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Biomedical subjects

H Iseki

Publications and source records attributed to H Iseki.

At least 19 recordsLinked to original sources
PubMed2006

Usefulness of intraoperative magnetic resonance imaging for glioma surgery.

BACKGROUND: Radical resection of gliomas can increase patient's survival. There is known concern, however, that aggressive tumour removal can result in neurological morbidity. The objective of the present study was to evaluate the usefulness of low magnetic field strength (0.3 Tesla) open intraoperative magnetic resonance imaging (iMRI) for complete resection of glioma with emphasis on functional outcome. METHODS: From 2000 to 2004, 96 patients with intracranial gliomas underwent tumour resection with the use of iMRI in Tokyo Women's Medical University. There were 50 men and 46 women; mean age was 39 years. Tumour volume varied from 1.2 ml to 198 ml (median: 36.5 mL). Resection rate and postoperative neurological status were compared between control group (46 cases, operated on during the initial period after installation of iMRI), and study group (50 most recent cases, in whom surgery was done using established treatment algorithm and improved image quality). FINDINGS: Overall, mean resection rate was 93%, and medial residual tumour volume was 0.17 ml. Total tumour removal was achieved in 44 cases (46%). Compared to control group, resection rate in the study group was significantly higher (91%, vs. 95%; P < 0.05), whereas residual tumour volume was significantly smaller (1.7 mL vs. 0.025 mL; P < 0.001). Nine patients in the control group (20%) and 24 in the study group (48%) experienced temporary postoperative neurological deterioration (P < 0.01), however, the rate of permanent morbidity evaluated 3 months after surgery did not differ significantly between the groups investigated (13% vs. 14%). CONCLUSIONS: Use of iMRI during surgery for intracranial gliomas permits to attain aggressive tumour resection with good functional outcome. Nevertheless, surgical experience with the iMRI system, establishment of treatment algorithm, and improvement of image quality are of paramount importance for optimal results.

Adult↗
PubMed2006

Financial management of Kashima Rinkai Specified Sewage Works.

The Kashima Rinkai Specified Sewage Works (KRSSW) is located at the northern side of the Kashima Coastal Industrial Zone, facing the Sea of Kashimanada (Pacific Ocean). It straddles one city and two townships: the city of Kashima, which boasts Kashima Port, a transportation center that was constructed on Kashimanada Beach by digging into the virgin sands, and the towns of Kamisu and Hasaki. The industries located there include steel, petrochemicals, chemicals, foodstuffs, livestock feeds, electric power and machinery metals. Industrial wastewaters with public sewage, except steel industry, are treated by the Fukashiba Treatment Plant which is managed by the Ibaraki Prefectural Government. The financial management of KRSSW is analysed to show its stand-alone condition.

Cities↗
PubMed2002

Flexible endoscope-assisted endonasal transsphenoidal surgery for pituitary tumors.

We have performed rigid endoscope-assisted endonasal transsphenoidal microsurgeries for pituitary tumors in 230 patients. Recently, we further introduced the use of a flexible endoscope to inspect the tumor bed and suprasellar structures more extensively. We report our experience with the flexible endoscope in endonasal transsphenoidal surgery for pituitary tumors. The endoscopes were used to complement the microscope in visualization. The flexible endoscopes were used in 34 recent cases with suprasellar and/or lateral tumor extension. During or after removal of the main tumor bulk, the flexible endoscope together with a rigid endoscope was used to inspect the tumor cavity, especially at the blind spot of the microscope. Despite limited resolving power, in all the 34 cases the flexible endoscope was a highly efficient tool permitting extensive visualization of almost the whole surgical area, even in narrow surgical fields and spaces not visible with an operating microscope or a rigid endoscope, and allowing continuous change of viewing angle. The residual tumor situated laterally or in the suprasellar areas that could not be reached and was impossible to remove by a rigid endoscope could be dissected and extirpated under a flexible endoscope using grasping forceps in 5 patients with pituitary adenoma and all the craniopharyngioma cases. The flexible endoscope may be more efficient in the lateral and suprasellar areas than the rigid endoscope in compensating for the narrow surgical field in endonasal pituitary surgery, despite its limited resolving power. Surgeons should make the best use of the advantages of each instrument.

Adenoma↗
PubMed2001

Depth of invasion parallels increased cyclooxygenase-2 levels in patients with gastric carcinoma.

BACKGROUND: Nonsteroidal anti-inflammatory drugs may reduce the incidence of intestinal carcinoma, presumably through inhibition of cyclooxygenase-2 (COX-2). The authors correlated tumor expression of COX-2 with clinicopathologic features in tissues from patients with gastric carcinoma. METHODS: Thirty-three surgical specimens, including carcinomas and corresponding noncancerous mucosa, were sampled. Reverse transcription-polymerase chain reaction analysis was performed concomitantly for COX-1 and COX-2. A COX-2 index was determined from the band density ratio of COX-2 to constitutively expressed COX-1. Immunohistochemical staining with COX-2 antibody and routine histologic assessment were performed in the same specimens. RESULTS: The COX-2 index in gastric carcinoma was significantly higher than in normal mucosa (3.4 +/- 0.7 vs. 2.2 +/- 0.7; P < 0.05). COX-2 indices were significantly higher in gastric carcinoma tissues with deep invasion; indices for pT1, pT2, pT3, and pT4 carcinomas were 0.8 +/- 0.3, 2.8 +/- 0.5, 4.3 +/- 1.0, and 8.8 +/- 5.5, respectively (P < 0.05). Immunohistochemistry demonstrated COX-2 protein diffusely in the cytoplasm of tumor cells but not in surrounding stroma or in noncancerous mucosa. CONCLUSIONS: COX-2 mRNA expression in gastric carcinoma tissue is correlated closely with depth of invasion, indicating that COX-2 is involved in the growth of gastric carcinoma.

Adenocarcinoma↗
PubMed2001

Comprehensive analysis of 28 patients with latex allergy and prevalence of latex sensitization among hospital personnel.

Recently anaphylactic shock caused by latex gloves and medical instruments has been discussed as an important problem in surgical operations. Patients with contact urticaria or anaphylaxis due to natural rubber latex were first reported in Japan in 1993, and the number of cases is gradually increasing. In the present study, we analyzed 28 patients examined in our clinic from 1993 to 1998. The diagnosis of latex allergy was made on the basis of clinical history, latex specific IgE antibody, skin test, and use test. The 3 male and 25 female patients included 20 nurses, 4 doctors, 2 housewives, one animal hospital employee, and one worker in a senile rehabilitation center. The majority were health care workers. Contact urticaria from rubber gloves was the most common clinical symptom. Some of the patients developed severe attacks of anaphylaxis. During the period from 1995 to 1997, we also performed a questionnaire study and a serum examination of latex specific IgE antibody among the personnel of our university hospital. The screening test for the antibody was more reliable than our questionnaire study in detecting latex-sensitive persons. The prevalence of latex allergy was found to be 4.6%. This indicates that not only dermatologists but also all hospital workers should be aware of this type of allergy.

Adult↗
PubMed2001

Propagation of rat parvovirus in thymic lymphoma cell line C58(NT)d and subsequent appearance of a resistant cell clone after lytic infection.

Rat parvovirus (RPV) is nonpathogenic in rats but causes persistent lymphocytotropic infection. We found that RPV was propagated in rat thymic lymphoma cell line C58(NT)D and induced apoptosis. Interestingly, a resistant subclone, C58(NT)D/R, from surviving cells after lytic infection had differentiated phenotypic modifications, such as increased cell adherence, resistance to apoptosis, and suppressed tumorigenicity.

Animals↗
PubMed2001

New possibilities for stereotaxis. Information-guided stereotaxis.

Information-guided stereotaxis, assisted by visualization of medical information, will become the next generation of neurosurgical systems. We performed 76 open MRI surgeries at Tokyo Women's Medical University between March 3, 2000 and April 12, 2001. Of them, comparisons of pre- and post-operative MR images for malignant gliomas in 21 cases revealed an average resection rate of 90.3% (the maximum 100%, the minimum 55%). In this article we describe real time updated navigation, augmented reality navigation, three-dimensional navigation, chemical navigation, information-guided navigation system (High definition visual Computer Aided Surgery System: HivisCAS), and open MRI-guided surgery that we are developing.

Humans↗
PubMed2001

Clinical application of an ultrasonically activated scalpel in neurosurgery.

Ultrasonically activated scalpel (UAS) is a surgical device utilizing ultrasonic energy to cut and coagulate tissues simultaneously. The actions and features of UAS are considerably different from those of conventional ultrasonic cavitational aspirators (UCA) that have been used frequently in the neurosurgical field. The UAS has been used routinely in a number of general surgeries, including laparoscopic surgeries and open surgeries of the lung and liver. However, neurosurgical application of UAS has not been reported. We used UAS in surgical resection of intracranial tumors consisting of five meningiomas, two gliomas, and one metastatic brain tumor, and monitored thermal changes in tissues using thermoencephaloscopy to investigate the possibility of heat injury by UAS. It was used to achieve both dissection of the attachment of meningiomas and internal decompression of the tumors and allowed efficient resection of various tumors with minimal bleeding by adjustment of the combination of coagulation and cutting powers at five different positions. The attachment of meningiomas was coagulated and cut easily and safely by UAS. Moreover, infrared thermographic study showed that the degree of temperature increase and the area of elevated temperature were extremely limited in UAS. The current study suggests that it is a promising device in neurosurgery.

Body Temperature↗
PubMed2000

Thermological study of drilling bone tissue with a high-speed drill.

OBJECTIVE: To perform a detailed quantitative analysis of the effect of intermittent drilling and irrigation to lower the temperature during high-speed drilling. METHODS: We examined the thermal changes for 15 bone flaps while drilling a 7- x 7-mm area for 18 seconds and a specific point for 9 seconds, under the following conditions: continuous or intermittent drilling; with a fluted steel or a diamond ball cutter; without or with irrigation, with room temperature or cold (8 degrees C) Ringer solution. RESULTS: The maximum temperature during continuous drilling with a diamond cutter (or steel cutter) was 82.4 +/- 1.3 degrees C (55.2 +/- 1.0 degrees C) without irrigation, 42.5 +/- 1.2 degrees C (35.4 +/- 0.9 degrees C) with room temperature Ringer irrigation, and 22.5 +/- 1.4 degrees C (21.6 +/- 0.3 degrees C) with cold Ringer irrigation, whereas that during intermittent drilling was 66.1 +/- 1.2 degrees C (35.6 +/- 0.8 degrees C), 35.0 +/- 0.8 degrees C (25.4 +/- 0.7 degrees C), and 21.5 +/- 0.6 degrees C (21.8 +/- 0.4 degrees C), respectively. During continuous drilling of a specific point, the radius of the concentric isothermal line for 43 degrees C (thermal threshold for neurons) was 3.6 +/- 0.8 mm with a steel cutter, and it was 8.1 +/- 0.3 mm with a diamond cutter. The radius was 4.2 +/- 0.8 mm during intermittent drilling with a diamond cutter, and it was 4.0 +/- 0.1 mm during continuous drilling with room temperature Ringer irrigation. Intermittent drilling with cold Ringer irrigation kept the temperature, even at the center of the drilled area, below 20 degrees C. CONCLUSION: Intentional intermittent drilling with irrigation reduces temperature elevation and its expansion. These procedures are necessary for safe drilling, especially with a diamond burr. Although cold irrigation can minimize temperature elevation, its substantial effect on nerves or other structures needs to be elucidated.

Adult↗
PubMed2000

Covered stent implantation by the puncture method for the treatment of a small aneurysm of the common iliac artery.

A method to repair endovascular aneurysms with covered stents has recently been developed. In the present paper, the implantation of a covered stent through a 12Fr sheath by the puncture method for the treatment of an isolated aneurysm of the right common iliac artery is reported. The aneurysm was less than 3 cm in diameter, and computed tomography showed no signs of aneurysm rupture, but the patient nonetheless complained of right lower abdominal pain and constipation. It was decided to implant a covered stent in lieu of surgical repair because it was difficult to prove a causal relationship between the aneurysm and the patient's complaints. Fortunately, after implantation, the symptoms were resolved. In conclusion, it is possible to choose this less invasive type of therapy for the treatment of an isolated iliac artery aneurysm if the patient complains only of general malaise and there are no certain signs of an impending rupture, although surgery should be indicated regardless of aneurysm size.

Aged↗
PubMed2000

Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using 99mTc-tetrofosmin for left ventricular dysfunction.

OBJECTIVE: The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). PATIENTS: In 20 patients with left ventricular dysfunction who underwent ECG gated 99mTc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. RESULTS: QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. CONCLUSIONS: The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction.

Adult↗
PubMed1999

Characterization of two novel proabsorptive peptide YY analogs, BIM-43073D and BIM-43004C.

Effective clinical therapy to augment intestinal absorption of water and electrolytes does not exist; the gut hormone, peptide YY (PYY), is a potent proabsorptive agent in animal models. The purpose of our study was to evaluate the effects of two novel PYY analogs, BIM-43073D and BIM-43004C, on intestinal absorption. Dogs with ileal Thiry-Vella fistulae (TVF) were treated with either PYY, BIM-43073D, or BIM-43004C. Administration of BIM-43073D significantly increased water and sodium absorption over baseline and maintained this level of increased absorption for a longer duration than an equimolar dose of PYY. Administration of BIM-43004C significantly increased sodium and water absorption over baseline at a level equal to that of PYY. The novel PYY analogs, BIM-43073D and BIM-43004C, are effective proabsorptive agents with BIM-43073D producing more sustained effects than PYY. These compounds may be clinically useful in the treatment of gut malabsorption in conditions such as cholera, Crohn's disease, and the short-bowel syndrome.

Animals↗
PubMed1999

Induction of parturition in bitches with minimal side effects by two injections of a low dose of fenprostalene, a prostaglandin F2alpha analogue, and pretreatment with prifinium bromide.

An experiment using 16 Beagle bitches (aged 11 months to 6 years and 2 months) in their 56th to 58th day of pregnancy was carried out to investigate the effects of two injections of a low dose of fenprostalene, a long-acting prostaglandin F2alpha analogue, and pretreatment with prifinium bromide, a parasympathetic nerve blocking agent, on the induction of parturition and severity of side effects. The bitches were divided into three treatment groups: one injection of 5 microg/kg of fenprostalene (group I, n=5); one injection of 7.5 mg/head of prifinium bromide followed by one injection of 5 microg/kg of fenprostalene at 5 min after prifinium bromide injection (group II, n=6); and one injection of 7.5 mg/head of prifinium bromide followed by two injections of 2.5 microg/kg of fenprostalene, one injection at 5 min after prifinium bromide injection and the next at 1 hr after the fenprostalene first injection (group III, n=5). Following the injection of fenprostalene, side effects such as salivation, vomiting, colic symptoms, and watery diarrhea occurred most frequently (80-100% of cases) in group I bitches. Apart from colic symptoms, no side effects were observed in group III bitches. Group III bitches also showed the smallest increase in plasma cortisol concentration. No significant difference in the time to initiation of parturition was found between the three groups. The one-week survival rate of newborn puppies was highest in group III. The results showed that pretreatment with prifinium bromide and two injections of 2.5 microg/kg of fenprostalene can alleviate side effects following fenprostalene administration and have no adverse effect on the survival of newborn puppies, indicating that this method is a reliable and safe way of inducing parturition in bitches.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

Localized pericarditis with calcifications mimicking a pericardial tumor.

A 62-year-old man was admitted with increasing palpitations. Radiography of the chest demonstrated a calcified mass. Magnetic resonance imaging revealed compression of the right ventricle by a tumor. At the time of cardiac catheterization, the coronary arteries were found not to supply blood flow of the mass, and no dip-and-plateau pattern was seen in the right ventricular pressure measurements. At the time of surgery, the mass was found to be a focal calcified thickening of the pericardium containing only pus. The thickening resembled an oval pericardial tumor. Microbiologic examination of the pus revealed Propionibacterium acnes.

Calcinosis↗
PubMed1999

[Selective peripheral denervation for spasmodic torticollis involving the levator scapulae muscle].

Patients with laterocollis or rotatory type torticollis tend to show abnormal contraction of the levator scapulae muscle and the scalene muscles. These muscles are innervated from the anterior branches of the cervical spinal nerves. Because of this, the traditional Bertrand operation dealing with posterior branches does not adequately affect the symptoms of laterocollis. The authors report selective denervation of the levator scapulae muscle in three patients and discuss its rationale. All the three patients underwent denervation of both the C1-C6 posterior spinal rami and the branches from the C3 and C4 anterior rami to the levator scapulae muscle. We added myotomy of the scalene muscle in one patient, and denervation of the omohyoid muscle which is innervated from the ansa cervicalis and the descending branch of the hypoglossal nerve. The pre/post-operative Tsui scores were 12/4, 15/1, and 14/3 respectively. There were no complications. We conclude that selective peripheral denervation of the levator scapulae muscle is safe and effective in the treatment of laterocollic type torticollis.

Adult↗
PubMed1999

[Attenuation of reperfusion phenomenon by reperfusion using leukocyte-depleted blood during direct percutaneous transluminal coronary angioplasty for acute myocardial infarction].

Leukocytes are important in the occurrence of reperfusion injury in coronary intervention for acute myocardial infarction (AMI). This study compared reperfusion injury caused by reperfusion using leukocyte-depleted blood (LD) and that by conventional angioplasty (control) through the reperfusion phenomenon including reperfusion arrhythmia and additional ST elevation during direct percutaneous transluminal coronary angioplasty (PTCA) in 41 patients with 21 left anterior descending artery (LAD) lesions and 20 right coronary artery (RCA) lesions. LD was prepared from 20 ml of venous blood, 20 ml of mixed blood and 60 ml of arterial blood from the patients (LD group; LAD-LD: n = 10, RCA-LD: n = 10) which was passed through a leukocyte removal filter. The blood was injected from the tip of the balloon catheter at 10 ml/min during inflation for 10 min before balloon deflation. The control group (LAD-control: n = 11, RCA-control: n = 10) underwent conventional angioplasty. The appearance of reperfusion arrhythmia [atrioventricular block (AVB) > II, accelerated idioventricular rhythm (AIVR), ventricular tachycardia (VT), ventricular fibrillation (Vf)] and measurements of STmax deviation before and after reperfusion, the differences of the STmax deviation (delta ST) and additional ST elevation (LAD: > or = 0.5 mV increase of sigma ST in lead V1-V6, RCA: > or = 0.3 mV increase of sigma ST in lead II, III and aVF) were studied. The appearance of reperfusion arrhythmias was as follows; LAD-LD: AVB 0, AIVR 1, VT 1, Vf 0, LAD-control: AVB 0, AIVR 4, VT 2, Vf 1, NS, and RCA-LD: AVB 0, AIVR 0, VT 0, Vf 0, RCA-control: AVB 2, AIVR 0, VT 1, Vf 0, NS. There was no reperfusion arrhythmia in the RCA-LD group. There was no significant difference in the appearance of reperfusion arrhythmias between the LAD-LD and LAD-control or RCA-LD and RCA-control groups. Before reperfusion the STmax deviation (mV) was LAD-LD 0.86 +/- 0.46 vs LAD-control 0.74 +/- 0.49 and RCA-LD 0.29 +/- 0.18 vs RCA-control 0.15 +/- 0.09 and after reperfusion LAD-LD 0.63 +/- 0.35 vs LAD-control 0.81 +/- 0.49 and RCA-LD 0.13 +/- 0.15 vs RCA-control 0.20 +/- 0.12, respectively. There were no significant differences between LAD-LD and LAD-control or RCA-LD and RCA-control groups. delta ST (mV) was LAD-LD 0.23 +/- 0.56 vs LAD-control 0.07 +/- 0.60, p = 0.09 and RCA-LD 0.16 +/- 0.12 vs RCA-control 0.06 +/- 0.14, p = 0.002, respectively. The number of patients with additional ST elevation soon after reperfusion was LAD-LD 3 vs LAD-control 10, p < 0.05 and RCA-LD 0 vs RCA-control 8, p < 0.001, respectively.

Angioplasty, Balloon, Coronary↗