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Biomedical subjects

N Ikeda

Publications and source records attributed to N Ikeda.

At least 19 recordsLinked to original sources

Prevalence of gallstone disease in relation to smoking, alcohol use, obesity, and glucose tolerance: a study of self-defense officials in Japan.

Risk factors of gallstone disease were investigated in male self-defense officials who received, between October 1986 and December 1990, a retirement health examination at the Self-Defense Forces Fukuoka Hospital, Fukuoka, Japan. Gallbladder ultrasonography, successfully performed with 2,739 of 2,756 men, found 61 men with gallstones and 38 men with previous removal of the gallbladder; the overall prevalence of gallstone disease was 3.6%. Multiple logistic regression analysis assessed the risk of gallstone disease in relation to smoking, alcohol use, body mass index, glucose tolerance, and rank. Alcohol use was associated with a decreased risk, and body mass index was positively related to gallstone disease. Men with impaired glucose tolerance had a slightly elevated risk, whereas diabetes mellitus was not associated with gallstone disease. Analysis for prevalent gallstones and the postcholecystectomy state showed an inverse association of alcohol use with the latter; a positive association with impaired glucose tolerance was also confined primarily to the latter condition. These findings provide little support for a protective effect of alcohol use in the formation of gallstones. It was inconclusive whether impaired glucose tolerance was associated selectively with postcholecystectomy.

Alcohol Drinking

Comparative studies on the extractability of collagen from aortas of stroke-prone spontaneously hypertensive and normotensive rats.

The molecular states of collagen in the aortas of age-matched stroke-prone spontaneously hypertensive (SHRSP) and normotensive Wistar Kyoto rats (WKY) were studied by analyzing its extractability under defined conditions. The monomeric and oligomeric collagen extractable with 0.5 M acetic acid/6 M urea from aortic homogenates of 9-month-old SHRSP and WKY comprised approx. 0.6 and 2.0%, respectively, of the total collagen. On incubation of the acetic acid/urea-extracted residues with pepsin at 4 degrees C, the levels of the collagen alpha 1(I) and alpha 2(I) chains solubilized from the SHRSP residues were both less than 50% of those from the WKY residues. When the residues were incubated with pepsin at 15 or 25 degrees C, the differences became smaller. When the acetic acid/urea residues were hydrolyzed with cyanogen bromide, nearly identical peptide maps were obtained for SHRSP and WKY. The aortas from 2-month-old SHRSP and WKY contained much larger proportions of acid/urea-extractable collagen than those of the older rats (8.2 and 13% of the respective total collagen). The levels of the alpha 1(I) and alpha 2(I) chains solubilizable from the respective residues by pepsin at 4 degrees C were similar to each other. These results indicate that aortic collagen fibrils in SHRSP are stiffened more prominently than those in WKY.

Aging

Morphological differences between hepatocellular carcinoma and hepatocellular carcinomalike lesions.

In an attempt to provide a quantitative basis for differentiation between well-differentiated hepatocellular carcinoma and hepatocellular carcinomalike lesions (focal nodular hyperplasia, regenerative nodular hyperplasia and hepatocellular adenoma), histopathological and morphometrical analyses were performed on 208 cases of various liver diseases with the aid of an image analyzer. As practical indicators for hepatocellular carcinoma, the following six morphometrical features were established: (a) nuclear shape factor of less than 0.93, (b) coefficient of variance of nuclei of more than 5%, (c) average width of trabecular cords greater than three cells, (d) nucleocytoplasmic ratio increased to more than 0.3, (e) cellular density of more than 40 liver cells and (f) individual nuclear dimension larger than 50 microns2. The manifest categories increased with dedifferentiation of cells in hepatocellular carcinoma; the number and degree of cellular and structural atypia became more prominent. Data were analyzed statistically by two multivariate analyses. Logistic analysis was able to correctly separate hepatocellular carcinoma from conditions that were not hepatocellular carcinoma, including hepatocellular carcinomalike lesions. The incidence of 13 descriptive histopathological findings such as fibrous capsule, portal triads and clear-cell clusters were also compared in hepatocellular carcinomalike lesions and hepatocellular carcinomas graded according to Edmondson's classification. Presence of a fibrous capsule, portal triads, mosaiclike patterns and tumor vessels showed statistical differences between hepatocellular carcinomalike lesions and well-differentiated hepatocellular carcinoma by the chi 2 test (p less than 0.005).

Autopsy

The course of respiration and circulation in death due to typical hanging.

Experiments were carried out on 15 dogs to investigate the course of respiration and circulation during the agonal period of death due to typical hanging. Animals were asphyxiated by a method simulating typical hanging. Electrocardiogram (ECG), electroencephalogram (EEG), blood pressure (BP) in the femoral artery and intrathoracic pressure (ITP) were registered. In typical hanging, the course of respiration was characterized by shorter stages of dyspnoea and initial apnoea and a longer stage of the terminal respiration when compared with obstructive asphyxia. However, the whole time of the course of respiration and circulation in typical hanging was almost the same as that in obstructive asphyxia. The BP increased rapidly, was maintained during the dyspnoea stage, and then decreased gradually. EEG disappeared with, or a short time after, the end of the dyspnoea stage. The increased heart rate in the dyspnoea stage remained until circulatory collapse. The analysis of the ECG complexes revealed that the heart muscle adapted to oxygen deficiency during typical hanging.

Airway Obstruction

Obliteration of portal systemic shunts as therapy for hepatic encephalopathy in patients with non-cirrhotic portal hypertension.

The effects of obliteration of portal systemic shunts (PSS) in 5 patients with non-cirrhotic hepatic encephalopathy is reported. All patients had a history of disturbance of consciousness for several years, and examinations revealed large PSS, most of which connecting the left gastric vein to the left renal vein. After the obliteration of PSS, portal vein pressure elevated, the shunt ratio of the portal blood flow decreased, the indocyanine green disappearance rate increased, and serum albumin increased. Blood ammonia (NH3) decreased significantly accompanied by disappearance of hepatic encephalopathy. This treatment may open a way to improve the quality of life in patients with large PSS without severe hepatic injury.

Aged

Evaluation of five computer programs in the diagnosis of second-degree AV block.

Five electrocardiogram (ECG) analyzing systems were tested with a microcomputer-based ECG signal generator to assess the accuracy of the systems in interpreting Wenckebach periodicity. Although normal sinus rhythm with normal PR intervals and sinus rhythms with first-degree atrioventricular (AV) block were diagnosed by all five systems, second-degree AV block with classic Wenckebach periodicity was routinely misdiagnosed by four of the five systems. No system recognized the atypical Wenckebach periods in a total of 200 trials, misinterpreting the phenomenon as atrial fibrillation, supraventricular rhythm, sinoatrial block, and other rhythm disturbances. In advanced AV block and a variety of ventricular arrhythmias, none of the five systems diagnosed second-degree AV block with Wenckebach periods. Marked unsatisfactory performance with regard to the diagnosis of Wenckebach periodicity indicates the urgent need for accelerated and comprehensive testing of ECG diagnostic equipment. The present generating device was seen as an effective troubleshooter in optimizing the diagnostic competency of computerized ECG systems.

Computer Simulation

Green tea consumption and serum lipid profiles: a cross-sectional study in northern Kyushu, Japan.

METHODS. The relation between green tea consumption and serum lipid concentrations was examined using cross-sectional data on 1,306 males who received the retirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and December 1988. RESULTS. After adjustment for rank, smoking, alcohol use, physical activity, and body mass index, serum total cholesterol levels were found to be inversely related to the consumption of green tea while no association was noted with serum triglycerides and high-density lipoprotein cholesterol. Adjusted mean concentrations of total cholesterol were 8 mg/dl lower in men drinking nine cups or more per day than in those consuming zero to two cups per day. Serum cholesterol levels were inversely associated with traditional Japanese dietary habits (intake of rice and soy bean paste soup) and positively associated with Westernized habits. Additional adjustment for these dietary variables did not alter the inverse relation between green tea and total cholesterol.

Cholesterol

Sudden infant death syndrome and hypertrophy of the palatine tonsil: reports on two cases.

Two cases of sudden infant death syndrome (SIDS) with hypertrophy of the palatine tonsil were reported. The pathogenesis of the SIDS has been clarified (Guilleminault et al., Pediatrics, 68 (1981) 354-360). According to this theory, it is due to a central impairment of the breathing control during sleep, which is particularly pronounced in predisposed subjects. The present cases suggest that the hypertrophied palatine tonsil might contribute as a predisposing factor to the emergence of a SIDS by mechanical impediment to breathing by narrowing of the upper airway.

Airway Obstruction

Homicidal manual strangulation and multiple stun-gun injuries.

Stun guns are electric shock devices that are used by a number of law enforcement agencies to subdue violent offenders, but sometimes are discharged into human bodies as offensive weapons. We autopsied a 22-year-old woman who was strangled and had many stun-gun injuries on her head, chest, abdomen, arms, and legs. The stun-gun injuries consisted of many pairs of round erythemas with or without central paleness, some of which were accompanied by circumferential abrasions. To determine whether the electric shocks were administered before or after her death, we studied stun-gun injuries on pigs before and after death and found that the shocks after death did not mark the animal skin. Based on this experiment, all of the stun-gun injuries on the victim's body were concluded to have been inflicted before her death.

Adult

An unusual case of accidental smothering.

A rare accidental death case is presented in which four pieces of packing tape adhered tightly over the nose and mouth. The notes for his experimental report, left in his room, suggested that the accident happened during his trial to prove his theory on respiration to improve physical exercise.

Adult

Characterization of four-stranded DNA and RNA fragments.

We have investigated the structures formed by deoxyribo- and ribooligonucleotides containing guanine-rich sequences. Inter- and intrastrand guanine tetrads are not only more stable in the presence of K+ than they are in the presence of Na+, but also more compact.

DNA

The course of respiration and circulation in death due to various types of asphyxia.

To investigate the course of respiration and circulation in death due to various types of asphyxia, dogs were asphyxiated by a method simulating typical hanging, by plastic-bag suffocation, by breathing pure nitrogen and low concentration of oxygen. Intrathoracic pressure, blood pressure in the femoral artery, electrocardiogram and electroencephalogram were registered and were compared with the course in death due to obstructive asphyxia.

Animals

[A case of hepatic hydrothorax treated by pleuro-venous shunt].

We reported a successful pleuro-venous shunt operation (Pl-V shunt) for a patient of liver cirrhosis with secondary hydrothorax. A 78-year-old female was admitted to our hospital because of severe dyspnea and palpitation. Chest x-ray film revealed right sided massive pleural effusion. Over several weeks the chest tube drainaged about 1,500 ml of transudative fluid per day. We performed Pl-V shunting and pleural effusion subsequently decreased in amount and dyspnea disappeared. This Pl-V shunting is thought to be useful for such a patient with massive pleural effusion which failed to respond to medical therapy.

Aged

Online bibliographic information: integration into an emerging IAIMS environment.

The Medical Library at Yale University has developed an online free-text database containing Current Contents citations. The database was designed to be integrated into an emerging campus-wide information environment. To this end Current Contents at Yale was designed with a user interface familiar to the Yale community, an alerting service based on electronic mail, and search expansion using the National Library of Medicine's Meta-1 metathesaurus.

Consumer Behavior

[A successfully treated case of empyema with a large tracheal fistula after a radical operation of esophageal cancer by fixation and plombage with major pectoral muscle flap].

We reported a successfully treated case of empyema with a large tracheal fistula which had developed after a radical operation of esophageal cancer (reconstructed with stomach). This 59-year-old male was treated by the method of fixation and plombage with major pectoral muscle flap and thoracoplasty, because we could not use the omentum that were frequently used nowadays for closure of the fistula. The size of the tracheal fistula was a large as the main bronchus bronchoscopically. Postoperative care were the following, the endotracheal tube was inserted from the tracheal stoma to the left main bronchus and 9 days left hemi-ventilation was performed. Continuous suction was performed at the same time from the right main bronchus in order to prevent secretion and blood pour into the left lung. Bronchoscopical examination done 28 postoperative day, the small fistula remained the tip of the muscle flap. But 72 postoperative day, the surface of the fixed muscle flap was replaced by normal bronchial mucomembrane and tracheal fistula was obliterated. Major pectoral muscle could be used as local flap to obliterate empyema cavity associated with tracheal fistula. We believe that utilizing an muscle flap for those who had undergone abdominal operation like our case is a valuable method.

Empyema

[A clinical study on coexistence of active pulmonary tuberculosis and lung cancer].

Twenty-two patients were diagnosed as coexisting active pulmonary tuberculosis and lung cancer during last ten years until 1989. They were nineteen men and three women and their age ranged from 61 to 84 years with a mean age of 71.3. Six patients had history of tuberculosis, three had undergone gastrectomy and four patients were complicated with diabetes mellitus. Histological types of lung cancer were epidermoid cell carcinoma in 13, adenocarcinoma in 3, large cell carcinoma in 2, and small cell carcinoma in 4 and clinical stages were "stage I" in 2, "stage II" in 2, "stage IIIA" in 5, "stage IIIB" in 4 and "stage IV" in 7, except 2 patients after surgical treatment. Localizations of lesions of cancer and tuberculosis were in the same lobes in 6, in ipsilateral lung in 6, and in contralateral lung in 6, except 4 cases, whose lesion of tuberculosis was not detectable roentgenologically and all cancers of "same lobe" cases were peripheral origins. Although, the prognosis was poor, which reflects the prognosis of lung cancer as a whole, the efficacy of anti-tuberculous chemotherapy was as good as patients without lung cancer. We mainly discussed the diagnostic points to detect the coexistence of lung cancer and pulmonary tuberculosis at early stage.

Aged

Lifestyles, glucose tolerance and blood pressure in male self-defence officials in northern Kyushu, Japan.

Evidence on determinants of BP is mostly derived from studies in western populations. The relationship of BP with lifestyle variables and glucose tolerance was studied in 1,302 male self-defence officials aged 49-56 years who received a health examination before retirement at the Self-Defense Forces Fukuoka Hospital from October 1986 to December 1988. Those with treated hypertension or diabetes mellitus and those with conditions affecting BP levels were excluded from the study. In multiple regression analysis, alcohol use, body mass index and glucose intolerance were strongly associated with elevated BP while there was an inverse relation between cigarette smoking and BP. Physical activity expressed as the time spent in vigorous exercise was not associated with either systolic or diastolic BP. These findings indicate that alcohol use, obesity and glucose intolerance are also important determinants of BP in male Japanese, and that cigarette smoking is a potential covariate in the study of BP.

Alcohol Drinking