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Biomedical subjects

S Yamaji

Publications and source records attributed to S Yamaji.

At least 37 records · Page 2Linked to original sources

Lateral dominance of legs in maximal muscle power, muscular endurance, and grading ability.

The purpose of this study was to examine lateral dominance in maximal muscle power, muscular endurance, and grading ability, using isokinetic mulscular strength in knee extension and flexion. The subjects were 50 healthy male students whose ages ranged from 19 to 23 years (M height: 173.6+/-6.2 cm, M weight: 67.2+/-6.8 kg). Their dominant legs for power exertion and for functional use were based on questionnaire items selected from those used in previous studies. The angular velocities of extension and flexion for exerting maximal muscle power were 60, 180, and 300 x sec.(-1). A continuous exertion 30 times at an angular velocity of 180 sec.(-1) was used as the load for muscular endurance. For grading ability, 25%, 50% and 75% of the maximal muscle strength at angular velocities of 60 and 180 x sec.(-1) were the required values, and the difference between these values and the exerted muscular strength was evaluated. The dominant leg and nondominant leg were compared for both power exertion and functional use. There was no lateral dominance in maximal muscle power and muscular endurance. In muscular endurance, especially, some subjects showed one leg superior in power exertion and some superior in functional use. Lateral dominance was noted across maximal muscle power and muscular endurance in grading ability. The dominant leg tended to be better than the nondominant leg in functional use. However, lateral dominance was not remarkable for flexing motion and in exertion for a short time.

Adult↗

Subcutaneous extramedullary hematopoiesis in a patient with secondary myelofibrosis following polycythemia vera.

We describe the case of a 73-year-old woman with secondary myelofibrosis who developed subcutaneous extramedullary hematopoiesis. Although extramedullary hematopoiesis has been generally observed in primary myelofibrosis, in this case it was seen in myelofibrosis secondary to polycythemia vera. Histological examination of the subcutaneous nodule revealed that the lesion included cells from the myeloid and megakaryocytic series. The skin lesion almost disappeared after treatment with hydroxyurea. We report here this rare manifestation in secondary myelofibrosis including a review of literature.

Aged↗

New prediction equation for residual volume in Japanese male and female young adults.

BACKGROUND: The purpose of this study was to establish a convenient prediction equation for residual volume for Japanese male and female young adults after comparisons in reliability and validity with previous equations widely used in studies of body composition with Japanese subjects. METHODS: The subjects were healthy Japanese, 110 males aged 18 to 27 years and 82 females aged 18 to 22 years. Measured residual volume (MRV) was measured with a nitrogen washout technique and each predicted residual volume (PRV) was predicted using a prediction equation. Multiple regression analysis on all possible selections was applied to determine a suitable and convenient prediction equation for residual volume. RESULTS: Intra-class correlation coefficient and a coefficient of Cronbach in MRV exceeded 0.9, indicating high reliability. Pearson s correlation coefficients between MRV and each PRV for males and females ranged from 0.225 to 0.327 and - 0.485 to 0.507, respectively. Multiple correlation coefficient adjusted for degrees of freedom applying the one variables of height was 0.592 for males and 0.670 for females. CONCLUSIONS: Considering the practicability of measurement, prediction equations for residual volume with height in Japanese male and female young adults have been proposed. The new prediction equations (PRVnew) are as follows: male: PRVnew= 32.16 yen height (cm) - 4113.70 (Radj= 0.592, SE= 247.13 ml); female: PRVnew = 34.03 yen height (cm) - 4407.78 (Radj= 0.670, SE= 195.74 ml).

Adolescent↗

[Successful second transplant from one-locus HLA-mismatched unrelated donor for graft rejection following initial transplant from another unrelated donor in a patient with chronic myelogenous leukemia].

We report a patient with chronic myelogenous leukemia who received a second transplant from a one-locus HLA-mismatched unrelated donor after rejection of an initial bone marrow graft. For the first transplant, HLAs were fully matched, conditioning with busulfan + cyclophosphamide (CY) was applied, and cyclosporin A + short-term methotrexate (sMTX) was used for prophylaxis against GVHD. A complete chimera was not obtained, and the graft was rejected on day 122. For the second transplant, there was a one-HLA locus (DR) mismatch, conditioning was done with total body irradiation + cytarabine + CY, and GVHD prophylaxis consisted of FK506 + sMTX. Engraftment was obtained on day 27, and no graft failure was occurred at the time of writing. This case suggests that strong immunosuppression may have prevented rejection of the second bone marrow graft.

Adult↗

A diagnostic method for suspected Alzheimer's disease using H(2)15O positron emission tomography perfusion Z score.

We developed cerebral perfusion Z score map (Z map) images using H(2)15O and positron emission tomography (PET), and examined their use in diagnosing Alzheimer's disease (AD). Cerebral blood flow (CBF) images were obtained using the PET and H(2)15O autoradiographic method. The best region for normalising the CBF value to remove individual variantion was determined. Then CBF images were transformed to Talairach's standard space, and each pixel value of an individual's image set was normalized to the mean value of the sensorimotor area. Based on the CBF images of 20 normal volunteers, normative mean and standard deviation (SD) CBF images were constructed. Then, each pixel value of the axial CBF images in 28 patients with probable AD and 10 further normal volunteers was converted to a Z score (Z = [normal mean--individual value]/normal SD). A Z map, showing pixels exceeding a threshold of Z score > 2 on MRI of standardised anatomical space was demonstrated. These 38 Z maps were interpreted by four radiologists. When regions in the temporoparietal area were found with Z scores > 2, the subject was diagnosed as having AD. A receiver operating characteristic (ROC) analysis was performed to compare the conventional CBF images and Z maps. The diagnostic performance of the Z map was superior to that of visual inspection of conventional CBF images (mean areas under the ROC curve of the four radiologists were 0.946 and 0.584, respectively). These results indicate that a Z map obtained in this way is superior to conventional PET for diagnosing AD.

Aged↗

Evaluation of standardized uptake value to assess cerebral glucose metabolism.

PURPOSE: When the cerebral metabolic rate of glucose (CMRglc) is to be measured, arterial blood sampling is usually required for fluorine-18 fluorodeoxyglucose (FDG) and positron emission tomography (PET) studies. However, blood sampling is inconvenient because it requires several staff members and is invasive for patients. METHODS: To assess cerebral glucose metabolism by a noninvasive and simplified method, the authors used the standardized uptake value (SUV), which requires no input function or blood sampling. The study participants included 18 healthy volunteers (4 men and 14 women; mean +/- SD age, 68.2+/-6.3 years), 18 patients with mild Alzheimer's disease (AD) (4 men and 14 women; mean +/- SD age, 68.8+/-7.3 years), and 18 patients with moderate AD (5 men and 13 women, mean +/- SD age, 69.5+/-8.5 years). Regional CMRglc and regional cerebral SUV were measured in the three groups using FDG PET, and the correlation between global CMRglc and global SUV was estimated. RESULTS: The correlation coefficients of global CMRglc and global SUV in the healthy volunteers, mild AD patients, and moderate AD patients were 0.82, 0.67, and 0.62, respectively. Compared with the healthy persons, the patients with mild AD showed significantly decreased CMRglc in the temporal, frontal, and parietal cortices, but they did not show significantly decreased SUV in any region. Patients with moderate AD had significantly decreased CMRglc in the temporal, frontal, occipital, parietal, and sensorimotor cortices and significantly decreased SUV in the temporal, frontal, occipital, and parietal cortices. CONCLUSION: The SUV would be useful as a semiquantitative index of cerebral glucose metabolism only in healthy persons or those with mild AD.

Aged↗

Ability to coordinate exertion of force by the dominant hand: comparisons among university students and 65- to 78-year-old men and women.

The purposes of this study were to examine the characteristics of ability to coordinate exertion of force in 60 healthy older people (30 men, 30 women) from the viewpoint of sex differences and to compare their performance with those of 60 healthy university students (30 men, 30 women). The test of ability to coordinate exertion of force was conducted by having the subject fit the exertion value of grip strength to a changing demand value appearing on the display of a personal computer (using a bar chart-description form). The changes in the demand value were tracked. The variable estimating ability to coordinate exertion of force was the total sum of the differences between demand and the produced grip strength induced by time lapses. The ability to coordinate exertion of force in the older subjects was inferior to that of the younger subjects, and large individual differences were observed. Unlike the younger subjects, the means of the ability to coordinate exertion of force of the older subjects significantly decreased between trials. The ability to coordinate exertion of force of the older women was significantly inferior to that of the older men, but the means of the measurements among three trials shows a similar tendency to decrease in both sexes.

Adolescent↗

Examination of force-production properties during static explosive grip based on force-time curve parameters.

The present study attempts to clarify the properties of force-time curves in the force-development phase during static explosive grip exertion and to determine force-time parameters in relation to static explosive strength. 80 healthy young males (age 17.8 +/- 2.5 yr.) exerted maximal isometric force as fast and forcefully as possible. In total, 21 variables, e.g., time to fixed level, integrated area, average force, integrated area to fixed time, force at the maximal rate of force development, and maximal rate of force development, were selected as force-time parameters. Good reliability was obtained for average force in force levels above 90% of maximal strength (.64-.93), integrated area to a fixed time of 1.0-2.0 sec. (.86-.93), force at the maximal rate of force development (.67), and maximal rate of force development (.73). In addition, these values correlated closely with maximal grip strength (r= .65-.93). Further, significant differences in maximal grip strength, average force in force levels above 90% of maximal strength, integrated area to fixed time, and force at the maximal rate of force development were found among three groups categorized by average force in force levels of maximal strength. These results suggested that individual differences were present in the force-time curve patterns during the force-development phase of static explosive grip exertion and that the average force in force levels of maximal strength might be a valuable tool for evaluating static explosive strength.

Adolescent↗

Regional cerebral blood flow difference between dementia with Lewy bodies and AD.

The authors studied 14 patients with dementia with Lewy bodies (DLB), 14 patients with AD, and 14 healthy control subjects with N-isopropyl-p-[123I]iodoamphetamine SPECT. Comparison with the statistical parametric mappings revealed that relative cerebral blood flow was lower in the occipital lobes and higher in the right medial temporal lobe in the DLB group than in the AD group. Decreased occipital perfusion and relatively well preserved medial temporal perfusion are features that distinguish DLB from AD.

Aged↗

Low-dose cytarabine-induced hepatic and renal dysfunction in a patient with myelodysplastic syndrome.

We report a 49-year-old female patient with secondary myelodysplastic syndrome who developed liver dysfunction and acute renal failure caused by low-dose cytosine arabinoside (Ara-C) therapy. Treatment of low-dose Ara-C has widely been used for acute myelogeous leukemia and myelodysplastic syndrome, and it is thought to be a low toxicity except for myelosuppression. The patient complained of a transient adverse reaction in the second and third course of therapy. This rare case indicates that careful observation should be carried out during low-dose Ara-C therapy in view of allergic reactions.

Acute Kidney Injury↗

Tc-99m ethyl cysteinate dimer SPECT and 2-[F-18]fluoro-2-deoxy-D-glucose PET in Alzheimer's disease. Comparison of perfusion and metabolic patterns.

PURPOSE: This study compared Tc-99m ethyl cysteinate dimer (ECD) SPECT images with 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) PET images in the same patients with Alzheimer's disease and determined whether ECD SPECT is as useful as FDG PET clinically. METHODS: Ten patients with probable Alzheimer's disease (mean +/- SD: age, 71 +/- 5.2 years; 6 women and 4 men; Mini-Mental State Examination score, 19.2 +/- 5.3) were evaluated in this study. Both ECD SPECT and FDG PET were performed within 1.5 months in each patient. RESULTS: ECD SPECT showed a reduction in parieto-temporal perfusion in 8 of the 10 patients, whereas FDG PET showed a reduction in temporoparietal metabolism in 9. The ECD images showed greater radiotracer uptake in the cerebellum and occipital lobe than did FDG images. The contrast between the radiotracer uptake in the sensorimotor area and that in the parietotemporal region was not as great in the ECD images as it was in the FDG images. CONCLUSION: Although ECD SPECT may not be superior to FDG PET, it is useful for the clinical evaluation of patients with Alzheimer's disease.

Aged↗

Characteristics of ADL ability on partially dependent older adults: comparison among different ambulatory activities levels.

The purpose of the present study was to clarify the characteristics of ADL ability among different ambulatory level groups. The subjects were 448 partially dependent older adults (PD; 126 male, 81.7 +/- 8.22 year; 322 female, 82.5 +/- 7.25 year) over 60 years of age, and they were divided into 3 groups based on ambulatory activity level; G1 could not walk without assistance; G2 could walk with a stick; G3 could walk without assistance. The PD were asked 17 ADL questionnaires representing seven ADL domains to evaluate the ADL ability. Total and domain ADL scores, and achievement rates for each item were calculated, and compared among different ambulatory activity groups. It is confirmed that ADL ability level in PD significantly relates to ambulatory level and becomes gradually higher as the ambulatory activity level advances. It is considered that in the G1, lower limb ability level is low, and the contribution of ability level regarding changing posture and manual activities to total ADL ability level is high. On the other hand, in the G3 the achievement levels in manual activities and high-difficulty ADLs using lower limbs reflects the differences in the ADL ability level among individuals. Gender differences for ADL ability are not found in any ADL domain, while age differences are found in only the G3. It is inferred that for the G1, the achievement levels of ADLs are largely influenced by disease morbidity and age contributes very little to the decline of ability level.

Activities of Daily Living↗

[Successful emergency operation for subdural hematoma and acute epidural hematoma in a patient with acute promyelocytic leukemia].

A 22-year-old woman was admitted with purpura. Acute promyelocytic leukemia (APL) with disseminated intravascular coagulation (DIC) was diagnosed. On the 17th day after treatment with all-trans retinoic acid (ATRA), left subdural hematoma developed. Although coagulation abnormalities were still observed, emergency surgery was performed. Acute epidural hematoma was confirmed by computed tomographic scan after the operation. A second operation for drainage was successful. Post-operative intracranial hematoma may be caused by rapid decompression induced by surgery, but DIC could also be involved. This case underscored the need for careful consideration of the indications for surgical treatment of such DIC patients, with close follow-up monitoring for the postoperative development of neurological symptoms.

Acute Disease↗

Cerebral blood flow changes in the primary motor and premotor cortices during hyperventilation.

The aim of this study was to clarify the regional differences in cerebral blood flow (CBF) change during hyperventilation by using H2(15)O and positron emission tomography (PET). Eight healthy volunteers (age: 63.0 +/- 8.9 yr.) were studied. Regional CBF was measured by the H2(15)O autoradiographic method and PET. Statistical parametric maps (SPM) and conventional regions of interest (ROI) analysis were used for estimating regional CBF differences in the normocapnic state with normal breathing and the hypocapnic state induced by hyperventilation. Total CBF decreased during the hypocapnic state. The SPM revealed that primary motor and premotor cortices were significantly activated by hyperventilation. In these areas absolute CBF values were significantly higher than those in the temporal, occipital and parietal lobes in the hypocapnic state, but there were no significant regional differences in the normocapnic state. In the hypocapnic state induced by hyperventilation, the primary motor and premotor CBF shows combined changes with vasoreaction to hypocapnia and increase in activation due to hyperventilation.

Aged↗

Frontotemporal dementia and Alzheimer disease: evaluation of cortical atrophy with automated hemispheric surface display generated with MR images.

PURPOSE: To determine the features of cortical atrophy in frontotemporal dementia (FTD) and Alzheimer disease by using a hemispheric surface display generated with magnetic resonance (MR) images. MATERIALS AND METHODS: The extent of cortical atrophy was evaluated with automated MR hemispheric surface display and volumetry in 18 patients with FTD and in 18 matched patients with Alzheimer disease. Results were compared with those in 18 healthy, matched control subjects. RESULTS: Most cortical regions were significantly atrophic in FTD and Alzheimer disease. The frontal and anterior temporal lobes were significantly more atrophic in FTD than in Alzheimer disease. The mean hemispheric-to-intracranial volume ratio in patients with FTD (56.2%) and those with Alzheimer disease (58.4%) was significantly smaller than the ratio in the control subjects (66.0%). Asymmetry of hemispheric volume was significantly larger in the FTD group than in the Alzheimer disease and control groups. CONCLUSION: Cortical atrophy in FTD is more widespread than was previously thought. Asymmetric frontal and anterior temporal atrophy is a distinctive feature of FTD and distinguishes it from Alzheimer disease. Hemispheric surface display is a useful complement to tomographic images and is useful for the evaluation of focal cortical atrophy in degenerative dementias, especially FTD.

Aged↗

Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease.

OBJECTIVE: To delineate the features of regional cerebral metabolic rate of glucose (CMRglc) in dementia with Lewy bodies (DLB). METHODS: We compared absolute CMRglc in 12 patients with a clinical diagnosis of DLB, 12 patients with a clinical diagnosis of Alzheimer's disease (AD), and 12 normal volunteers (NC), using 18F-fluorodeoxyglucose (FDG) and PET. The three groups were matched for age and sex, and there were no differences in disease duration or severity of cognitive disturbances between the DLB and AD groups. RESULTS: CMRglc was significantly lower in patients with DLB than in that of NC in most parts of the brain, except the sensorimotor cortices, basal ganglia, thalamus, and pons. Between the DLB and AD groups, there were significant regional CMRglc differences in the medial and lateral occipital lobes. In DLB and AD, the CMRglc reduction patterns were similar, though the global metabolic reduction was larger in DLB, and the occipital CMRglc reduction in DLB could differentiate DLB from AD. The relative occipital CMRglc (normalized to the sensorimotor CMRglc) was a useful measure for the differential diagnosis of DLB from AD. The sensitivity and the specificity were 92% when using the minimal value of the normalized occipital CMRglc in the NC group as the cut-off point. CONCLUSION: These different regional CMRglc reductions substantiate the pathologic, neurochemical, and clinical differences between DLB and AD.

Aged↗