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Biomedical subjects

Kiminori Sato

Publications and source records attributed to Kiminori Sato.

At least 19 recordsLinked to original sources
PubMed2006

Laryngopharyngeal reflux disease with nocturnal gastric acid breakthrough while on proton pump inhibitor therapy.

Laryngopharyngeal reflux disease (LPRD) with nocturnal recovery of gastric acid secretion (nocturnal acid breakthrough: NAB) with proton pump inhibitors (PPI) was first reported. A 79-year-old Japanese woman complained of globus pharyngeus and mild heartburn was examined with the use of tetra-probe 24-h pH monitoring. She had been treated for reflux esophagitis (GERD) for 12 months prior to her visit to our office. She took Lansoprazole (30 mg/day) before dinner every day. The tetra-probe 24-h pH monitoring revealed that the recovery of gastric acid secretion occurred 6.5 h after taking the dose of PPI. The intragastric pH dropped < 4 at about 23:00 and remained below that level for 4 h and 50 min. The 24-h pH-metry at each probe showed that the nocturnal recovery of gastric acid secretion with PPI (NAB on PPI) influenced gastroesophageal and laryngopharyngeal refluxes. The symptoms of the pharynx and esophagus disappeared after taking H2 receptor antagonist (H2RA) additionally before bedtime.

Aged↗
PubMed2006

Age related changes in the distribution of laryngeal glands in the human adult larynx.

OBJECTIVE: To understand the defense status of glandular tissue in the human adult larynx, we examined the glandular distribution, concentration and the ratio of the mucous glands in the subglottic and supraglottic larynx. METHODS: One-hundred and seven adult larynges were examined. The area of the mucosa and glands were measured using an image analyzing system. The correlations of the concentration as well as the ratio of the mucous glands with age were analyzed. RESULTS: The ratio of the areas occupied by the glandular acini of the subglottis was almost equal to that of infants as we reported earlier. The concentration of the laryngeal glands decreased in higher-aged adults at the level of the supraglottis, but not at the level of the subglottis. CONCLUSIONS: In comparison to infants, the ratio of laryngeal glands of the human subglottic larynx is rather constant in human adults. However, the supraglottic larynx seems to be influenced by increasing age. The changes deserved in the laryngeal glands predominantly occur in the supraglottic larynx.

Adult↗
PubMed2006

Human adult deglutition during sleep.

OBJECTIVES: Clearance of the pharynx by deglutition is important in protecting the airway. The pattern of deglutition during sleep was investigated. METHODS: Deglutition during sleep was examined in 8 normal human adults via time-matched recordings of polysomnography and surface electromyography (EMG) of the thyrohyoid and suprahyoid muscles. RESULTS: During sleep, deglutition was episodic, and was absent for long periods. The mean number of swallows per hour (+/-SD) during the total sleep time was 2.9 +/- 1.3. The mean period of the longest absence of deglutition was 50.6 +/- 10.2 minutes. Most deglutition occurred in association with spontaneous electroencephalographic arousal in rapid eye movement (REM) sleep and non-REM sleep. Deglutition was related to sleep stage. The mean number of swallows per hour was 7.2 +/- 3.5 during stage 1 sleep and 2.0 +/- 0.7 during stage 2 sleep. There was little deglutition during stages 3 and 4. The deeper the sleep stage became, the lower the mean deglutition frequency became. The mean number of swallows per hour was 2.7 +/- 2.2 during REM sleep. The EMG amplitude dropped to the lowest level of recording and hypotonic EMG activity increased during REM sleep. CONCLUSIONS: Deglutition, a vital function, is infrequent during sleep.

Adult↗
PubMed2006

Expression and distribution of CD44 and hyaluronic acid in human vocal fold mucosa.

OBJECTIVES: Expression of CD44 (a cell surface receptor for hyaluronic acid) and the distribution of hyaluronic acid were examined in the human vocal fold mucosa. METHODS: Light microscopic investigation was carried out on 10 normal larynges of newborn, infant, younger adult, and older adults with Alcian blue staining, a hyaluronidase digestion study, and immunohistochemistry for CD44. RESULTS: Before the appearance of hyaluronic acid in the newborn vocal fold mucosa, CD44 was expressed on the stellate cells in the macula flava and on the fibroblasts in Reinke's space. During infancy, hyaluronic acid appeared and was distributed in the vocal fold mucosa. Many more stellate cells in the macula flava showed CD44 expression, and a large amount of hyaluronic acid was present around the infant stellate cells; however, the fibroblasts in Reinke's space expressed little CD44. During adulthood, hyaluronic acid was distributed in the vocal fold mucosa. Almost all of the stellate cells in the macula flava showed CD44 expression, and much hyaluronic acid existed around the stellate cells in the adult macula flava. However, fibroblasts in the adult Reinke's space expressed little CD44, and hyaluronic acid density in that space was lower than that in the macula flava. CONCLUSIONS: Stellate cells in the macula flava and CD44 cooperatively play important roles in maintaining hyaluronic acid in the human vocal fold mucosa as a vibrating tissue.

Adult↗
PubMed2006

Histopathologic changes in laryngeal mucosa of extremely low-birth weight infants after endotracheal intubation.

OBJECTIVES: Advances in medicine have improved the survival of infants with increasingly lower birth weights. The histopathologic changes of intubation-related laryngeal injury in extremely low-birth weight infants (less than 1,000 g) have not been well known. We examined histopathologic changes in infant larynges, including extremely low-birth weight infants, after endotracheal intubation. METHODS: Forty-four infants, including 21 extremely low-birth weight infants, who had been intubated for periods ranging from 10 minutes to 138 days, were examined in a whole organ serial section study. RESULTS: As the duration of intubation increased, the ulceration was found to be larger and deeper. The injury at the subglottis and posterior glottis was greater than that at other portions. The perichondrium of the cartilage was exposed in many cases intubated longer than 8 days. Repaired epithelium that was composed of squamous epithelium was present in 6 of 7 larynges that had been intubated more than 20 days, indicating that not only injury but also the healing process occurred during long intubation. There were no obvious relationships between the degree of intubation injury and the birth weight of the infants. CONCLUSIONS: Prolonged intubation is better tolerated by infants than adults. The intubation-related laryngeal injuries of extremely low-birth weight infants were histopathologically the same as those of infants of other birth weights.

Disease Progression↗
PubMed2006

[Indications for pharyngeal surgery in adult with sleep-disordered breathing patients].

We assessed the indications for pharyngeal surgery, including tonsillectomy and uvulopalatopharyngoplasty (UPPP) for patients with sleep-disordered breathing (SDB). The indications for surgery can be divided into two groups. In the first group, the indicated surgery is a radical treatment of SDB. The characteristics of this group were (1) grade 1 tonsillar hypertrophy, (2) bilateral (side to side type) oropharyngeal stenosis, as determined using a snoring sound test, and (3) no risk of facial disfiguration. In this group, the improvement in AHI (Apnea Hypopnea Index) was 76.2%, while the improvement in AI (Apnea Index) was 95.7%. In the second group, the treatment was designated as supplemental. The characteristics of this group were (1) bilateral oropharyngeal stenosis, (2) tonsillar hypertrophy larger than grade 2, and (3) unsuccessful treatment with NCPAP (Nasal Continuous Positive Airway Pressure) or oral appliances. In this group, the improvement in AHI was 50.7%, but, surgery remained an effective means of treating SDB.

Adult↗
PubMed2005

Vitamin A-storing stellate cells in the human newborn vocal fold.

OBJECTIVES: Vocal fold stellate cells (VFSCs) in the newborn vocal fold were examined and compared with VFSCs in the adult vocal fold. METHODS: Light and electron microscopic investigation of VFSCs was carried out on 5 human newborn larynges. RESULTS: The VFSCs were distributed in human newborn maculae flavae. They were stellate or oval in shape, and possessed cytoplasmic processes. The VFSCs in some cells formed a gap junction with each other. A few lipid droplets were present in the cytoplasm, but they were much fewer than those of an adult. The nucleus-cytoplasm ratio was high, and the intracellular organelles were not very well developed. Free ribosomes were well developed in the cytoplasm. The VFSCs in some cells showed strong cytoplasm staining with periodic acid-Schiff stain and type III collagen. There were vesicles along the periphery of the cytoplasm of the VFSCs, and newly released amorphous materials were seen, but fewer were observed on the cell surface. The newborn VFSCs had started to synthesize extracellular matrices such as collagenous fibers, reticular fibers, elastic fibers, and glycosaminoglycan. CONCLUSIONS: The VFSCs in the newborn maculae flavae were immature, but had already started the synthesis of extracellular matrices essential for the viscoelastic properties of the vocal fold mucosa.

Extracellular Matrix↗
PubMed2005

Endoscopic sinus surgery for antrochoanal polyp using CO2 laser and/or microresector: a long-term result.

Endoscopic sinus surgery procedure using CO2 laser and/or microresector for paediatric and adult chronic sinusitis with antrochoanal polyp (ACP), with long-term follow-up, was examined. Twelve children and 13 adults underwent the surgical procedure. The following two techniques were used to remove the antral portion of an ACP with a 70 degrees endoscope: (1) CO2 laser--The base of the ACP was vaporized and removed via an enlarged natural ostium with a pipe-guide handpiece with a deflective tip. (2) Microresector--The ACP was resected via an enlarged natural ostium and/or nasoantral window opened under the inferior turbinate with the curved and straight blade of a microresector. In the endoscopic follow up for 10 to 57 months, no patient who underwent the primary surgery required reoperation for ACP recurrence. One out of the seven patients who underwent secondary surgery required a revised operation with microresector and CO2 laser.

Adolescent↗
PubMed2005

Characterization of zeolite NaA membrane by FTIR-ATR and its application to the rapid evaluation of dehydration performance.

A zeolite NaA (LTA) membrane supported by an alumina porous support tube was characterized by Fourier Transform Infrared Attenuated Total Reflectance method (FTIR-ATR) with a diamond prism as the waveguide. A method using the FTIR-ATR was developed to estimate rapidly the EtOH/H2O pervaporation (PV) performance of the membrane. The Si-O asymmetric stretching vibration region of LTA membrane spectra synthesized hydrothermally on seeded alumina substrates showed a bimodal peak (830 - 1200 cm(-1)). The two peaks were assigned to a surface LTA directly derived from the seed crystal (1012 cm(-1)), and to LTA and/or amorphous substances embedded in the alumina porous support (930 cm(-1)). The spectrum from LTA membrane synthesized on nonseeded alumina substrate, however, showed a single broad peak similar to the powder-formed one. These results indicate that the Si-O spectral shape of the LTA membrane is influenced strongly by the synthesis method. Also, the FTIR-ATR of the LTA membrane can detect the Si-O peaks as part of the depth information. It was first shown that the relative ratio (930 cm(-1)/1012 cm(-1)) of the two Si-O peaks from the LTA membranes on seeded alumina substrates closely relates to the water selectivity (alpha) in the PV of EtOH/H2O mixture; the alpha increases exponentially with the peak ratio. This result suggests that the differences in the vertical distribution of LTA crystal and amorphous material strongly affect the dehydration performance in the EtOH/H2O PV, that is, the amorphous-like material embedded in the alumina porous support plays an important role. The relative peak ratio measurement can be used for the rapid evaluation of the dehydration performance of the membrane.

Journal Article↗
PubMed2005

[Continuous positive airway pressure therapy in multidisciplinary treatment].

We studied the acceptability of nasal continuous positive airway pressure (CPAP) therapy in 74 patients with obstructive sleep apnea-hypopnea (OSAH). CPAP was conducted in multidisciplinary treatment, combined with surgery and oral appliances. OSAH was defined by an apnea-hypopnea index > 20/h. Follow-up was 3 to 21 months. Automated titration during full polysomnography was conducted in the hospital using auto-CPAP devices (Autoset T, RESMED Co, Australia). CPAP alone was done in 37 (50%); CPAP with conservative nasal treatment in 25 (34%); CPAP with nasal surgery, endoscopic nose and/or sinus surgery in 10 (14%); and CPAP with uvulopalatopharyngoplasty and endoscopic nose and sinus surgery in 1 patient (1%). CPAP with an oral appliance was done in 1 (1%) to provide lower therapeutic pressure to avoid electroencephalography arousal caused by CPAP. Consequently CPAP with conservative nasal treatment and/or endoscopic nose and sinus surgery were conducted in 36 (49%). It was very important to improve nasal resistance to continue CPAP therapy. No statistically significant differences were seen between compliant and noncompliant patients in severity of OSAH, improvement of daytime somnolence, mask trouble, or nasal resistance. At the latest follow-up, 71 of 74 were still using CPAP. CPAP compliance by Kaplan-Meier evaluation was 96%. Multidisciplinary treatment involving CPAP combined with surgery and oral appliances thus improved the acceptability of CPAP therapy.

Continuous Positive Airway Pressure↗
PubMed2005

[Combination therapy for severe sleep apnea syndrome].

We assessed the treatment of severe SAS (sleep apnea syndrome) patients who had an AHI (apnea hypopnea index) over 100. Eleven (3.3%) of the 374 patients who came to our hospital between May 2002 and December 2003 had an AHI over 100. They received CPAP (continuous positive airway pressure) therapy as initial therapy, and the AHI recovered within normal limit in the five patients who did not have tonsillar hypertrophy. The other six patients had tonsillar hypertrophy, and the effect of CPAP was poor. Two of the six patients with tonsillar hypertrophy, underwent UPPP (uvuropalatopharyngoplasty), and CPAP become effective postoperatively. These results indicate that combined treatment by CPAP and surgery is an effective means of treating severe SAS with tonsillar hypertrophy.

Adult↗
PubMed2004

Diffusion weighted image negative transient ischaemic attack and reversible ischaemic neurological deficit. A report of 10 patients with complete recovery.

Diffusion-weighted magnetic resonance imaging (DWI MRI)-negative transient ischaemic attack (TIA) in hyperacute stroke is a well-known clinical entity. However, no precise analysis of this phenomenon has been reported. We identified 10 patients with TIA or reversible ischaemic neurological deficits (RIND) with no focal hyperintensity on DWI MRI among 108 consecutive acute stroke patients who underwent DWI MRI. In these patients, we analysed the apparent diffusion coefficient (ADC) and determined the ipsilateral/contralateral ratio (IC ratio) to elucidate factors that may contribute to this phenomenon. Each patient also underwent simultaneous magnetic resonance angiography (MRA). The mean IC ratio in our study population was 0.976. Of the 10 patients, 7 had a proximal vascular stenosis on MRA. We discuss the pathophysiology underlying negative DWI MRI results in patients with TIA or RIND.

Adult↗
PubMed2004

Autologous fat injection laryngohypopharyngoplasty for aspiration after vocal fold paralysis.

Injection laryngoplasty is one of the procedures for treating unilateral vocal fold paralysis. This is a preliminary report on modified injection laryngoplasty, ie, injection of liposuctioned autologous fat into the larynx and hypopharynx of patients who have aspiration and voice disorders after vocal fold paralysis. Lipoinjection was performed in 3 patients with these complaints with the endolaryngeal microsurgical technique under general anesthesia. The locations of fat injection were the vocal fold, the false vocal fold, the aryepiglottic fold of the larynx, and the medial wall of the pyriform sinus of the hypopharynx. Lipoinjection into the vocal fold, false vocal fold, and aryepiglottic fold strengthened laryngeal closure. Lipoinjection, performed into the thyroarytenoid muscle lateral to the oblong fovea of the arytenoid cartilage, made arytenoid cartilage rotation possible, and consequently strengthened laryngeal closure. Lipoinjection into the medial wall of the pyriform sinus of the hypopharynx reduced its capacity; consequently, the amount of residual food retained in it was reduced and pharyngeal clearance on the affected side was improved. The longest follow-up among the 3 patients has been 24 months. Their aspiration and glottal incompetence have been improved by this operation. We conclude that modified injection laryngoplasty (laryngohypopharyngoplasty) is one of the surgical options for preventing aspiration after vocal fold paralysis.

Adipose Tissue↗
PubMed2004

Age-related changes in vitamin A--storing stellate cells of human vocal folds.

Light and electron microscopic investigation of age-related changes in vocal fold stellate cells (VFSCs) of the human vocal fold mucosa was carried out on 10 excised human adult larynges from autopsy and surgical cases. The results are summarized as follows. Aged VFSCs were stellate in shape and possessed slender cytoplasmic processes. Aged VFSCs also possessed lipid droplets in the cytoplasm and stored vitamin A. Basically, the morphological characteristics of the aged VFSCs were the same as those of younger adults. The number of VFSCs had decreased. There were fewer intercellular organelles than in younger adults. Some components of the cytoplasm had degenerated. The nuclei of the VFSCs were dense and cleaved. There were few vesicles at the periphery of the cytoplasm of aged VFSCs, and few newly released amorphous materials. Some aged VFSCs had degenerated, and an accumulation of glycogen particles was seen in the cytoplasm. The number of fibers synthesized by these inactivated cells had decreased. These findings were recognized to various degrees. The aged VFSCs in the maculae flavae appear to have decreased activity, have abnormal metabolism, and undergo degeneration. Age-related changes in the VFSCs of the maculae flavae are postulated to influence the metabolism of extracellular matrices in the vocal fold mucosa, as well as the viscoelasticity of the aged vocal fold mucosa, and are one of the causes of aging of the voice.

Aged↗
PubMed2004

[Unattended automated titration to determine therapeutic continuous positive airway pressure in patients with obstructive sleep apnea].

Recently, devices which use a new technology that automatically titrates positive airway pressure have become available. Such devices continually adjust the pressure to maintain airway patency. In this paper, unattended automated titration to determine the therapeutic continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea was evaluated to ascertain of it was a feasible titration to determine the therapeutic CPAP. Thirty patients participated in this study with obstructive sleep apnea syndrome defined by an apnea hypopnea index > 20/h. Automated titration during full polysomnography was performed in the hospital using auto CPAP devices (Autoset T, RESMED Co, Australia). During titration, there was no direct supervision by a technician. The titration method was as follows. Data obtained during the use of auto CPAP devices and polysomnography were used to provide a fixed single pressure for subsequent treatment. After determining the therapeutic continuous positive airway pressure, the efficacy of the patient's CPAP device was reconfirmed during full polysomnography. The results were, 1) Proper fixed single therapeutic pressure could be determined with this unattended automated titration, consequently apnea and sleep structure could be improved (Total sleep time, Sleep efficiency, %Stage 3 + 4, Apnea index, Apnea hypopnea index, Arousal index, Lowest SpO2, and Duration of SpO2 less than 90% were improved statistically (p < 0.05)). 2) The 95th percentile airway pressure of the auto CPAP device should be applied for the therapeutic pressure. 3) Automated titration during full polysomnography should be performed using auto CPAP devices. 4) After determining the therapeutic CPAP, the efficacy of the patient's CPAP device should be reconfirmed during full polysomnography. 5) This method of titration was useful at the institution without attendant technician intervention.

Automation↗
PubMed2003

3D structure of the macula flava in the human vocal fold.

OBJECTIVE: To investigate the 3D structure of the macula flava in the human vocal fold. MATERIAL AND METHODS: The 3D structure of the macula flava in the human vocal fold was investigated by means of scanning electron microscopy using a chemical digestion method (modified sodium hydroxide maceration method) and the results compared with those obtained using light microscopy. RESULTS: The macula flava of the human vocal fold comprised a dense mass of cells and extracellular matrices. Many cells were stellate in shape and possessed cytoplasmic processes. Extracellular matrices were composed of collagenous, reticular and elastic fibers, and ground substances (hyaluronic acid). Many fibers ran in various directions. The stellate cells were surrounded by these extracellular matrices. Amorphous materials were attached to the surface of the stellate cells. Extracellular matrices in the macula flava extended to those in the lamina propria of the vocal fold mucosa. CONCLUSION: Anterior and posterior maculae flavae in the human vocal fold mucosa are postulated to be involved in the metabolism of extracellular matrices, which are essential to the viscoelasticity of the lamina propria (the vibrating tissue) of the human adult vocal fold mucosa.

Adult↗
PubMed2003

Vitamin A-storing stellate cells in the human vocal fold.

OBJECTIVE: Previously, we discovered cells with a star-like appearance that constantly synthesized extracellular matrices in the human adult vocal fold mucosa. These cells had no nomenclature and were thus designated "vocal fold stellate cells (VFSC)". The aim of the present study was to detect vitamin A (retinol) in the VFSC. MATERIAL AND METHODS: Five normal human adult vocal folds obtained from surgical specimens were used. Light microscopy using the gold chloride method and fluorescence microscopy were used to detect vitamin A. RESULTS: VFSC distributed in the maculae flavae of human adult vocal folds possessed lipid droplets and stored vitamin A. CONCLUSION: It is generally accepted that vitamin A, an essential liposoluble vitamin, is used as a morphogen that controls the differentiation and morphogenesis of cells. In our previous investigation and in this study VFSC were found to differ morphologically from conventional fibroblasts. VFSC represent morphologically a new category of cells in the human vocal fold.

Female↗