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Biomedical subjects

A Hosaka

Publications and source records attributed to A Hosaka.

At least 19 recordsLinked to original sources

Carotid endarterectomy may reduce the high stroke rate for patients with the disease of abdominal aorta and peripheral arteries.

AIM: The prevalence of carotid stenosis is reported to be high among patients with arteriosclerosis, but the hazards of carotid stenosis and the benefits of carotid endarterectomy (CEA) on long-term event-free survival are still unknown. The aim of this prospective study was to screen preoperative patients with arterial disease for carotid stenosis, and to determine whether CEA had any effect on stroke during the postoperative follow-up period. METHODS: From 1999 to 2003, 406 consecutive preoperative patients with arterial disease underwent routine carotid duplex scan. Patients with known carotid stenosis and those due to undergo operation in emergency were excluded from the study. CEA was performed before or simultaneously with vascular surgery if necessary. The prevalence and risk factors for carotid stenosis were studied, and the patients were followed up for stroke or death. RESULTS: Among the 406 patients examined, 19.4% had greater than 50% stenosis and 11.3% had greater than 70% stenosis. The risk factors for carotid stenosis were having occlusive arterial disease (P=0.0001), and history of stroke (P=0.0038). Long-term follow-up study revealed that patients with greater than 70% carotid stenosis without CEA had a higher tendency for stroke or death, but the stroke rate in patients with severe stenosis who underwent CEA remained low, as in patients with less than 70% stenosis. CONCLUSIONS: Patients with greater than 70% carotid stenosis, diagnosed before arterial operation who did not undergo CEA, had a higher risk for stroke during the postoperative follow-up period. However, their risk could be reduced by performing CEA before or simultaneously with scheduled vascular surgery.

Aged↗

Reduced vascular reserve measured by stressed single photon emission computed tomography carries a high risk for stroke in patients with carotid stenosis.

AIM: A few studies have observed reduced vascular reserve measured by single photon emission computed tomography (SPECT) to be a risk factor for stroke in patients with carotid artery occlusion, but stenosis has been excluded from these former studies. This study has evaluated the prognosis of reduced vascular reserve in patients with stenosis, and the effect of carotid endarterectomy (CEA) on these patients. METHODS: Forty patients diagnosed as having >70% stenosis of the carotid artery at the University of Tokyo Hospital, between 2001 and 2004, underwent acetazolamide-stress SPECT test first. A resting SPECT study was performed on a different day from the stressed SPECT study. The patients were grouped as having reduced vascular reserve or normal vascular reserve from the SPECT results. Analysis of risk factors and the stroke-free curve analysis for reduced vascular reserve was performed. RESULTS: Of the 40 patients, 24 (60%) had reduced vascular reserve and 18 underwent CEA. The mean follow-up period was 21.5+/-15.5 months (mean+/-SD). Four strokes occurred during follow-up: in 1 patient with CEA and 3 without CEA. All stroke patients had reduced vascular reserve. The patients with reduced vascular reserve without any surgery had a significantly lower stroke-free rate compared with those with normal vascular reserve or reduced vascular reserve, but also receiving CEA. CONCLUSIONS: We propose performing SPECT tests in patients with severe carotid stenosis regardless of symptoms, and performing CEA on those with a reduction in vascular reserve.

Aged↗

Postnatal and postprandial changes in plasma concentrations of glicentin in term and preterm infants.

AIM: To examined the changes in basal plasma concentrations of glicentin in developing children and the postnatal and postprandial changes in plasma glicentin levels in infants. METHODS: Glicentin, an active component of enteroglucagon, is considered to have a significant trophic action on the intestinal mucosa. Fasting plasma concentrations of glicentin in healthy children and in term and preterm infants were measured before and 30 min after feeding during the first 14 d of life. RESULTS: Plasma basal concentrations of glicentin in children under 1 y of age were significantly higher than those in children aged 1 to 15 y. Plasma basal concentrations of glicentin at 5 or 6 d (2496 and 2190 pg/ml) and at 14 d (2987 and 2817 pg/ml) after birth were significantly higher than those at 1 or 2 d (1098 and 1240 pg/ml) after birth in normal birthweight (NBW) and low-birthweight (LBW) infants. There was no significant difference in the glicentin level between infants at 1 or 2 d (1864 pg/ml) and at 5 or 6 d (1910 pg/ml) after birth in very-low birthweight (VLBW) infants, but the levels at 14 d (3310 pg/ml) after birth were significantly higher than either of those levels. Plasma glicentin concentrations after feeding were significantly higher than those before feeding at 1 or 2 d and at 5 or 6 d after birth in NBW and LBW infants, but a significant increase in the plasma glicentin level after feeding was first observed at 14 d after birth in VLBW infants. There were no significant differences in the basal plasma (2401 and 2718 pg/ml) and postprandial (3007 and 3912 pg/ml) glicentin levels between breastfed and formula-fed infants. CONCLUSION: The results of the study suggest that glicentin may play an important role in intestinal mucosal growth in the early period of life, although its role in VLBW infants should be further investigated.

Breast Feeding↗

Graves' disease associated with exophthalmos, cerebral ventricular dilatation and accelerated growth.

A report is presented of a girl with Graves' disease, which was diagnosed at the age of 1.7 years. The mother had no thyroid disease. The patient developed signs of hyperthyroidism shortly before her first birthday, and the most prominent manifestations were accelerated skeletal maturation and linear growth, and dilatation of the brain ventricles. The latter manifestation, which has not been reported previously, was reversible upon normalisation of thyroid function with antithyroid treatment for three years.

Adrenergic beta-Agonists↗

Central diabetes insipidus in hypoxic brain damage.

We describe two children who after cardiopulmonary arrest developed hypernatremia at the terminal stage. Urinary antidiuretic hormone concentration was very low, indicating central diabetes insipidus. These cases illustrate the necessity of alertness to the development of central diabetes insipidus in patients with severe hypoxic brain damage.

Adolescent↗

[Changes in ocular structure and in blood-ocular barrier permeability of experimental myopia induced in monkeys].

We induced myopia by eyelid suturing in one eye each of six 9-month-old cynomolgus monkeys to elucidate the condition by studying changes in the ocular structure and the blood-ocular barrier (BOB) permeability. Optical elements were measured by A-mode ultrasonography; vitreous fluorophotometry was carried out to document BOB permeability before eyelid suturing and 3, 10, 16, and 28 months after suturing. The axial length of the sutured eyes increased significantly compared with that of the non-sutured contralateral eyes at 10 months after suturing and continued to lengthen with time. The dioptric power (D) of the sutured eyes changed in the same way. (mean, -3.08D 28 months after suturing). The permeability of the blood-retinal barrier of the sutured eyes significantly increased from 10 months after suturing compared with that of the fellow eyes, and continued to increase over the period of observation. The permeability index of the blood-aqueous barrier also increased significantly from only 16 months after suturing further increasing as the period of observation lengthened. We hypothesize that in the transition from emmetropia to myopia, the permeability of the BOB rises, and continue to rise as myopia develops. Thus, the breakdown of the BOB, i.e., the breakdown of the ocular homeostasis, is considered to be closely related to the occurrence and the development of myopia.

Animals↗

Blood-ocular barrier permeability in experimental myopia.

Vitreous fluorophotometry (VFP) was performed for myopic eyes induced by unilateral eyelid suturing of six young cynomolgus monkeys in order to study the permeability of the blood-ocular barrier. The eyelid fusion was temporarily cut and opened at about five-month intervals, and the dioptric power and axial length of test and control eyes were measured. VFP was carried out before and after intravenous injections of fluorescein-Na. The inward permeability of the blood-retinal barrier (P(in)) was estimated by our computer simulation method, and the index of permeability of the blood-aqueous barrier (AQ) was also obtained. Significant prolongation of the length of the vitreous cavity was first seen 10 months after suturing, with the degree of myopia progressing subsequently. P(in) and AQ values increased as myopia progressed: significant increases were observed at 10 and 16 months after suturing, respectively. These results indicate a close relationship between the occurrence and progress of myopia and increased permeability of the blood-ocular barrier.

Animals↗