the clinical presentation and management of a case of bilateral phrenic nerve palsy subsequent to the surgery for cervical OPLL. Also, the literature is reviewed concerning surgical approaches for the treatment of OPLL and the occurrence of phrenic nerve palsy subsequent to any form of therapy. RESULTS: Bilateral phrenic nerve palsy occurred after anterior decompression and fusion for cervical OPLL. Bilateral phrenic nerve palsy was diagnosed radiographically: postoperative chest radiograph showed bilateral laxity of the diaphragm. Movement of the bilateral diaphragm appeared 3 weeks after surgery. The patient successfully returned to normal daily life after ventilatory support for 3 months, although nocturnal oxygen support was still necessary at the latest follow-up, 3 years after surgery. The possible causes of this complication include bilateral C4 nerve root stretching, iatrogenic injury of the gray matter in the ventral horn, alteration of blood circulation related to spinal edema, or re-impingement on the spinal cord at the cranial part of the decompression site. CONCLUSIONS: Bilateral phrenic nerve palsy occurred after anterior decompression and fusion for cervical OPLL. Bilateral phrenic nerve palsy should be kept in mind as a serious complication of spinal surgery. It should be considered when patients unexpectedly fail to wean from the ventilator after surgery.

Cervical Vertebrae↗

PubMed2001

Multidrug resistance gene (MDR-1) expression as a useful prognostic factor in patients with human hepatocellular carcinoma after surgical resection.

BACKGROUND: Multidrug resistance gene (MDR-1) overexpression has been correlated with tumor aggressiveness and worse prognosis in some human neoplasms. The aim of this study is to evaluate the clinical value of MDR-1 mRNA expression as a prognostic factor after surgical resection in human hepatocellular carcinoma (HCC). METHODS: MDR-1 mRNA levels in tissue samples from 34 patients with HCC, who underwent surgical resection, were measured by quantitative northern blot analysis. We stratified these patients into two groups according to a ratio of MDR-1 mRNA levels of HCC to nontumorous tissue; MDR-1 mRNA ratio > or = 1.0 and < 1.0. The overall and disease-free survival rates were analyzed using multivariate regression analysis. RESULTS: The median survival periods were 10.3 and 35.8 months for patients with the MDR-1 mRNA ratio > or = 1.0 and < 1.0, respectively, and the corresponding 5-year survival rates were 33 and 54%, respectively, P < 0.05. The multivariate analysis revealed that TNM stage and MDR-1 mRNA ratio were independent factors for predicting overall survival after surgical resection. CONCLUSION: This study suggested that the measurement of the MDR-1 mRNA levels in HCC and nontumorous liver tissue might be a useful prognostic factor after surgical resection in patients with HCC.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2001

Cycling treatment of anaerobic and aerobic incubation increases the content of gamma-aminobutyric acid in tea shoots.

Gamma-Aminobutyric acid (GABA), a hypotensive compound, is formed from glutamic acid under anaerobic condition in tea shoots. Glutamic acid was exhausted in the first three hours of anaerobic incubation and the increase of GABA stopped. After that, when tea shoots were released under aerobic condition, glutamic acid reproduced rapidly. After one hour of aerobic incubation, tea shoots were given three hours of anaerobic incubation again and then accumulated glutamic acid changed to GABA. The content of GABA increased much more than usual anaerobic incubation. GABA was more in the tea stem than in the leaf.

Aerobiosis↗

PubMed2001

Simultaneous determination of glycyrrhizin, glycyrrhetic acid and glycyrrhetic acid mono-glucuronide in Shakuyaku-kanzo-to incubated with rat feces by semi-micro high-performance liquid chromatography.

A method for semi-micro high-performance liquid chromatography (HPLC) has been established for the simultaneous determination of glycyrrhizin (GL), glycyrrhetic acid (GA) and glycyrrhetic acid mono-glucuronide (GAMG) in incubation mixtures of rat feces with Shakuyaku-kanzo-to decoction (combination of licorice root and peony root). The analysis could be accomplished within 20 min with a TSKgel ODS-80TsQA (150 x 2.0 mm i.d.) column by linear gradient elution using a mobile phase containing aqueous phosphoric acid and acetonitrile at a flow rate of 0.2 ml x min(-1), a thermostatic oven at 25 degrees C, and detection at 254 nm. The detection limits of these compounds were 0.1-0.85 pmol per injection (5 microl). The concentrations of GL and its metabolites in the incubation mixture after continuous consumption of Shakuyaku-kanzo-to were significantly different compared with those of untreated control. GL-hydrolysis of rat feces was enhanced by pre-consumption of Shakuyaku-kanzo-to.

Anaerobiosis↗

PubMed2001

Doppler echocardiography-derived index of myocardial performance (TEI index): comparison with brain natriuretic peptide levels in various heart disease.

Plasma brain natriuretic peptide (BNP) has diagnostic and prognostic value in heart failure. Cardiac dysfunction varies from systolic or diastolic dysfunction alone to the combination of both. In the present study, Doppler echocardiographic parameters, including the Doppler echocardiography-derived index (TEI index), were compared with plasma BNP levels in 74 patients with various heart diseases. Blood sampling was performed before an echocardiographic examination was conducted. The TEI index was defined as the summation of isovolumic contraction and relaxation time divided by ejection time. In patients with left ventricular (LV) systolic dysfunction (ejection fraction <50%), the TEI index and BNP were increased significantly compared with patients with normal LV systolic function (p<0.05). Patients with a TEI index > or =0.45 showed significantly increased BNP levels compared with patients with a TEI index <0.45, irrespective of LV systolic function (241.4+/-451.2 vs 65.9+/-81.8pg/ml; p<0.05). The TEI index was significantly higher in patients with a BNP > or =73pg/ml than in patients with BNP <73pg/ml (0.57+/-0.24 vs 0.46+/-0.17; p<0.05). Other echocardiographic parameters did not correlate significantly with levels of plasma BNP. Of the echocardiographic parameters, a simple Doppler index (TEI index) that combines systolic and diastolic function can detect LV dysfunction in patients with high levels of plasma BNP in various heart diseases.

Adolescent↗

PubMed2001

Drop in plasma brain natriuretic peptide levels after successful direct current cardioversion in chronic atrial fibrillation.

BACKGROUND: According to previous reports, plasma atrial natriuretic peptide levels increase in atrial fibrillation (AF) and decrease after successful direct current (DC) cardioversion, but there have been no reports on plasma brain natriuretic peptide (BNP). OBJECTIVE: To determine whether plasma BNP levels decrease after successful direct DC cardioversion in patients with chronic AF. PATIENTS AND METHODS: Twenty patients who remained in sinus rhythm for at least seven days after cardioversion, and 20 normal control subjects, were studied. Group A consisted of 10 patients with underlying heart disease, including dilated cardiomyopathy (n=2), hypertrophic cardiomyopathy (n=1), mitral valve disease (n=3), hypertensive heart disease (n=3) and status after atrial septal closure (n=1). Group B consisted of 10 patients with just AF. Group C (serving as controls) comprised 20 subjects with normal sinus rhythm and no risk factors. RESULTS: Before cardioversion, plasma BNP levels were higher in group A (176.7+/-128.1 ng/mL) and in group B (96.8+/-51.7 ng/ml) than in group C (6.3+/-3.8 ng/ml) (P<0.01 for all). After successful cardioversion, mean plasma BNP levels in groups A and B decreased from 136.8+/-105.5 ng/mL to 46.4+/-44.2 ng/mL (P<0.01). In group A, plasma BNP levels decreased from 176.7+/-128.1 ng/mL to 62.5+/-54.6 ng/mL (P<0.01), and in group B, plasma BNP levels decreased from 96.8+/-51.7 ng/mL to 30.3+/-23.8 ng/mL (P<0.01). CONCLUSIONS: Lone AF raises plasma BNP levels, which is more marked if there is underlying structural heart disease present, and cardioversion reduces plasma BNP levels. Therefore, high plasma BNP levels in patients with chronic AF are likely to be caused by AF and reflect cardiac overloading associated with, although contributed to in part by, underlying heart diseases.

Adult↗

PubMed2000

Fatal cardiac rupture: a case of subepicardial aneurysm after myocardial infarction.

We report a case in which 2-dimensional echocardiography established the diagnosis of a left ventricular subepicardial aneurysm that was followed by rupture and sudden death before surgery. Two-dimensional echocardiography is of great help in detecting this rare complication after myocardial infarction. Urgent surgical treatment is warranted for this condition.

Aged↗

PubMed2000

Application of fibroin in controlled release tablets containing theophylline.

The applicability of fibroin, a major silk protein, to controlled release type dosage tablets was investigated in vitro and in vivo. Fibroin tablets containing theophylline were easily prepared by a direct compression method without additives. Five types of fibroin tablets with the same surface area and different amounts of theophylline were prepared. In an in vitro drug study, the drug release from the tablets was not affected by the pH of the release medium. The greater the fibroin content in the tablets, the lower the percentage released at time t. The Higuchi plots of the release data showed a linear release profile, indicating that the drug release from the fibroin tablets was diffusion-controlled through the matrix. Theophylline powder or a TF-41 tablet (theophylline: fibroin=4 : 1), or a commercial tablet, Uniphyl (once-a-day type) was administered to 5 healthy volunteers. The areas under the saliva theophylline concentration-time curve (AUC) of Uniphyl and TF-41 to that of powder were 85% and 70%, respectively (fasted). Conversely, the mean residence time and mean absorption time of TF-41 were long compared to Uniphyl (fasted). Therefore, the reduction of bioavailability in TF-41 was due to the delayed release from the tablets in vivo. Taken after a meal, the AUCs of TF-41 and Uniphyl increased and the absorption was completed. This suggested that the drug release from TF-41 may increase due to the stimulation of food on TF-41 itself and due to movement of the gastro-intestinal tract. In conclusion, fibroin could be used as the matrix in controlled-release tablets.

Adult↗

PubMed1999

Mechanism of ubiquitous expression of mouse uncoupling protein 2 mRNA: control by cis-acting DNA element in 5'-flanking region.

Uncoupling protein (UCP) 2 is a member of the uncoupling-protein family, and it appears to function as an uncoupler of oxidative phosphorylation. To identify cis-acting regulatory elements controlling this gene's expression, we cloned an approx. 6.2-kb region upstream from the translation-initiation site of the mouse UCP2 gene and analysed its transcription activity using chimaeric mouse UCP2 promoter-placental-alkaline-phosphatase (PLAP) reporter-gene constructs. Sequence analysis showed that the 5'-flanking region of the mouse UCP2 gene was not similar to those of mouse UCP1 or UCP3. For the mouse UCP2, the region near the transcription-initiation site lacked the typical TATA box, but was GC-rich, resulting in presence of several potential specificity protein 1 (Sp-1), activator protein (AP)-1 and AP-2 binding sites. The putative regulatory motifs for muscle-regulatory protein (MyoD), brown-fat regulatory element, CCAAT box, cAMP-response element and Y box were also found in the mouse UCP2 promoter region by computer-assisted analysis. From the results of Northern-blot analysis and transient expression assay, we found that the mouse UCP2 gene responded to the cAMP-dependent protein kinase alpha-catalytic subunit signal activation at the transcription level. Additionally, deletion analysis of the UCP2 promoter-PLAP constructs indicated that the minimal region exhibiting the promoter activity was located between nt -33 and +100, and that a strong enhancer was present within 601 bp of the 5'-promoter region. In particular, the region from nt -233 to -34 significantly induced PLAP activity in the cell lines derived from various tissues and in the primary culture cells of rat brown adipose tissue, suggesting that this region is most important for the ubiquitous expression of mouse UCP2 mRNA. Furthermore, it was shown that two silencer elements were involved in the mouse UCP2 gene; one was located between nt -2746 and -602, and the other was identified in intron 1. These regions deprived the enhancer of the ability to induce PLAP activity. This study shows a fundamental role for positive and negative cis-acting DNA elements in regulating the basal and cAMP-induced transcription activity of the mouse UCP2 gene.

3T3 Cells↗

PubMed1999

Aggressive surgical resection for hepatic metastases involving the inferior vena cava.

BACKGROUND: The implications of aggressive surgical approaches for hepatic metastases involving the inferior vena cava (IVC) have not been clarified yet. The aim of this study is to assess the preliminary results of aggressive surgical resection for hepatic metastases involving the IVC. METHODS: Sixteen patients with hepatic metastases involving the IVC underwent surgical resections with the repair and reconstruction of the IVC: patch repair in 2 and ringed Goretex in 1, primary closure in 13 patients. Hepatic metastases were from colorectal cancer in 14, stomach cancer in 1, and uterine cancer in 1 patient. RESULTS: Vascular control utilized for resecting the IVC were total hepatic vascular exclusion in 8, hypothermic isolated hepatic perfusion in 3, and side clamp in 5 patients. The combined IVC resection with hepatectomy in 16 patients brought about 25% and 6% surgical morbidity and mortality rates, respectively. Survival rates following surgical resections were 64%, 33%, 33%, 22%, 22% for 14 patients of colorectal metastases involving the IVC as compared with 82%, 58%, 41%, 37%, 27% at 1, 2, 3, 4, 5 years, respectively, for 154 patients of colorectal metastases not involving the IVC. CONCLUSION: Hepatic metastases involving the IVC could be safely resected without an increase in surgical risk. Aggressive surgical approaches might bring about a favorable outcome in select patients with colorectal hepatic metastases involving the IVC.

Adult↗

PubMed1999

Simultaneous determination of ephedrine, pseudoephedrine, norephedrine and methylephedrine in Kampo medicines by high-performance liquid chromatography.

A simultaneous high-performance liquid chromatographic method for the determination of ephedrine, pseudoephedrine, norephedrine and methylephedrine (ephedrine alkaloids) in Kampo medicines which contain Ephedrae Herba was established. The analysis can be accomplished within 25 min with a Wakosil-II 5C18 HG column by isocratic elution using a mixture of water, acetonitrile and sodium dodecyl sulfate (65:35:0.4) as the mobile phase at a flow-rate of 1.0 ml min(-1), and detection at 210 nm. The detection limits of ephedrine alkaloids are 0.37-1.06 microM per injection (5 microl). This method was applied to analyze the quantities in eight Kampo decoctions; Mao-to, Makyo-yokukan-to, Makyo-kanseki-to, Yokuinin-to, Sho-seiryu-to, Keima-kakuhan-to, Kakkon-to and Kakkon-to-ka-senkyu-sin'i. The concentration (per Ephedrae Herba gram) of ephedrine alkaloids was higher in the Makyo-kanseki-to decoction than in the others. Calcium sulfate from Gypsum Fibrosum raised ephedrine alkaloids dissolution in the Makyo-kanseki-to decoction.

Central Nervous System Stimulants↗

PubMed1999

Enhanced polymorphonuclear neutrophil-mediated endothelial cell injury and its relation to high surgical mortality rate in cirrhotic patients.

OBJECTIVE: A high incidence of complications has been documented in patients with cirrhosis after operations. Recently, polymorphonuclear neutrophils (PMN) have been revealed to have the capacity to injure vascular endothelium and to cause organ damage. Furthermore, the altered function of PMN has been shown in patients with cirrhosis. However, there are few reports investigating the interaction between PMN and endothelial cells and its relation to a high incidence of postoperative complications in cirrhosis. The aim of this study was to evaluate PMN-mediated endothelial cell injury in patients with cirrhosis. METHODS: Patients were divided into two groups: those who had normal liver with metastatic liver carcinoma and those who had cirrhosis with hepatocellular carcinoma. All patients in both groups underwent hepatic resection. PMN were isolated from patients before operation. Human umbilical vein endothelial cells and PMN were cocultured after addition of phorbol myristate acetate. The release of lactate dehydrogenase (LDH) and thrombomodulin in the cocultured medium and the elastase activity in PMN suspension were measured. RESULTS: The release of both LDH and thrombomodulin in the group with cirrhosis was significantly higher than in the group with normal liver. The elastase activity was similarly higher in the group with cirrhosis than in the group with normal liver. The surgical morbidity rate was remarkably higher in the group with cirrhosis (50%) than in the group with normal liver (0%). CONCLUSIONS: This study shows that PMN have an enhanced potential to cause endothelial cell injury in patients with cirrhosis. This PMN "priming" may be responsible for the occurrence of postoperative complications in patients with cirrhosis after hepatectomy.

Adult↗

PubMed1999

Sustained release liquid preparation using sodium alginate for eradication of Helicobacter pyroli.

We prepared a new liquid preparation for eradication of Helicobacter pylori (HP), and examined drug release in vitro and in vivo. The liquid preparation mainly consisted of a sodium alginate (AG) aqueous solution containing ampicillin (ABPC), an antibiotic drug, or methylene blue, a dye. Drug release was retarded by Ca pre-treatment (0.10 M, 20 s) of the AG preparation in in vitro drug release studies due to gel-formation at the liquid surface. In in vivo experiments, the AG preparations were administered orally to rats. The rats were divided into two groups, with or without pre-administration of ranitidine hydrochloride (RH, an H2-blocker). The total remaining % of ABPC in the stomach was high in the rats administered the AG preparation compared to the ABPC solution. The AG preparation might float in the stomach without adhering to the gastric wall in the rats without pre-administration of RH. The total remaining % of ABPC at 30 min was almost 100% in the RH pre-administration rats administered the AG preparation, and about 80% of the drug existed in fraction 2 (implying adhesion of the preparation on the gastric mucus). At 60 min, the total remaining % in the AG preparation plus Ca (mean 87%) increased about 2-fold compared to that in the AG preparation alone (mean 44%). In this case, a large portion of the remaining ABPC also existed in fraction 2. This preparation may be useful for eradication of HP.

Administration, Oral↗