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Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 811 records · Page 45Linked to original sources
PubMed1992

[The pathology and treatment of incontinence].

In order to understand the pathology of incontinence, it is important to investigate urinary symptoms, urological and neurological examinations and urodynamics. There are two kinds of incontinence. One is true incontinence in which urine passes through urethra, and the other is false incontinence due to the ectopic opening of the ureter, for example to the vagina. The former includes stress incontinence, urge incontinence, reflex incontinence, overflow incontinence and total incontinence. Stress incontinence occurs with the sudden increase of abdominal pressure such as cough, running and exertion. The cause of stress incontinence is thought to be weakening of pelvic floor muscles after delivery or aging. In these patients, the bladder base and urethra move downwards and backwards, which make the posterior vesico-urethral angle more than 120 degrees. Treatment of stress incontinence includes pelvic floor exercise, administration of alpha-stimulants which increase the tonus of the internal sphincter and surgery to elevate the urethra. Urge incontinence is observed when detrusor instability occurs. It is also seen in patients with neurological diseases such as multiple cerebral infarction or with benign prostatic hypertrophy (BPH). Treatment of urge incontinence includes administration of anticholinergics to decrease bladder hyperreflexia. Reflex incontinence is seen in patients with spinal cord disorders. It occurs due to reflex contraction of detrusor and the treatment involves administration of anti-cholinergics. Overflow incontinence is seen in patients with voiding difficulties due to BPH. It occurs when residual urine increases and when the intravesical pressure exceeds urethral pressure on body movement. Treatment for this is intended to improve voiding difficulties. Total incontinence occurs when total sphincter function is damaged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Hyalinizing trabecular adenoma.

A case is presented of hyalinizing trabecular adenoma in a 54-year-old Japanese female. The patient underwent a hemithyroidectomy for the diagnosis of thyroid carcinoma. An intraoperative frozen section diagnosis was medullary carcinoma. Hematoxylin and eosin stained permanent sections from the surgical specimen, a well encapsulated 3.0 x 2.0 x 1 cm nodule, also led us to suspect medullary carcinoma, but immunohistochemical staining for thyrocalcitonin, CEA, and thyroglobulin showed that it was a hyalinizing trabecular adenoma.

Adenoma↗
PubMed1992

Differential expression of somatostatin receptor subtypes in brain.

The tetradecapeptide somatostatin has been implicated as an important regulator of neuronal and neuroendocrine function in the CNS. The cellular actions of somatostatin are mediated by specific receptors. The genes encoding two different somatostatin receptors (SSTRs) have been isolated and characterized, and RNA blotting studies have shown that both SSTR1 and SSTR2 are expressed in the brain. In order to gain a better understanding of the functions of somatostatin in the CNS, the distribution of SSTR1 and SSTR2 mRNAs was determined using the technique of in situ hybridization. SSTR1 mRNA was present throughout the mouse brain, particularly in the supra- and infragranular layers of the cortex, the amygdala, hippocampus, bed nucleus of the stria terminalis, substantia innominata, hypothalamus, pretectum, substantia nigra, parabrachial nucleus, and nucleus of the solitary tract. SSTR2 mRNA was primarily observed in the infragranular layers of the cortex, the amygdala, claustrum, endopiriform nucleus, arcuate and paraventricular nuclei of the hypothalamus, and medial habenular nucleus. Several regions of the brain reported to contain dense somatostatin-like immunoreactive terminal fields and receptor binding sites were devoid of both SSTR1 and SSTR2 mRNA, suggesting the existence of additional SSTR subtypes.

Animals↗
PubMed1992

Chemiluminescent simultaneous determination of phosphatidylcholine hydroperoxide and phosphatidylethanolamine hydroperoxide in the liver and brain of the rat.

The quantification of phospholipid hydroperoxides in biological tissues is important in order to know the degree of peroxidative damage of membrane lipids. For this purpose, optimal conditions for the chemiluminescent simultaneous assay of phosphatidylcholine hydroperoxide (PCOOH) and phosphatidylethanolamine hydroperoxide (PEOOH) in rat liver and brain were determined. A chemiluminescence detection-high performance liquid chromatography (CL-HPLC) method that incorporates cytochrome c and luminol as a post-column hydroperoxide-specific luminescent reagent was used (Miyazawa et al. 1987. Anal. Lett. 20: 915-925; Miyazawa. 1989. Free Radical Biol. Med. 7: 209-217). An n-propylamine-bound silica column with hexane-2-propanol-methanol-water 5:7:2:1 (v/v/v/v) (flow rate 1.0 ml/min) as eluant was used to determine both PCOOH and PEOOH, which were separated from each other and from other lipids and lipid-soluble antioxidants. High reproducibility and sensitivity as low as 10 pmol hydroperoxide-O2 were observed with a mixture of 10 micrograms/ml cytochrome c and 2 micrograms/ml luminol in 50 mM borate buffer (pH 10.0, flow rate 1.1 ml/min) as luminescent reagent and a post-column mixing joint temperature of 40 degrees C. Using the established analytical conditions, it was confirmed that both PCOOH (1324 +/- 122 pmol/g liver, 114 +/- 18 pmol/g brain, mean +/- SD) and PEOOH (728 +/- 89 pmol/g liver, 349 +/- 60 pmol/g brain, mean +/- SD) are present in the liver and brain of Sprague-Dawley rats bred on a slightly modified AIN-76A semisynthetic diet for 3 months. The phospholipid hydroperoxide content in the rat liver was shown to be affected by dietary oils, but not significantly affected in the brain.

Animals↗
PubMed1992

[Study on changes of serum vitamin K1 level and K dependent coagulation factors in patients with coumarin derivatives (warfarin) therapy].

Serum level of vitamin K1 (= phylloquinone, hereinafter K1) and K dependent blood coagulation factors were determined by HPLC in normal subject, liver cirrhosis, hepatocellular carcinoma, acute hepatitis, chronic hepatitis, chronic renal failure with hemodialysis and patients under warfarin therapy. Normal range of serum K1 concentration was decided on 0.20-2.30 (0.87 +/- 0.53, n = 96) ng/ml. Serum K1 level showed no significant differences among normal subject, various diseases and warfarin therapy. Correlation between serum K1 level and F-VII (r = 0.879, p less than 0.001) or protein C activity (r = 0.839, p less than 0.01) was found in patients whose thrombotest was 20% and less. However serum K1 level didn't correlate with any K dependent coagulation factors in patients if thrombotest was over 20%.

Adolescent↗
PubMed1992

A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis.

High tibial osteotomy (HTO) was performed on 86 medially osteoarthritic knees in 78 patients. Twelve patients died during the follow-up period. Fifty-six knees of 51 patients were evaluated twice postoperatively: once at six years after surgery and again after ten to 15 years. Results were satisfactory in 88% of the knees at the six-year follow-up evaluation and in 63% at the post-ten-year follow-up evaluation. Ten-year follow-up results significantly deteriorated. The femorotibial angle (FTA) at the time of bone union after HTO was a significant factor that contributed to the ten-year results. In patients maintaining excellent improvement of knee function at the post-ten-year follow-up evaluation, the mean FTA at one year after surgery was 165 degrees; this value was constant through ten years after HTO. An FTA of 164 degrees-168 degrees should be attained to ensure favorable long-term results in HTO.

Bone Nails↗
PubMed1992

[Vesicoenteric fistula complicating Crohn's disease, responded to medical treatment: a case report].

A 20-year-old man was admitted on February 2, 1990 with the chief complaint of pollakisuria, miction pain and macrohematuria. Urinalysis revealed numerous leukocytes and Enterobacter was identified by urine culture. Cystoscopy revealed an edematous region. Contrast film of small intestines demonstrated vesicoileal fistula. Judging from these and the radiographic findings, we made the diagnosis of vesicoileal fistula with Crohn's disease. After medical therapy between February 22 and May 25, urinalysis became normal and we assumed that the fistula had closed. Now, it is about a year since the therapy began, the patient remains well, without urinary and enteric symptoms. Cystoscopy and urinalysis did not reveal recurrence of the fistula. Despite previous reports that vesicoenteric fistulas complicating Crohn's disease require surgical treatment, this case responded to medication, and required no surgical treatment. This case is a reminder of the importance of the principle of therapy.

Adult↗
PubMed1992

Value of isokinetic angle-specific torque measurements in normal and injured knees.

This study assessed the relationship between the isokinetic peak torque (PT) (speed of movement 60 and 180 degrees.s-1) and the angle-specific torques (ASTs) at 15 and 75 degrees of knee flexion in multiple contractions of the quadriceps and hamstrings in 80 subjects with a grade I knee injury. At every test speed, the Pearson product moment (r) and the Spearman rank (rs) correlation coefficients between the PT and ASTs were highly significant (P less than 0.001) for both muscle groups in the uninjured (r = 0.73-0.88, rs = 0.75-0.89) as well as in the injured (r = 0.63-0.91, rs = 0.65-0.91) knees. In both extremities, a great majority of the correlation coefficients exceeded 0.80, which was the predetermined threshold for the coefficients to exceed before the relationship could be considered clinically important. Using regression analysis, both extremities showed completely nonsystematic distribution of the residuals. The variability of the AST measurements was clearly higher than corresponding PT measurements. In conclusion, concerning healthy or grade I injured knees, the predictability of ASTs from PT was good; and, therefore, AST analyses offer little additional information about thigh muscle function than that obtained through the simpler and more commonly used measurement, PT analysis. Because of large variability, the routine use of the AST measurements for grade I knee injuries is not recommended.

Adult↗
PubMed1992

[Clinical study of intracranial pressure and auditory brain stem response in the cases of diffuse axonal injury].

The course of intracranial pressure (ICP) and the finding of auditory brain stem response (ABR) was discussed in the cases diagnosed as diffuse axonal injury (DAI) established by Gennarelli. ICP was measured in twenty-six cases which were divided into three groups according to the course of ICP: Group (1), in which ICP remained below 20 mmHg (group I, 9 cases). Group (2), in which ICP rose above 20 mmHg but was controlled by therapy (group II, 8 cases). Group (3), in which ICP rose above 20 mmHg and could not be controlled by any therapies (group III, 9 cases). Glasgow outcome scale 3 months after the injury in the cases of group I and II was severe disability (SD) and/or persistent vegetative state (PVS), but all of the cases in group III died. The findings of serial ABR were divided into 3 groups. These were group A (2 cases) which showed normal record, group B (5 cases) which showed elongation of latencies between the first and fifth waves, and group C (5 cases) in which there was no response in ABR. GOS in group A or B was SD and/or PVS, but all of the cases in group C were shown to be dead in GOS. Our studies suggest that the level of ICP in DAI is rather higher than that published in previous reports, and the continuous measurements of ICP and serial records of ABR are useful for evaluating the outcome of DAI.

Adolescent↗
PubMed1992

[Repair of two cases of partial anomalous pulmonary venous return by draining total right pulmonary venous blood to the left atrium through dilated atrial septal defect].

Two cases of partial anomalous pulmonary venous return were reported in whom right pulmonary veins were totally drained to the coronary sinus and to the right atrium respectively. Re-routing of pulmonary veins was done by dilated atrial septal defect and making intra-atrial tunnel using equine pericardial patch. Postoperative courses were uneventful. MRI was useful to identify the pathway from right pulmonary veins to the left atrium.

Adult↗
PubMed1992

[A case of extra-anatomic bypass for ruptured thoracoabdominal aortic aneurysm with tuberculosis].

Now aneurysmectomy and graft replacement is the most popular surgical method of aortic aneurysm, but there are many opinions about surgical methods and assist circulation for emergency operation of ruptured aortic aneurysm. We experienced the case of ruptured thoracoabdominal aortic aneurysm with tuberculosis, and rescued the patient by extra-anatomic bypass (EAB). A 60-year-old woman, who had been treated with tuberculosis for about 40 years, was operated on for cold abscess of her left psoas muscle by other orthopedic surgeons. At that time, massive bleeding happened, and she was transferred to us under diagnosis of ruptured thoracoabdominal aortic aneurysm. EAB, as emergency operation, was done because we considered it was dirty and dangerous to replace the prosthesis beside the abscess. The postoperative course was almost uneventful except the evidence of Gaffky's first stage. We considered EAB was an useful method for emergency cases and some infectious aortic aneurysms.

Aorta, Abdominal↗
PubMed1992

[A case of bronchiolitis obliterans organizing pneumonia with positive anti Jo-1 antibody preceding polymyositis].

We describe a 58-year-old female with BOOP associated with polymyositis. Four months prior to the appearance of distinctive manifestation of polymyositis, she presented with a two-week history of cough, dyspnea on exertion, and fever. Chest roentgenogram demonstrated bilateral basal infiltrative shadows. The patient was treated with prednisolone, 30 mg/day because of progressive hypoxemia. Open lung biopsy revealed organizing masses of granulation tissue extending from the respiratory bronchioles into the intra-alveolar spaces, which was consistent with BOOP. She developed muscle pain in her legs, fever, dry cough, hypoxemia, and high CPK value in the course of tapering of steroid dose. The findings of biopsy from the left rectus femoris muscle were compatible with polymyositis. Retrospective study of the patient's serum on admission showed positive anti Jo-1 antibody.

Antibodies, Antinuclear↗
PubMed1992

[Effect of aortic valve replacement on left ventricular function in adult patients with aortic stenosis].

Echocardiographic and hemodynamic studies were obtained in 16 consecutive adult patients who underwent aortic valve replacement (AVR) with St. Jude Medical valve for aortic stenosis (AS). Three cases of congenital AS was included and two of them had undergone aortic valvotomy in childhood. One of 16 patients died due to late cardiac tamponade six weeks after AVR. Postoperative studies showed improved left ventricular (LV) functions. LV end diastolic and end systolic diameter (LVDs and LVDs) fell from 50.3 and 38.2 to 44.6 and 31.6 mm respectively (p less than 0.05). Fractional shortening (%FS) rose from 26.5 to 32.2% (p less than 0.05). End systolic wall stress (ESWS) fell from 126.2 to 69.6 k dynes/cm2 (p less than 0.01). Cardiac index and pulmonary arterial wedge pressure improved from 3.4 and 14.4 to 3.6 l/min/m2 and 10.5 mmHg respectively (ns). Preoperatively, six were functional class II, eight were class III and one was class IV (New York Heart Association classification). Postoperative improvement was as follows, eight: class I, seven: class II. In four cases, preoperative echocardiography revealed most depressed LV function in %FS (smaller than 21%) and ESWS (greater than 140). Postoperatively they improved from 18.3 and 164 to 26.0% and 72.8 k dynes/cm2 respectively. These results suggested that depressed LV function in the patients with longstanding AS was largely related to limited preload reserve due to LV enlargement and mechanical unloading of LV (correction of afterload mismatch) resulted in improvement of LV function. In conclusion, LV dysfunction owing to AS alone is reversible and AVR results in great clinical improvement.

Adolescent↗
PubMed1992

[Magnetic resonance imaging in diffuse brain injury].

Forty cases diagnosed as diffuse brain injury (DBI) were studied by magnetic resonance imaging (MRI) performed within 3 days after injury. These cases were divided into two groups, which were the concussion group and diffuse axonal injury (DAI) group established by Gennarelli. There were no findings on computerized tomography (CT) in the concussion group except for two cases which had a brain edema or subarachnoid hemorrhage. But on MRI, high intensity areas on T2 weighted imaging were demonstrated in the cerebral white matter in this group. Many lesions in this group were thought to be edemas of the cerebral white matter, because of the fact that, on serial MRI, they were isointense. In mild types of DAI, the lesions on MRI were located only in the cerebral white matter, whereas, in the severe types of DAI, lesions were located in the basal ganglia, the corpus callosum, the dorsal part of the brain stem as well as in the cerebral white matter. As for CT findings, parenchymal lesions were not visualized especially in mild DAI. Our results suggested that the lesions in cerebral concussion were edemas in cerebral white matter. In mild DAI they were non-hemorrhagic contusion; and in severe DAI they were hemorrhagic contusions in the cerebral white matter, the basal ganglia, the corpus callosum or the dorsal part of the brain stem.

Adolescent↗
PubMed1991

[A study of anti-pituitary-antibodies in patients with hypopituitarism and their hereditary background].

Recently several types of anti-pituitary-antibodies (APA) have been found in patients with pituitary disorders including hypopituitarism and diabetes insipidus, and in postpartum women. However, the pathophysiological role(s) of APA still remains unknown. In order to elucidate the clinical significance of APA, longitudinal follow-up and family study of APA in patients with hypopituitarism were performed. APA in serum was examined in a total of 11 patients with various types of hypopituitarism (7 of isolated ACTH deficiency, 1 of partial hypopituitarism, 3 of Sheehan's syndrome, 6 males and 5 females). Chronic thyroiditis was associated in 3 out of 7 patients with isolated ACTH deficiency, and empty sella was found in each one patient with isolated ACTH deficiency and partial hypopituitarism, and in 3 patients with Sheehan's syndrome. APA was examined on 2 or 3 occasions at more than a 6 month interval (longitudinal study). In 5 patients, their 16 family members were examined for the presence of APA, and pituitary functions were evaluated in 3 out of 7 family members with positive APA (family study). For pituitary function tests, arginine infusion test, TRH, LH-RH or CRH test and insulin tolerance test were performed. APA reacting to rat pituitary cytoplasmic antigens (pituitary cell antibodies: PCA) and APA reacting to rat GH3 cells and/or mouse AtT20 cells surface antigens (pituitary cell surface antibodies: PCSA) were assayed with indirect immunofluorescence method. At the initial examination, 6 out of 11 patients (55%) showed positive APA. The patients were divided into 3 subgroups according to the longitudinal study: the group with disappearance of initially positive APA (3 patients), the group with altered titers or types of initially positive APA (3 patients), and the group with sustained initially negative APA (4 patients). No effects of replacement therapy on the alterations of APA were observed. In 16 family members of 5 patients (each 1 with partial hypopituitarism and isolated ACTH deficiency syndrome, and 3 with Sheehan's syndrome), APA in their sera were investigated. Seven out of 16 members (44%) showed positive APA. Among 6 first-degree relatives of 16 family members, both or either one of APA and PCSA were positive in 4 (67%). Out of 10 of their second- or third-degree relatives, 3 (30%) were positive for PCA or PCSA. All of 3 relatives with positive APA studied showed mild pituitary hypofunction without any clinical manifestations.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

Effect of 17 beta-estradiol on PAF and prostaglandin levels in oophorectomized rat uterus.

The effects of 17 beta-estradiol on the levels of platelet-activating factor (PAF) and prostaglandins and their precursor phospholipid in the uterus of oophorectomized rats were studied. Oophorectomy results in the decrease in the uterine PAF level to one-third of that in natural estrus. This level was recovered by subcutaneous administration of 17 beta-estradiol. The level of uterine phospholipids, which are rich in arachidonic acid, was significantly decreased by estradiol treatment. More arachidonate-PC was depleted than arachidonate-PE. The molecular structure was confirmed by gas chromatography-mass spectrometry. The amount of PGF2 alpha in the oophorectomized uterine tissue was 10-times that of PAF, but like the latter, increased 3-4 times on estradiol treatment. The chemical structures of PAF and PGF2 alpha formed on estradiol treatment were confirmed by mass spectrometry. The present data strongly suggest a correlation between the formations of PAF and PGF2 alpha, and indicate that estradiol may regulate the physiological formations of PAF and PGs in non-pregnant rat uterus.

Animals↗