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Biomedical subjects

Izumi Koizuka

Publications and source records attributed to Izumi Koizuka.

At least 19 recordsLinked to original sources

Adaptive plasticity in the otolith-ocular reflex.

This review focuses on the plasticity in the vestibulo-ocular reflex (VOR), especially in the otolith-ocular reflex (OOR). The VOR is a mechanism for the production of rapid compensatory eye movements during head movements. The VOR is under adaptive control which corrects VOR performance when visual-vestibular mismatch arises during head movements. It has been demonstrated that chronic exposure to certain visual environments, those generated by magnifying lenses and reversing prisms, alter the gain and phase of VOR in the dark in numerous species. Most experiments concerning such modification of the VOR have used semicircular canal stimulation. The VOR consists of the semicircular-ocular reflex (ScOR) and the OOR. There are few results regarding the relationship between the gain of the ScOR and the OOR. This review summarizes the studies on plasticity in the OOR. In addition, the difficulty in evaluating the OOR using current conventional methods including earth horizontal axis (EHA) rotation, off-vertical axis rotation (OVAR) and linear sled, is discussed. We believe that the ScOR and the OOR share common neural pathways in such a way that a change in the synaptic efficacy of one pathway is accompanied by a change in the other.

Animals↗

Wallenberg's syndrome: neurotological classification.

OBJECTIVES: Visually induced eye movements were investigated in 26 patients with Wallenberg's syndrome. METHODS: Slow-phase optokinetic nystagmus (OKN) velocities, pursuit gains, and percentage fixation suppression (%FS) of caloric nystagmus were recorded by DC electrooculography (EOG), and stored directly onto FM magnetic tape. RESULTS: OKN velocities, pursuit gains, and %FS decreased toward the lesion side (group A), whereas OKN velocities and pursuit gains decreased toward the side contralateral to the lesion side. %FS decreased toward the lesion side (group B). MR images in group A showed that lesions were only in and near to the vestibular nuclei, and images in group B showed that lesions extended to the cerebellum. CONCLUSION: Visually guided eye movements allow classification of Wallenberg's syndrome into two types, one with brainstem lesions and one with both brainstem and cerebellar lesions. This demonstrates that assessing eye movements is helpful in supplementing MRI data.

Adult↗

Saccadic adaptation in the horizontal and vertical directions in normal subjects.

We studied the properties of adaptive gain control in the saccadic system and examined whether the adaptations in the horizontal direction transferred to those in the vertical direction, and vice versa, in 16 normal subjects. Eye movements were measured using search coil system. In the adaptive session, a target moved randomly in amplitude steps of 20 degrees or 30 degrees, with half of the subjects performing in the horizontal direction and the others in the vertical direction. The target eccentricity was changed by a constant percentage (70%) during each saccade aimed at the target. Gains were gradually decreased during the course of 120 repetitions, and then approached approximately 70%. Comparison was made of the accuracy (saccadic amplitude/first target step amplitude) of horizontal and vertical vectors of oblique saccades before and after the adaptation. After the horizontal adaptation, the accuracy of horizontal vectors decreased in the horizontal direction (P<0.05) but not in the vertical direction. After the vertical adaptation, however, the accuracy of horizontal and vertical vectors did not decrease. Our data show that adaptive gain control in the horizontal direction might not transfer to that in the vertical direction, nor vice versa.

Adult↗

End-to-end anastomosis in chronic tracheal stenosis.

OBJECTIVE: This study assessed the efficacy and safety of end-to-end anastomosis of the trachea following segmental resection in chronic tracheal stenosis. METHODS: End-to-end anastomoses of the trachea were performed in 35 patients with chronic tracheal stenosis; 18 patients with tracheal invasion of thyroid cancer and 17 patients with long-term intubation and blunt injuries of the trachea. RESULTS: All operations were successful, except one whose unilateral recurrent nerve had not been identified in the recurrent thyroid cancer invasion with trachea. CONCLUSION: This operation provides a one-step cure for the stenosed trachea and can be applied to the resection of less than six tracheal segments.

Adenocarcinoma↗

A case of large dermoid cyst in the floor of the mouth.

Dermoid cysts in the floor of the mouth are rarely observed. When they develop, they do not appear until they grow large enough or appear through infection. Some operative approaches and management have been performed to large dermoid cysts in the floor of the mouth with some variations. Intra-oral approach is the most useful for cosmetic appearance. We presented a 24-year-old female who underwent expedient surgical excision using finger end serviceable enucleation through the intra-oral approach.

Adult↗

Horizontal eye response to an abrupt lateral head drop in normal subjects and patients with Meniere's disease.

OBJECTIVE: To detect the endolymphatic hydrops by using the otolithic nature in patients with Meniere's disease and delayed hydrops. METHODS: We developed a new technique for measuring horizontal eye movements, corresponding to lateral head drop in total darkness, approximately 1g environment. Normal subjects (n=16, mean age: 27.3 years old) and patients (seven for pre-operative state, four for furosemide test at pre-operative state; two for post-operative state) were employed in the test. The principle of the test is to drop the head in a lateral position separately from the body with a rapid release exposing the head. Bitemporal EOG, accelometric and trigger signals for the releaser were recorded for processing at 1 KHz sampling time. RESULTS: The drop was performed five times in succession. The latency of horizontal eye response was of 40 ms order in normal subjects on both sides and were never beyond 60 ms. Eye response of the patients was in different patterns from normal subjects and the latencies delayed either to normal side or to the affected side. Following furosemide intravenous injection, more certain information was obtained. Three of four patients were recovered to normal range as to the latency. CONCLUSIONS: We emphasize that this test may provide a new measure sensitive to the hydrops and can underline this test to detect the hydrops in Meniere's disease.

Adult↗

Physical therapy for benign paroxysmal positional vertigo patients with movement disability.

OBJECTIVE: Particle repositioning manoeuvres are broadly recognized effective for benign paroxysmal positional vertigo (BPPV), however, we think that these therapies are not suitable for all BPPV patients. In this study we investigate whether these manoeuvres can be used for BPPV patients with the movement disability. In addition, we introduce our habituation training (HT) and report the results of treatment with it. METHODS: Nine BPPV patients with the movement disability due to orthopedic disease were examined. For each patient we determined their movement disabilities, and assessed the suitability of particle repositioning manoeuvres, Brandt-Daroff (B-D) manoeuvre and HT for them. RESULTS: All of these nine patients had neck or trunk movement disabilities due to orthopedic disease, and we judged that particle repositioning manoeuvres and B-D manoeuvre were impossible or too risky to be employed in them. Although HT was suitable for them and symptoms and signs of them improved within a short period of time. CONCLUSION: Particle repositioning manoeuvres were not suitable for BPPV patients with the movement disability because these manoeuvres required various movements. These patients were able to perform HT depending on their capabilities. We think that HT is caused by the fatigability of BPPV, and it accelerates the natural curing process.

Aged↗

A case of carcinoid tumor of the middle ear.

We report here a case of a carcinoid tumor observed in the middle ear (ME), which was initially diagnosed as ME adenoma. The patient was a 64-year-old woman who was first seen in our hospital in March 2001 for a 7-month hearing loss. On otoscopic examination, a whitish mass could be observed through the intact tympanic membrane. High-resolution computed tomography demonstrated a tumor-like lesion in the ME with no evidence of bone destruction. A myringotomy and biopsy were performed and an initial diagnosis of ME adenoma was made. Light microscopy showed fragments of cellular tissue in which both glandular (adenomatous) and trabecular (carcinoid) growth patterns could be identified, but neuroendocrine differentiation was not detected by immunohistochemistry (negative staining for chromogranin A and synaptophysin). On the basis of this diagnosis, the patient underwent a tympanomastoidectomy in June 2001, in which the presumed ME adenoma was completely excised and the diagnosis was modified to ME carcinoid tumor. Immunohistochemical examinations at that time showed positive staining of the tumor cells for chromogranin A and synaptophysin. This case suggests the difficulties in distinguishing ME carcinoid tumors from ME adenomas. The patient is without recurrence of her disease to date.

Adenoma↗

Sensitization of head and neck squamous cell carcinoma cells to Fas-mediated apoptosis by the inhibition of Bcl-X(L) expression.

BACKGROUND: Various types of malignant tumor cells are known to acquire resistance to Fas receptor (Fas)-mediated apoptosis. In Fas-sensitive cells, Fas-mediated apoptosis is observed when anti-Fas antibody is bound to Fas. Bcl-2 and Bcl-X(L) are representative anti-apoptosis proteins reported to be capable of suppressing Fas-mediated apoptosis. OBJECTIVE: To investigate the mechanism of resistance acquisition to Fas-mediated apoptosis in cultured human head and neck squamous cell carcinoma cells (HNSCCs). METHODS AND RESULTS: We applied an anti-Fas antibody (CH11) to Fas-expressing HNSCCs (HSC-2) and the CH11 did not induce cell death in HSC-2. Treatment with actinomycin D (ActD) converted the phenotypes of HSC-2 from CH11-resistant to CH11-sensitive. Western blot analysis showed no differences between ActD-treated and ActD-untreated HSC-2 in the expression of Bcl-2. On the other hand, the expression of Bcl-X(L) was greatly reduced in ActD-treated HSC-2. Moreover, the reduction of Bcl-X(L) by specific antisense oligonucleotide treatment enhanced the CH11-induced cell death of HSC-2. CONCLUSION: Our data suggest that Fas-signaling might be regulated by a Bcl-X(L)-inhibitable step in CH11-resistant HSC-2.

Antibodies, Monoclonal↗

Inhibition of caspase-9 activity and Apaf-1 expression in cisplatin-resistant head and neck squamous cell carcinoma cells.

We have previously reported that cisplatin induces caspase-9 (Casp9) activation in head and neck squamous cell carcinoma cells in vitro (HNSCCs). Our purpose here was to examine whether HNSCCs selected for resistance to cisplatin fail to exhibit Casp9 activation in response to cisplatin. The cisplatin-resistant HNSCCs (HSC-2CR) were selected from cisplatin-sensitive HNSCCs (HSC-2) for growth in the presence of cisplatin. Following cisplatin treatment, protelyzed Casp9 subunits were detected in HSC-2, but not detected in HSC-2CR. Using a direct enzymatic assay measuring cleavage of the synthetic peptide substrate (LEHD-AFC), Casp9 activity in cisplatin-treated HSC-2CR was less than that in cisplatin-treated HSC-2. Apoptotic protease-activating factor 1 (Apaf-1) has been shown to participate as an adaptor molecule in Casp9 activation. In the presence of cytochrome c (Cyt c) released from mitochondria, Apaf-1 binds to Casp9 and causes its activation. HSC-2 expressed 2-fold higher levels of Apaf-1 compared with HSC-2CR. On the other hand, following cisplatin treatment, the same degree of increase in cytoplasmic Cyt c was detected in both HSC-2 and HSC-2CR. These results suggest that in a certain type of HNSCCs, the inhibition of Casp9 activity and Apaf-1 expression may represent a mechanism of acquired cisplatin resistance.

Apoptotic Protease-Activating Factor 1↗

A case of an inverted tooth in the nasal cavity.

We report a case of an inverted tooth in the nasal cavity. The patient was a 27-year-old man who attended our hospital in May 1998, complaining of left cheek-pain. There was nothing remarkable in his medical or family history. Fiberscopic (intranasal) and radiological examinations revealed a white foreign body in the left nasal cavity, within 2 cm of the left nostril. This foreign body was diagnosed as an inverted tooth. It was removed under general anesthesia and found to be 17 mm in length. Although the tooth showed a single root, it possessed two cusps and we deduced it to be a molar.

Adult↗

Rare localization of paraganglioma in head and neck.

In this paper, we describe the clinical course of a 61-year-old female patient with paraganglioma in the head and neck region. Computed tomographic scan (CT), magnetic resonance imaging (MRI), ultrasound scan (US) and arteriogram findings initially led us to suspect that this tumor originated in the vagal nerve. In particular, a color Doppler US enabled an easy diagnosis of hypervascular tumor. We removed this surgically, but the tumor was easy to peel from the vagal nerve and carotid bifurcation. The distal side of the tumor was under the digastric muscle and running into the hypoglossal nerve. The intraoperative findings were highly suggestive of localization at the hypoglossal nerve, although Xth and XIIth cranial nerve palsies have remained.

Angiography↗

A case of relapsing polychondritis involving placement of an expandable metallic stent.

Relapsing polychondritis is a relatively uncommon disease characterized by recurrence of progressive inflammation of cartilaginous structures. Laryngotracheal involvement occurs in 50-70% of cases, and occasionally results in acute airway obstruction. We reported a case of relapsing polychondritis with severe tracheal stenosis that was treated by the placement of two expandable metallic stents. A 58-year-old man was hospitalized with fever and breathing difficulties. A tracheostomy was performed and a silicone T-tube was placed. A diagnosis of relapsing polychondritis was made based on the biopsy from auricular and tracheal cartilages. Two expandable metallic stents were placed in the trachea to bilateral main bronchus. This dilated the airway lumen and resulted in the dyspnea disappearing completely. However, 18 months later a sudden massive hemorrhage occurred through the tracheostoma, and he died of respiratory failure. Autopsy showed a tracheoinnominate artery fistula. We discuss the management of relapsing polychondritis with severe tracheal stenosis.

Airway Obstruction↗

Flexibility of vestibulo-ocular reflex adaptation to modified visual input in human.

The vestibulo-ocular reflex (VOR) serves to keep images relatively stable on the retina. To maintain appropriate performance and minimize image slip throughout life, VOR is subjected to long-term adaptive regulation by visual input. It has been reported that adaptive changes in VOR gain (eye velocity/head velocity) are evoked either by fitting subjects with magnifying, miniaturizing, or reversing spectacles during normal behavior, or by moving a large visual field in or out of phase relative to the subject's head movement. The changes in VOR gain are frequency selective. Here, we examine the extent of VOR gain flexibility by causing VORs of similar direction to undergo different behavioral gain changes. Nine healthy adults participated in the study, ranging in age from 24 to 38 years (mean: 26 years) and with no history of neurotological symptoms. All subjects were clinically normal according to a screening battery that included combined neurologic and otologic physical examinations. Horizontal and vertical eye positions were recorded by bitemporal DC-coupled electro-oculography (EOG). The subject sat in a rotating chair. The axis of rotation of the body was always earth-vertical, with the interaural axis crossing the axis of rotation of the chair. The head was pointed 20 degrees downwards in all experiments and stabilized in this position using a chin rest. The chair was surrounded by a half-cylindrical optokinetic screen (78 cm in diameter) placed in front of the subject, onto which random dot patterns were projected. Goggles were used to ensure that the subject was in complete darkness during both pre- and postadaptation periods. The chair was rotated sinusoidally at maximum amplitude of 30 degrees or 60 degrees : for 30 degrees the stimulation was at 0.1, 0.2, 0.3, and 0.4 Hz; for 60 degrees it was at 0.1, 0.2, and 0.3 Hz. VOR adaptation was obtained by inducing a retinal slip velocity by short-term alteration of the visual input of the large field; this change was produced by a combination of sinusoidal head rotation and the random dot patterns. In each adaptation session, the sinusoidal head rotation was either at 0.1 or 0.3 Hz and the amplitude was 30 degrees. The random dot pattern was synchronized with sinusoidal head rotation in the same direction (x0 experiment) to make the retinal slip zero, and in the opposite direction to make the retinal slip twofold (x2 experiment). Therefore, a total of four adaptation protocols were tested. The subjects were asked to fixate on a single dot with the eyes straight-ahead in the x0 experiment, and follow it within random dot patterns in the x2 experiment. Each adaptation session lasted for 30 min. Two adaptation experiments were performed on each subject once per day. The averages of VOR gain and phase lag were calculated using Fourier analysis. Seven of the subjects who participated in the x2 adaptation experiment at 0.3 Hz and 30 degrees amplitude showed a steady increase of VOR gain within a couple of trials. One of the remaining two subjects showed a decrease in VOR gain in all the three trials, and the other subject showed a VOR gain increase in three trials and decrease in two trials. In the x2 adaptation experiment at 0.3 Hz and 30 degrees amplitude (peak velocity: 28 degrees /s), the percentage gain change ((post-pre)/pre) was 133% at the same stimulation and 100% at 0.4 Hz (peak velocity: 37 degrees /s). The gain change was 65% at 0.1 Hz and 60 degrees amplitude (peak velocity: 18 degrees /s), and 64% at 0.2 Hz and 60 degrees amplitude (peak velocity: 37 degrees /s). In the x1 adaptation experiment (30 degrees at 0.3 Hz), the percentage gain change was -62% under the same conditions, -50% at 0.1 Hz and 60 degrees amplitude, and -30% at 0.2 Hz and 60 degrees amplitude. No change of VOR gain was observed at other frequencies, and the subject was not adapted at 0.1 Hz and 30 degrees amplitude. The larger VOR gain increase in the x2 adaptation experiment for the faster head angular acceleration leads to the conclusion that the VOR gain mechanism can set vuite similar in terms of the head acceleration.

Adult↗

Retrograde-labeling of pretecto-vestibular pathways in cats.

The projections of the nucleus of the optic tract (NOT) were studied in cats using three kinds of retrograde tracers (horseradish peroxidase wheat germ agglutinin (WGA-HRP), dextran fluorescein (DF) and dextran tetramethylrhodamine (DTR)). First, in the cases that WGA-HRP were injected into the rostral part of medial vestibular nucleus (VN), a significant number of retrograde-labeled neurons, which concentrated between 600 and 800 micrometer from the rostral part of the NOT, were observed in the NOT ipsilateral to the injection sites. Second, no double-labeled neurons were found following injections of DF in the medial VN and DTR in the nucleus prepositus hypoglossi (NPH) at the same time. In this experiment, it was made clear that two different kinds of neurons in the NOT projected to the medial VN and the NPH, respectively.

Animals↗

A case report of difficult diagnosis in the patient with advanced laryngeal tuberculosis.

We report a patient with severe laryngeal tuberculosis (LTB) involving thyroid cartilage and combined with whole-bone metastasis. A 57-year-old male had presented only with hoarseness. Radiological findings were indicative of suspected metastasis from a malignant tumor. However, tuberculosis was considered by histopathological findings, and so sputum samples were tested for acid-fast bacilli and purified protein derivatives of tuberculin in order to detect the presence of LTB. A polymerase chain reaction confirmed the diagnosis. Anti-tuberculous medications were effective in resolving the hoarseness, and the removal of the mass in the right wing of thyroid cartilage was confirmed by computed tomography (CT).

Antitubercular Agents↗

Effect of fexofenadine hydrochloride on cedar pollinosis.

OBJECTIVE: To investigate the therapeutic efficacy of fexofenadine hydrochloride (Allegra(R) tablets), an antihistaminic launched in 2001, in patients with cedar pollinosis by dividing them into two groups for comparison, i.e. the early-treatment group in which treatment was started before the initial day of the pollen scattering, and the therapeutic-treatment group in which treatment was started after the initial day of the pollen scattering. METHODS: Early-treatment group: patients who visited the hospital before the initial day of cedar pollen scattering were orally given one tablet of the drug twice daily. Therapeutic-treatment group: patients who visited the hospital after the initial day of cedar pollen scattering were orally given one tablet of the drug twice daily. The total number of cases in which the efficacy evaluation was possible was 37 cases (19 cases of the early-treatment group and 18 cases of the therapeutic-treatment group) after application of exclusion criteria. RESULTS: The useful rate of moderately effective or better against sneeze was 90% in the early-treatment group, and 78% in the therapeutic-treatment group, and there was a significant difference between both groups. The degree of satisfaction in the early-treatment group was 3.8 points, and 4.2 points in the therapeutic-treatment group, and the therapeutic-treatment group showed a higher score, but there was no significant difference between both groups. As adverse reaction, there was only one case of mild dizziness (2.7%), and no other adverse reactions such as sleepiness were observed. CONCLUSIONS: It was suggested that fexofenadine hydrochloride administered in patients with cedar pollinosis from before substantial pollen scattering might control their symptoms to mild ones, and might control worsening of their symptoms after the substantial pollen scattering, and, therefore, the drug was considered to be useful in early therapy.

Adolescent↗

Two cases of Aspergillus sinusitis with bone destruction.

We experienced the clinical courses of two cases of destructive Aspergillus in paranasal sinuses in which an Aspergillus fungus ball was formed, and which caused bony destruction are described. The case in which a nidus could not be completely surgically removed and with intervening diabetes had an unfavorable prognosis. It is recommend to perform an early expanded operation as well as to administer a sufficient amount of antifungal drugs for the treatment of destructive Aspergillus in paranasal sinuses.

Aged↗