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Biomedical subjects

Yoshiaki Hashimoto

Publications and source records attributed to Yoshiaki Hashimoto.

33 records · Page 2Linked to original sources
PubMed2003

Chemical factors affecting the interpretation of blood cyanide concentrations in fire victims.

The purpose of this study was to examine the effects of methemoglobinemia caused by fire gases on blood cyanide concentrations in fire victims. Twenty-two fire victims with postmortem intervals of 8-48 h were involved. Blood cyanide concentrations at the time of death (C(0)) were estimated using the formula: C(0)=Ce(0.046 t) (C=blood cyanide concentration detected at autopsy, 0.046=first-order rate constant of cyanide disappearing from blood in corpses, and t=postmortem interval). Total (free and combined with cyanide) methemoglobin (MetHb) content was used to estimate the maximum capacity of MetHb for combining cyanide. Blood cyanide concentrations at the time of death were very high (5.32-6.47 mg/l) in five victims. Three showed high saturation (54.7-63.0%) of carboxyhemoglobin (CO-Hb) and elevated total MetHb contents (2.6-5.0%). MetHb at these levels is capable of scavenging up to 8.6-11.4 mg/l of blood cyanide. Thus, blood cyanide might have been completely combined with MetHb at the time of their death. In the remaining two victims, CO-Hb saturation was not high (30.9 and 37.9%) and no free MetHb was detected. As a result they may have exhibited severe toxic effects of cyanide at the time of their death. Our results indicate that MetHb contents and CO-Hb saturation should be determined to evaluate the toxic effects of cyanide in fire victims.

Adult↗
PubMed2003

Distributions of ethanol and intubation-related lidocaine in the brain of a trauma patient who was brain dead for about 5 days.

A 48-year-old intoxicated man was admitted to a hospital with an acute subarachnoid hemorrhage from a blow to the head following a drinking session. Lidocaine jelly was used to facilitate intubation during cardiopulmonary resuscitation. While his heart resumed beating, he was classified as brain dead and his heart stopped 114 h after admission. His brain was soft and weighed 1.7 kg at autopsy. A small rupture (0.5 by 0.3 cm) of the left vertebral artery and diffuse subarachnoid hemorrhage were observed. Ethanol was detected only in the cerebrum, cerebellum and clotted blood in the superior sagittal sinus at 0.29, 0.15 and 0.12 mg/g, respectively. Lidocaine was also found in these areas at levels of 28, 24 and 7 ng/g, respectively. Significant amounts of ethanol were present in his brain because blood flow stopped after the injury. Smaller amounts of intubation-related lidocaine were probably distributed to the brain by limited cerebral circulation and remained there after circulation ceased. Toxicological analysis of the brain after death was useful for evaluating his state during treatment.

Anesthetics, Local↗
PubMed2003

Effects of environmental conditions to which nails are exposed on DNA analysis of them.

To investigate the feasibility of DNA analysis of nails taken from human remains after environmental exposure, we tested the quantity and quality of DNA that could be recovered from nails exposed to various conditions. We first investigated whether there is an inter- or intra-subject difference in the DNA content of nails using nails obtained from 333 volunteers. DNA content did not significantly differ between males and females, or between young and elderly groups. In addition, no statistically significant differences were observed among nail samples obtained from each finger of the same person. Then thumbnails of five volunteers were left in dried soil, wet soil, river water, sea water, distilled water or air for 3 months. Each nail sample was tested monthly for sex chromosome-specific repeats, ABO genotype, STRs (TH01, TPOX, CSF1PO, FES and vWA loci), and D1S80 locus. These markers were correctly detected from nails after 1 month, irrespective of environmental conditions. Thereafter, the detection rates were decreased to various degrees, except for nails left in air. The detection of longer DNA markers tended to be more difficult than the detection of shorter markers. Nails were more fragile in wet soil than in any other condition. However, nonspecific PCR products were not observed in any nail sample. Our results reconfirmed the usefulness of the nail as a specimen for forensic DNA analysis.

Adolescent↗
PubMed2003

Intramuscular bleeding of the tongue in the victims of house fire.

Intramuscular bleeding of the tongue is frequently observed in autopsy cases of house fire victims. The meaning of this finding has not yet been fully discussed. We examined 69 autopsy cases of house fire victims and investigated several factors contributing to intramuscular bleeding of the tongue. Victims comprised 45 males and 24 females, ranging in age from 1 to 95 years old. Sixty-four cases (93%) involved severely charred bodies, while the remaining five bodies displayed slight burns. Factors studied were age, sex, posture of the body at the scene of the fire, degree of burn injury and carboxyhemoglobin (CO-Hb) levels in blood. CO-Hb level proved to be the only factor relevant to intramuscular bleeding of the tongue. Of 69 autopsy cases, 23 (33%) demonstrated intramuscular bleeding of the tongue (13 cases of slight bleeding, ten cases of severe bleeding). Low concentrations of CO-Hb (</=30%) were observed in six of ten cases (60%) with severe intramuscular bleeding. Of 46 cases without intramuscular bleeding, ten (22%) displayed low concentrations of CO-Hb. These results may indicate that severe burn injuries occurring before inhaling air containing high levels of carbon monoxide represent the cause of intramuscular bleeding of the tongue in fire victims. The burned regions of the body in the early stage of the fire process were unclear due to severe charring in most victims. However, asphyxiation due to neck compression is known to often induce intramuscular bleeding of the tongue. Lack of skin elasticity following burns, particularly in the neck, might act in a similar manner to asphyxial neck compression. In conclusion, intramuscular bleeding of the tongue in fire victims may occur as a vital reaction to burns.

Adolescent↗
PubMed2003

Pilot clinical trial of the use of alpha-tocopherol for the prevention of hepatocellular carcinoma in patients with liver cirrhosis.

Patients with chronic hepatitis C virus (HCV) infection often develop liver cirrhosis and hepatocellular carcinoma (HCC). The purpose of this study was to test the chemopreventive effect of alpha-tocopherol on hepatocarcinogenesis in patients with liver cirrhosis and a history of HCV infection. Eighty-three patients with liver cirrhosis and with positive history of HCV infection were divided at random into two groups. Forty-four patients were treated with alpha-tocopherol (Vit E group) while the other 39 were followed as controls. The clinical background (gender, age, and laboratory data) was similar in the two groups. Serum levels of alpha-tocopherol, albumin, alanine aminotransferase (ALT), and total cholesterol and platelet count were measured serially over a period of five years. The mean serum concentration of alpha-tocopherol was low in both groups at entry and was significantly higher in the Vit E group than in the control group one month after treatment. Platelet count, serum albumin, ALT, and total cholesterol were not different between the two groups during the five-year period. Cumulative tumor-free survival and cumulative survival rate tended to be higher in the Vit E group than in controls, albeit statistically insignificant. The serum level of alpha-tocopherol was low in patients with liver cirrhosis and positive for HCV. Although the administration of alpha-tocopherol normalized the level one month later, it could neither improve liver function, suppress hepatocarcinogenesis, nor improve cumulative survival. Patients treated with alpha-tocopherol tended to live longer without development of HCC but the difference was not statistically significant.

Alanine Transaminase↗
PubMed2003

[Quantification of urinary hemoglobin by an immunological method].

The quantification method of urinary hemoglobin has not been established. We examined whether a reagent (Eiken, Tokyo) used to immunologically assay fecal hemoglobin could be utilized to quantify urinary hemoglobin. The coefficients of variation were 2.2-3.0% in the reproducibility of one-run assays using urine and 4.3-5.7% in that of multiple-run assays using the standard sample of hemoglobin. Urinary hemoglobin was unstable and decreased in a time- and temperature-dependent manner. However, addition of the hemoglobin stabilization buffer (50 mM phosphate buffer, pH 6.4) (Eiken) to urine made urinary hemoglobin stable. Urinary hemoglobin levels did not change significantly when stored at 4 degrees C for 7 days or at -80 degrees C for 30 days. The hemoglobin concentration (mean +/- SD) of urine showing 1+, 2+ and 3+ with a test strip was 385 +/- 165(n = 30), 1070 +/- 499(n = 40) and 4130 +/- 2770 ng/ml (n = 20), respectively. Urinary hemoglobin did not correlate with urinary albumin, transferrin, immunoglobulin G, N-acetyl-beta-D-glucosaminidase nor alpha 1 microglobulin. These results suggest that this immunological method using the hemoglobin stabilization buffer can be utilized for quantification of urinary hemoglobin, which may provide clinically important information.

Biomarkers↗
PubMed2002

A case of fatal hemorrhage in the cerebral ventricles following intravenous use of methamphetamine.

We describe a case of massive hemorrhage in the cerebral ventricles, probably caused by methamphetamine abuse. A 44-year-old male was found dead in a prone position in a hotel room. Old and new injection marks were observed in his right cubital fossa. Petechiae were observed on the conjunctiva of his right eye, laryngeal mucosa, epicardium and under the capsule of the liver (to a slight or moderate degree). The brain, weighing 1.67 kg, was heavily edematous; the lateral and fourth ventricles were filled with hematomas. Subarachnoid, intracerebral hemorrhages were not observed. Cerebral vascular abnormalities were not evident. There were no remarkable changes in other organs, other than congestion. Gas chromatographic-mass spectrometric analysis of the urine disclosed the presence of methamphetamine and amphetamine. The concentration of methamphetamine within the femoral venous blood and intraventricular hematoma was 0.347 microg/ml and 0.189 microg/g, respectively. Amphetamine was not detected in either sample. Urine contained 3.15 microg/ml methamphetamine and 0.063 microg/ml amphetamine. These results indicate that intraventricular hemorrhage might have occurred shortly after intravenous self-administration of methamphetamine. Cerebral arterial spasm and hypertension resulting from the administration of methamphetamine might have resulted in intraventricular hemorrhage.

Acetic Anhydrides↗
PubMed2002

Severe manifestation of acute hepatitis A recently found in Gunma, Japan.

BACKGROUND: The incidence of acute hepatitis A infection in Japan peaked 10 years ago and has been decreasing since then. However, an increase in severe cases of the disease has been documented recently. We experienced an outbreak in 1998-1999, and compared the clinical features of the disease in 1998-1999 (recent outbreak) and in 1987-1988 (past outbreak) in our prefecture (Gunma). METHODS: Forty patients with acute hepatitis A were admitted to nine Gunma hospitals from October 1998 to September 1999. Their clinical features were compared with those of 100 patients with acute hepatitis A admitted to the same hospitals in 1987-1988. RESULTS: Both outbreaks occurred mostly during the winter-spring season. Secondary familial infection was significantly decreased in the recent outbreak. Patients in the recent outbreak were 7 years older than those in the past outbreak. Laboratory findings, such as serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and prothrombin time, were worse in the recent than in the past outbreak. Severe-type hepatitis and fulminant hepatitis occurred in 5 patients (12.5%) in the recent outbreak but in only 2 patients (2.0%) in the past outbreak. CONCLUSIONS: Clinical data and manifestations were more severe in the recent outbreak than in the past outbreak of acute hepatitis A. It is important to be aware of hepatitis A virus infection and to take into account the available vaccination against hepatitis A virus in Japan.

Acute Disease↗
PubMed2002

Absence of specific symptoms in chronic hepatitis C.

BACKGROUND: No systematic research has been carried out on the symptoms of chronic hepatitis C, although the disease is believed to induce subjective symptoms such as fatigue or dullness in the legs. METHODS: The Todai Health Index has been developed as a symptom checklist that is used for screening particular diseases or for health management. The index was chosen as the most suitable questionnaire for measuring characteristic symptoms of chronic hepatitis C. Sixty patients with chronic hepatitis C who did not have any severe complications were compared with healthy control subjects who were selected randomly from the residents of Isesaki City, Gunma, Japan. RESULTS: The major findings were as follows: (1) male and female patients with chronic hepatitis C had no characteristic subjective physical symptoms when compared with the healthy controls, except for a significant difference in aggression, and (2) the severity of the hepatitis was not associated with the patients' symptoms after adjusting for age and treatments. CONCLUSIONS: Patients with chronic hepatitis C who did not have any severe complications did not show specific subjective physical symptoms.

Adult↗
PubMed2002

Apolipoprotein A-I deficiency with accumulated risk for CHD but no symptoms of CHD.

We evaluated a 69-year-old Japanese woman with apolipoprotein (apo) A-I deficiency, high levels of low-density lipoprotein (LDL)-cholesterol, hypertension and impaired glucose tolerance. The patient had corneal opacity, but neither xanthomas, xanthelasma, nor tonsillar hypertrophy. She was not symptomatic for coronary heart disease (CHD), and had normal electrocardiograms at rest and exercise using a cycle ergometer. She had severely reduced levels of high-density lipoprotein (HDL)-cholesterol (0.10-0.18 mmol/l) and no apo A-I (<0.6 mg/dl). LDL-cholesterol and apo B as well as apo E were increased even under treatment with 10 mg pravastatin per day. Gel filtration chromatography revealed that in addition to VLDL and LDL fractions, she had apo A-II rich and apo E rich fractions, which were present in the HDL fraction separated by ultracentrifugation. A cytosine deletion was identified by genomic DNA sequencing of the apo A-I gene of the patient at the third base of codon 184 in the fourth exon, which led to a frame shift mutation and early termination at codon 200. This patient is the oldest among those with apo A-I deficiency reported in the literature, and she had no symptoms of CHD despite the accumulated risk for the disease.

Aged↗
PubMed2002

Relationship between genetic polymorphisms of alcohol-metabolizing enzymes and changes in risk factors for coronary heart disease associated with alcohol consumption.

BACKGROUND: There are large individual variations in the responses of risk factors for coronary heart disease to alcohol consumption. To clarify the factors responsible for these individual variations, we studied the relationship between blood pressure, serum lipids, and uric acid and the genetic polymorphisms of alcohol dehydrogenase (ADH) 2 and aldehyde dehydrogenase (ALDH) 2 in alcohol drinkers. METHODS: We examined 133 male workers who drank >300 g of alcohol per week. Information regarding lifestyle habits was obtained by questionnaire. The ADH2 genotype was determined by PCR and subsequent digestion with MaeIII. The ALDH2 genotype was determined based on amplified product length polymorphisms. RESULTS: When the workers were divided into three groups: the ADH2(1)/2(1), ADH2(1)/2(2), and ADH2(2)/2(2) groups, the mean triglycerides and gamma-glutamyl transpeptidase concentrations were significantly higher in the ADH2(2)/2(2) group than in the ADH2(1)/2(1) group. In addition, multiple logistic regression analysis showed that the frequencies of individuals whose systolic blood pressure, triglycerides, and uric acid values were in the highest one third were significantly higher in the ADH2(2)/2(2) group than in the ADH2(1)/2(1) group. In contrast, no difference was observed between the ALDH2(1)/2(1) and (ALDH2(1)/2(2) + ALDH2(2)/2(2)) groups with regard to the mean value of any variable and to the frequency of individuals with any variable value in the highest one third. CONCLUSION: Individuals with the ADH2(1)/2(1) genotype might suffer fewer negative effects of drinking.

Alcohol Dehydrogenase↗
PubMedDate not supplied

Redistribution of diltiazem in the early postmortem period.

We determined tissue distribution of diltiazem after it was used to treat hypertension in two cases. The postmortem interval was 16 h in both cases. Diltiazem was isolated using liquid-liquid extraction, and it was identified and quantitated using gas chromatography-mass spectrometry (GC-MS) and GC, respectively. In one case, diltiazem concentrations in the lungs and pulmonary vessel blood were 62-82 and 27-30 times higher than right femoral blood, respectively. Although blood was not obtained from the left cardiac chambers, aortic blood showed a 10-times higher level of diltiazem than right femoral venous blood. Diltiazem concentration in blood in the right cardiac chambers was 3.6 times higher than that in right femoral venous blood. In another case, diltiazem concentrations in the lungs were 7.4-7.6 times higher than right femoral venous blood. Blood in the pulmonary arteries, pulmonary veins, left cardiac chambers, and aorta showed 2.0-3.1 times higher levels of diltiazem than right femoral venous blood. Blood in the right cardiac chambers displayed only 1.3 times higher level of diltiazem than right femoral venous blood. Our results strongly suggest that diltiazem accumulated in the lungs and was rapidly redistributed into pulmonary venous blood and then into the left cardiac chambers.

Antihypertensive Agents↗