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Biomedical subjects

T Kitano

Publications and source records attributed to T Kitano.

At least 19 recordsLinked to original sources

Fibrillar collagen-biphasic calcium phosphate composite as a bone graft substitute for spinal fusion.

The osteoconductive capacity of fibrillar collagen-biphasic calcium phosphate composition was compared to autogenous bone in a canine spinal fusion model. All animals underwent a standard intervertebral body fusion (L2-L4) with rigid internal fixation and received either autogenous bone alone or a mixture of the ceramic and autogenous bone (3:1) as the graft material. Animals were followed for 12 months and the quality of fusion in each animal assessed by biomechanical testing and histological analysis. The fused L2-L4 segment of each dog was embedded in bone cement and mounted in a specially designed mechanical tester for testing in flexion, extension, and side bending. Overall, the mean rigidity of the fusion mass was not significantly different between the two groups [10.5 +/- 4.1 (SD) for autogenous bone vs. 11.3 +/- 1.7 for the ceramic plus autogenous bone, p greater than 0.05]. Similar findings were obtained for mean bending moment, compressive load, angular deformation, and energy absorbed for the two groups. Histological analysis was performed on transverse nondecalcified specimens. Quantitation of bone ingrowth using back-scattered electron imaging disclosed no significant differences in the amount of new bone formed at the graft site between autogenous bone and the ceramic plus autogenous bone recipients (23.4 +/- 10% vs. 25.8 +/- 8.8%) when correction for the autogenous bone volumes was performed. Light microscopic analysis of toluidine blue-stained transverse sections demonstrated new bone growth around and through the ceramic bone graft material. These results suggest that use of a collagen-biphasic calcium phosphate ceramic and autogenous bone mixture (3:1) provides a suitable osteoconductive alternative to the use of autogenous bone and results in the formation of a mechanically competent fusion mass not significantly different from that obtained with autogenous bone alone.

Animals

Serial change of iodine-123 metaiodobenzylguanidine (MIBG) myocardial concentration in patients with dilated cardiomyopathy.

Serial change of the metaiodobenzylguanidine iodine-123 (123I-MIBG) myocardial concentration was investigated in patients with dilated cardiomyopathy (DCM). Eight DCM patients and 6 control subjects were examined. After the injection of thallium-201 and 123I-MIBG, planar chest images were obtained simultaneously for both tracers in every 30-60 min over 5 h. Serial changes of myocardial uptake ratio (MUR) were compared for both tracers. In DCM, the initial MUR of 123I-MIBG did not differ significantly from that of the controls. The washout of 123I-MIBG from the myocardium, however, was significantly increased in DCM. In particular, the decrease in the early phase (15-45 min) was significantly larger in DCM than in the controls (21.2% +/- 7.5% vs. 5.3% +/- 4.0%, P less than 0.01), showing a significant negative correlation with the left ventricular ejection fraction (r = -0.72 P less than 0.05). For 201Tl, neither the initial MUR nor the washout rate different significantly between the two. Thus, an early rapid decrease of the 123I-MIBG myocardial concentration might characterize DCM and reflect the severity of this disease.

3-Iodobenzylguanidine

Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers.

A 42-year-old female shiitake grower was investigated to clarify the etiology of skin lesions which developed during the planting of shiitake hyphae into bed logs. She complained of repeated eczematous skin lesions during the planting season, from March to July, for 10 years. She handled 7,000 pieces of small conic blocks made of beech, with shiitake hyphae attached to their surface, per day, and 300,000 pieces altogether per season. She was positive on patch testing with extracts of shiitake hyphae. In contrast, female shiitake growers with skin lesions associated with work other than planting, and without skin lesions, were negative on patch testing to the hyphae. Moderate allergenicity was observed to extracts of shiitake hyphae in a guinea pig maximization test. These findings indicated the etiology of skin lesions in shiitake growers to be allergic contact dermatitis induced by shiitake hyphae.

Adult

An epidemiological study with risk analysis of liver diseases in the general population living in a methyl mercury polluted area.

STUDY OBJECTIVE: The aim was to determine the actual prevalence of liver disease and to investigate the contribution of various risk factors to liver disease among the population in a methyl mercury polluted area. DESIGN: The study was a population based cross sectional mass screening survey. A case-control study was designed to estimate the role of various risk factors for liver diseases. SETTING: The study was confined to a small rural town 10 km north of Minamata City. SUBJECTS: 1406 persons aged 50 to 69 years were examined (78.3% of the total population of this age in the locality). MEASUREMENTS AND MAIN RESULTS: Measurements of liver disease were made on the basis of haematological, physical, and ultrasonographic examinations. Data on liver risk factors were collected by questionnaire, and by measurement of body height, weight (obesity), and hepatitis B surface antigen (HBsAg). The prevalence rate of liver tumour was 0.5% in males, liver cirrhosis was found in 0.5% of males and 0.1% of females, and hepatitis was seen in 5.4% of males and 1.0% of females. Frequency rates of risk factors for liver disease among subjects with obesity were significantly higher in the female patient group, and the frequency rate among subjects with alcoholic drinking habits was significantly higher in the male patient group. The odds ratio of past history of blood transfusion showed the highest value among other related factors (7.73) and the attributable risk for this was very high (87.1%); HBsAg was next in rank (odds ratio 3.04; attributable risk 67.1%). CONCLUSIONS: The prevalence of liver disease in this methyl mercury polluted area was not increased, contrary to what was expected based on the standard mortality ratios. The main risk factors for liver disease in this area appear to be alcoholic drinking habits and a history of blood transfusion.

Aged

Role of left atrial booster pump function in a worsening course of congestive heart failure.

We evaluated changes in left ventricular (LV) preload and the Doppler-derived transmitral late to early diastolic peak velocity ratio (A/E ratio) during the exercise in 27 patients with ischemic heart disease. After the exercise, A/E ratio decreased in 16 patients with a remarkable elevation in LV preload, and increased in 11 with a mild elevation. Further, Doppler transmitral flow in conjunction with pulmonary venous flow and hemodynamic parameters were analyzed in 11 dogs during a worsening course of heart failure induced by dextran infusion. The relationship of A/E ratio to LV end-diastolic pressure showed a quadratic curve concave to the pressure axis. A/E ratio, an index expressing left atrial (LA) contribution to LV filling, returned to that seen before volume loading under the condition of cardiac dysfunction. Pulmonary venous reflux fraction determined as the ratio of peak velocity of pulmonary venous reflux during LA systole to the sum of systolic and diastolic peak velocities of pulmonary venous antegrade flow, did not increase here. In this situation, blood could not be ejected from the left atrium into the left ventricle and even into the pulmonary veins during LA contraction. Finally, LV filling was not compensated by the left atrium, and LA booster pump function itself was deteriorated.

Aged

[Work history, health conditions and hearing loss of Ishigaki fishermen].

Based on our previous health survey among Ishigaki fishermen in 1979, this study aimed at clarifying the relations of their work histories to physical characteristics, physiological functions, blood conditions and hearing levels. Medical examination was conducted in 1987 on 118 fishermen inclusive of 33 followed-up fishermen, and in 1989 noise-level and noise-induced temporary threshold shift of hearing was measured for different fishing methods. The results were as follows; 1) Fishing history was not specifically associated with any physical characteristics. 2) High HDL cholesterol, which was observed among divers using diving apparatus, was considered to be a survival effect for divers, since HDL cholesterol is amplified by intensive muscle work. 3) Abnormalities of ECG except for a high R wave were notably observed among the divers, who once changed from unassisted diving to diving with apparatus and then to fishing lines. The main reason for switching jobs was claimed to be caisson disease, and it was suggested that diving with apparatus was related to a high risk of health hazards in the central nervous system and/or respiro-circulatory system. 4) Acoustic acuity greatly declined with aging, and which was commonly observed in groups with different work histories. By way of explanation, exposure to ship engine sounds during daily travelling was the most likely cause. It was also revealed that several hours' exposure to the engine sounds was needed to detect a temporary threshold shift of hearing before and after work.

Cardiovascular Diseases

[A comparison of the effects of omeprazole with those of ranitidine on intragastric pH and volume in patients for elective surgeries].

This study compared the effect of omeprazole with those of ranitidine on intragastric secretion during perioperative period. Thirty-one patients were randomly allocated to three groups. Each group received either omeprazole, ranitidine orally or one on the night before surgery. Intragastric pH and volume were measured after induction of anesthesia. Omeprazole group and ranitidine group had a higher mean pH than control group (P less than 0.01). None of the omeprazole group had an aspirate of pH lower than 2.5. One patient (10%) in the ranitidine group and five patients (50%) in the control group and five patients (50%) in the control group had aspirates of pH lower than 2.5. Mean gastric volume was not significantly different among these groups. A single dose of omeprazole 20 mg significantly decreased the number of patients at risk of aspiration pneumonitis.

Gastric Acid

[Coagulation changes during liver resection].

Thrombin-antithrombin III complex (TAT) and plasminogen activator inhibitor (PAI) were measured during liver resection surgery in 8 patients. TAT and PAI activities of patients under liver resection were compared with those of 11 patients under resection of esophageal carcinoma. TAT activity increased during liver resection (P < 0.001) and reached 14 times (P < 0.001) of its control value in the recovery room. PAI activity was very stable during operation, but increased to twice (P < 0.01) of its control value in the recovery room. TAT activity of patients after liver surgery in the recovery room was (P < 0.05) more than twice of that of patients after esophageal surgery. We conclude that hypercoagulable state occurred during liver resection to a greater degree compared with that observed with esophageal surgery, and that its cause might be liver resection itself.

Antithrombin III

[A cross-sectional study of lipid peroxide levels (plasma TBA levels) in a mass health examination].

Differences in plasma thiobarbituric acid (TBA) levels were studied by sex and age in 1,178 adults (471 males and 707 females) participating in a mass health examination conducted in a town of Kumamoto Prefecture in 1989. The relationships between plasma TBA levels and obesity, the consumption of cigarettes, alcohol, and fish, and various indices for health status derived from the data of physiological examinations were analyzed in age-groups 40-59 and 60-79 for both sexes. The prevalence of abnormal physiological findings by plasma TBA levels were further investigated. The results were as follows; 1. The highest plasma TBA levels for males were observed in the group aged 40-49, with levels gradually decreasing with age thereafter. The plasma TBA levels for females increased with age and the highest levels were obtained at age 60-69. The plasma TBA levels for males were significantly higher than for females at aged 40-49. 2. Plasma TBA levels for both sexes increased with obesity and the amount of fish consumed. 3. Plasma TBA levels in all examined groups had significant and strong positive correlations with serum total cholesterol levels and atherogenic indices, and had significant positive correlations with serum calcium and gamma-GTP levels. 4. A stepwise multiple regression analysis showed that plasma TBA levels for males were associated with serum total cholesterol, gamma-GTP, fish consumption and serum HDL-cholesterol in that order. The levels for female were associated with serum total cholesterol, body mass index, serum HDL-cholesterol and serum calcium in that order. The relationship with serum HDL-cholesterol was a negative correlation. 5. Prevalence of abnormal values of serum total cholesterol, atherogenic index and body mass index were significantly higher in the high-plasma TBA level group than in the group with median-plasma TBA level. These results suggest that plasma TBA levels may be useful as an index of undesirable lipid metabolism. Further studies should be performed to establish the significance of the relation of plasma TBA levels to fish consumption.

Adult

[Heat conservation during abdominal surgery].

Intraoperative hypothermia is a major problem in anesthetic management. We compared the heat conserving effect of a forced air warming system (Bair Hugger, Augustine Medical Inc.) with that of a warming blanket. Sixteen patients undergoing abdominal surgery were studied. Patients were anesthetized with nitrous oxide and oxygen combined with epidural anesthesia. Patients received tympanic, rectal, bladder and core temperature monitorings. Patients were divided randomly to Bair Hugger group (BH, n = 8) or warming blanket group (WB, n = 8). Temperature were measured every one hour over three hours. The BH group showed significantly higher temperatures than WB group. Bair Hugger system is an efficient way to maintain intraoperative body temperature.

Abdomen

Viscous carboxymethylcellulose in the prevention of epidural scar formation.

Six chemical agents were evaluated for their efficacy in preventing epidural scar formation following laminectomy in rabbits. One agent was carboxymethylcellulose and the other five agents represented various compositions of modified carboxymethylcellulose. Four weeks after laminectomy, spines were harvested and decalcified, and transverse sections were prepared for histologic analysis. Subjective evaluation suggested that two agents appeared to inhibit epidural scar formation compared with the untreated controls. Objective evaluation was performed by quantitating scar tissue area at the laminectomy site with a digitizing tablet. In agreement with the subjective evaluation, two agents were found to have significantly reduced epidural scar tissue area compared with the control (control = 0.418 +/- 0.16 SE mm2vs. Agent 2 = 0.067 +/- 0.02 [P less than 0.05] and Agent 5 = 0.089 +/- 0.02 [P less than 0.05]). Of the remaining four agents, one of which was the unmodified carboxymethylcellulose, none showed significant reduction in scar tissue formation. These findings indicate that viscous preparations of modified carboxymethylcellulose can act as a barrier against epidural scar formation following laminectomy.

Animals

A comparative study between a new, 50-degree right-semidecubital scanning and usual supine scanning of thallium-201 myocardial tomography for evaluation of coronary artery disease.

Images of thallium-201 cardiac tomography in the 50-degree right-lateral-semidecubital vs. usual supine positions were compared after a single dose of the isotope in 225 patients with or suspected of coronary artery diseases. Compared with the supine position method, the semidecubital position method enabled 25% shortening of the orbital radius (20.0 +/- 0.9 cm to 15.3 +/- 0.6 cm, n = 174, p less than 0.05), higher posteroinferior wall counts in both exercise and 3-hour-delayed images by up to 18%, better image sharpness and contrast, less motion artifact, more marked redistribution in the ischemic walls, and significantly higher specificity (57% vs. 78%, p less than 0.05) and accuracy (63% vs. 79%, p less than 0.05) for inferior wall lesions. The results indicate that the thallium cardiac scan is significantly affected by patient position during scanning, i.e., artifactual inferior wall defects due to photon attenuation in the supine position method. The semidecubital position method is recommended to minimize this artifact. The method is simple, easy to perform, well tolerated, feasible in any 1-headed tomography system, inexpensive, and free of running costs.

Angina Pectoris

[Measurement of intrahepatic shunt using Rutland method].

Intrahepatic shunt ratio was calculated from the fraction of the uptake constant and the blood background, analyzing the data of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatobiliary imaging by Rutland method. Shunt flow and total hepatic blood flow (THBF) were also calculated from the values for the effective hepatic blood flow (EHBF) estimated from the blood clearance technique. In 15 cases of normal volunteer, the average of the shunt ratio, shunt flow, and THBF were 18.4 +/- 5.4 (S.D.)%, 137.8 +/- 49 ml/min, and 753 +/- 83.2 ml/min, respectively. In 8 cases of chronic hepatitis, the values were 35.2 +/- 2.6%, 276 +/- 55.4 ml/min, and 794.1 +/- 119.4 ml/min, respectively. In 12 cases of liver cirrhosis, the values were 51.4 +/- 12.6%, 353.9 +/- 141.3 ml/min, and 685.6 +/- 174.8 ml/min, respectively. In cases of chronic hepatitis and liver cirrhosis, in comparison with normal cases, the values for the shunt ratio and shunt flow were significantly increased (p less than 0.001) and those for EHBF were significantly decreased (p less than 0.001), but those for THBF were not significantly altered. There was a significant inverse correlation between the shunt ratio and EHBF (r = -0.842) in all 35 cases. This method is considered to be useful for differential diagnosis, estimation of the grade of the diseases, and evaluation of pathophysiology of various diffuse liver diseases.

Chronic Disease

[The influence of the time activity variation on dynamic SPECT images in camera based SPECT].

Image quality of dynamic single photon emission computed tomography (SPECT) using a rotating gamma camera is dependent on the time activity variation of the tracer such as accumulation and excretion in the object's organ. Especially at the early time after injection of radionuclide, artifacts may occur strongly in the SPECT images. Simulated and experimental projection data of line sources and Jaszczak phantom were altered by sequentially weighting the projections with a function that varied linearly with time. With a variation of object activity given by linearly decaying functions, the main effect observed on the SPECT images obtained from simulated line sources was an elliptical deformation on the object. If the changing rate (R (t + 1)-R(t))/R(t) x 100 remained within 20% during acquisition, this deformation of SPECT images of line sources was not noticeable visually and resolution (FWHM) of line sources scarcely was degraded. In renal dynamic SPECT study using 99mTc-DTPA, the image quality of the first scan (30 sec) was considerably degraded. However, the changing rates after the third scan were less than 20% on the mean of 10 kidneys and the image quality was not noticeable visually.

Gamma Cameras

Inhibitory effect of a new antibiotic, guanine 7-N-oxide, on the replication of several RNA viruses.

Guanine 7-N-oxide (G-7-Ox) was examined for its antiviral activity against 9 viruses based on plaque reduction, neuraminidase activity reduction, a fluorescent antibody technique or ELISA. The following viruses were included in the tests: influenza, Sendai, simian virus 5 (SV5), respiratory syncytial, western equine encephalitis, Japanese encephalitis, vesicular stomatitis, rabies and polio. G-7-Ox showed broad anti-RNA viral activity against all viruses tested, except for poliovirus. Inhibition of persistent SV5 infection by G-7-Ox indicates that its antiviral activity is independent of cytotoxicity.

Animals

[Experiences in general anesthesia of patients with scoliosis presupposed to have difficulties in airway maintenance].

We experienced general anesthesia of two patients with cerebral palsy presupposed to have difficulties in tracheal intubation by reason of scoliosis. Case 1 is a 26-year-old woman. Chest X-ray photography and respiratory sounds in both pulmonary areas indicated neither airway stricture nor respiratory distress, but severe scoliosis presupposed difficult tracheal intubation. However, under the impression of possible intubation obtained by preoperative laryngoscopy, orotracheal intubation was tried with rapid induction. Epiglottis deviation to the left noted upon developing larynx made the glottis direct invisible, but some compression of cricoid from outside barely succeeded in intubation. The fixation of the endotracheal tube found much difficulties in its proper positioning so as to make stethoscopy uniform in both pulmonary areas, but trial rotations of the tube both in various directions and at various depths barely managed to find a position of uniform stethoscopy in both pulmonary areas, in which position the tube was fixed as proper positioning. Anesthesia was performed by nitrous oxide.oxygen.halothane; peroperative hemodynamics remained stable and arterial blood gas analysis presented no problems. Case II is a 16-year-old man. Resting respiration presented stridor and chest X-ray photography indicated scoliosis and laryngeal stricture. Patient's lack in the degree of cooperation made laryngoscopy impossible. Thus, in view of a high possibility of difficult tracheal intubation, orotracheal intubation was tried under the control of spontaneous respiration. While the intubation was being carried out by means of a stylet without developing larynx, severe bronchostriction was palpable at the point when the tube barely passed through the glottis, making the intubation impossible. However, the tube barely managed to be inserted while rotating with the stylet being extracted. Anesthesia was carried out by nitrous oxide.oxygen.halothane; peroperative hemodynamics underwent no remarkable change and arterial blood gas analysis presented no problems.

Adolescent

[Serial change of 123I-metaiodobenzylguanidine (MIBG) myocardial concentration in patients with dilated cardiomyopathy].

123I-Metaiodobenzylguanidine (MIBG) is expected to be useful agent for functional evaluation of the myocardial sympathetic innervation. The aim of this paper is to investigate serial change of 123I-MIBG myocardial concentration in patients (pts) with dilated cardiomyopathy (DCM) as compared with 201Tl uptake. Eight pts with DCM and six non-cardiac subjects (controls) were examined. After injection of 111 MBq (3mCi) 201Tl and 111 MBq (3 mCi) 123I-MIBG, simultaneous myocardial imaging in anterior view was performed for both tracers in every 30-60 minutes during 5 hours (6 images). Myocardial uptake ratio per pixel to the injected dose was calculated for each tracer with background and cross-talk correction on each image. In pts with DCM, myocardial uptake ratio of 123I-MIBG did not differ significantly from that of controls. The washout of 123I-MIBG from the myocardium, however, was significantly increased in pts with DCM as compared with controls. The % decrease of the radioactivity in 3 hours was 46.9 +/- 13.8% in DCM, whereas 18.0 +/- 7.7% in controls (p less than 0.05). Especially, the decrease in the early phase (less than 1 hour) was significantly larger in DCM than controls (21.2 +/- 7.5% vs 5.3 +/- 4.0%, p less than 0.01). For 201Tl, on the other hand, neither uptake ratio nor washout rate, differed significantly between the two. In conclusion, the rapid washout of 123I-MIBG in the early phase may reflect some sympathetic dysfunction in pts with DCM.

3-Iodobenzylguanidine