[Panic disorder and depression].
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Anti-Anxiety Agents↗
Biomedical subjects
Jun Horiguchi
Publications and source records attributed to Jun Horiguchi.
[Altitude insomnia].
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Altitude Sickness↗
[Adjustment sleep disorders].
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Dyssomnias↗
Immunohistochemical double staining with estrogen receptor and HER2 on primary breast cancer.
Immunohistochemical double staining with estrogen receptor (ER) and epidermal growth factor receptor 2 (HER2) was conducted in tissue sample of 125 women with invasive breast cancer. The age at the time of surgery ranged from 28 to 82 years. The tumor size was 2 cm or less in 42 patients and larger than 2 cm in 83. Axillary lymph node status was positive in 53 patients and negative in 72. Estrogen receptor (ER) which was measured using enzyme immunoassay (EIA) was positive in 67 patients, negative in 50 and unknown in 8. Of the 125 patients evaluated, 83 (66.4%) were immunohistochemically positive for ER. ER by immunohistochemistry (IHC) (ER-IHC) was significantly (p<0.01) correlated with ER by EIA (ER-EIA). ER-EIA values in ER-IHC scores were 1.4 fmol/mg protein in score 0, 0.0 in score 1, 19.0 in score 3, 21.2 in score 4, 12.2 in score 5, 17.6 in score 6, 30.0 in score 7 and 114.8 in score 8. ER-EIA values in ER-IHC-score 8 were significantly higher than in scores 0, 2, 3, 4, 5, 6 and 7. Of the 125 patients, 35 (28%) were immunohistologically positive for HER2. HER2 expression was inversely correlated with ER expression. When evaluated even in ER-positive patients, HER2 overexpression was associated with lower ER levels. In this study, we conducted immunohistochemical double staining with ER and HER2, and demonstrated that low ER levels might be one factor in the relative resistance of HER2-positive and ER-positive tumors to hormonal therapy.
Adult↗
[Psychiatric disorders and neural mechanisms underlying energy intake and expenditure: a review].
Anorexia is one of the common symptoms caused by various psychiatric disorders. Increasing evidence indicates that neuroleptics can induce weight gain, obesity, and diabetes mellitus. However, the mechanisms underlying these conditions have not been fully elucidated. In this review, we describe molecular neuroanatomic aspects of current biology of energy homeostasis that would help to address the psychiatric issues noted above, focusing on the central leptin/melanocortin system. An adipocyte-derived hormone, leptin acts on the arcuate hypothalamic nucleus (Arc) to inhibit feeding behavior and simultaneously to promote energy expenditure. Leptin activates Arc neurons producing alpha-melanocyte-stimulating hormone (alpha-MSH) and inhibits those producing agouti-related protein (AgRP). alpha-MSH is an endogenous agonist for the melanocortin-4 receptor (MC4-R) that is expressed exclusively in the central nervous system (CNS), whereas AgRP acts as a MC4-R antagonist. It is also established that MC4-R blockade produces an over-eating/obesity syndrome in rodents and humans. Thus, MC4-R-expressing neurons are downstream targets of leptin. Of interest, MC4-R-positive neurons densely populate in CNS sites critical for energy homeostasis and associated with psychiatric disorders, including the paraventricular hypothalamic nucleus and central amygdaloid nucleus. In addition, Arc alpha-MSH neurons receive serotonergic inputs from raphe neurons. Finally, an AgRP gene polymorphism has been associated with anorexia nervosa. These findings suggest that the central melanocortin system is a target for psychiatry.
Agouti-Related Protein↗
Use of multidetector row CT with volume renderings in right lobe living liver transplantation.
Multidetector row CT is a feasible diagnostic tool in pre- and postoperative liver partial transplantation. We can assess vascular anatomy and liver parenchyma as well as volumetry, which provide useful information for both donor selection and surgical planning. Disorders of the vascular and biliary systems are carefully observed in recipients. In addition, we evaluate liver regeneration of both the donor and the recipient by serial volumetry. We present how multidetector row CT with state-of-the-art three-dimensional volume renderings may be used in right lobe liver transplantation.
Blood Volume↗
Effect of risperidone on sleep in schizophrenia: a comparison with haloperidol.
The aim of the present study is to determine the effect of the atypical antipsychotic drug, risperidone on sleep measures in patients with schizophrenia by polysomnography. Sleep measures were compared in five schizophrenic patients who were receiving risperidone alone and five schizophrenic patients who were receiving haloperidol alone. There were no differences between these two groups in their demographic characteristics or doses of antipsychotic medication. The slow wave sleep period was significantly longer in the risperidone-treated group than in the haloperidol-treated group. There were, however, no other significant differences in sleep variables between these groups. This difference in the effect on sleep between risperidone and haloperidol may be due to their differential actions on serotonin (5-HT2) receptors. Risperidone, which is known to be a serotonin-dopamine antagonist, has the potential to improve the quality of sleep in schizophrenic patients.
Adult↗
Breast-conserving therapy versus modified radical mastectomy in the treatment of early breast cancer in Japan.
BACKGROUND: Breast-conserving therapy has been widely utilized as a treatment option for women with early breast cancer. However, no randomized study comparing modified radical mastectomy and breast-conserving therapy has been conducted in Japan. METHODS: Two hundred and twenty-eight Japanese women with early breast cancer enrolled in the Gunma Breast Conserving Therapy Study between 1991 and 1994 were examined to determine whether there is any difference in disease-free survival or overall survival between radical mastectomy and breast-conserving therapy. After informed consent was obtained, a total of 119 patients underwent breast-conserving therapy and 109 underwent mastectomy. RESULTS: Mastectomy was a more frequently utilized treatment than breast-conserving therapy in patients with clinical stage II lesions, older age, larger tumor size or shorter distance between tumor and nipple. The mean follow-up period for all patients was 81 months (median 86 months). There was no significant difference in overall survival or disease-free survival between breast-conserving therapy and mastectomy even after adjusting for the clinical stage of the disease. A multivariate analysis of tumor size, lymph node status, estrogen receptor status and operation method using the Cox proportion hazard model confirmed that only lymph node status was an independent prognostic factor. CONCLUSION: Breast-conserving therapy is comparable to modified radical mastectomy in overall survival and disease-free survival.
Adult↗
Three-dimensional navigator for retroperitoneal laparoscopic nephrectomy using multidetector row computerized tomography.
PURPOSE: We evaluated the efficacy of a 3-dimensional (D) navigator for retroperitoneal laparoscopic nephrectomy. MATERIALS AND METHODS: A total of 21 patients with malignant localized renal (16) or ureteral (5) neoplasms underwent multi-detector row computerized tomography. The 3-D navigator was created using volume rendering technique. These findings were compared with videos obtained during laparoscopy. RESULTS: The 3-D navigator depicted all renal arteries (100% sensitivity) and 24 of the 25 renal veins (96% sensitivity). Hilar anatomy, including the tumor, major vessels and adrenal gland, and their relationships were visualized as in laparoscopic views. CONCLUSIONS: The 3-D navigator has a potentially important role in retroperitoneal laparoscopic nephrectomy. It is able to guide surgeons and aid in avoiding operative risks and possible complications.
Adult↗
Primary amenorrhea accompanied by adrenal adenoma: start of menarche soon after tumor resection.
We report a patient with primary amenorrhea accompanied by adrenal adenoma. A 21-year-old woman was admitted to our hospital because of primary amenorrhea and hyperprogesteronemia without virilization. Venous sampling showed progesterone overproduction at the left adrenal gland. Computed tomography revealed a 7 cm mass in left adrenal gland. Serum pregnenorone, 17-hydroxypregnenorone, dehydroepiandrosterone, 17-hydroxyprogesterone, deoxycorticosterone, and 11-deoxycortisol were elevated. The diagnosis of steroid hormone producing tumor was made. Following tumor resection, serum progesterone normalized 4 days later, and menarche occurred 51 days after operation. The present case indicated that adrenal functioning tumor should not be overlooked in patients with primary amenorrhea.
Adenoma↗
Late onset anorexia nervosa: two case reports.
OBJECTIVE: Some patients develop an eating disorder at a late age. It is worth investigating why this syndrome develops at such widely different ages. METHODS: Two Japanese cases of late onset anorexia nervosa are reported. RESULTS: In these late onset cases, anorexia developed out of sadness over a loss such as bereavement, divorce, and fear or anxiety for the future. In addition, these two patients didn't demonstrate a fear of aging or of losing their attractiveness and sexuality, nor did they develop a dissociative disturbance based on an early traumatic history of sexual abuse in PTSD. CONCLUSION: Although the clinical features are similar, there appear to be differences between late onset and adolescent cases in psychological mechanisms.
Age Factors↗
Massive hemorrhage from internal carotid artery pseudoaneurysm successfully treated by transcatheter arterial embolization with assessment of regional cerebral oxygenation.
A 54-year-old male presented with intermittent massive hemorrhage from recurrent oropharyngeal cancer. The angiogram showed the encasements at the main trunk of the left internal carotid artery (ICA) and external carotid artery (ECA). Transcatheter arterial embolization (TAE) of the ECA with gelatin sponge particles and microcoils was performed. However, hemorrhage recurred several hours after the initial TAE. The second angiogram showed a large pseudoaneurysm of the ICA developing at the encasement on the initial angiogram. As a simple neurologic test, regional cerebral oxygenation (rSO2) was assessed with and without manual compression of the common carotid artery (CCA). With compression of the left CCA, the rSO2 did not change. We therefore performed isolation of the pseudoaneurysm. We embolized proximally and distally to the ICA pseudoaneurysm with microcoils and the pseudoaneurysm disappeared. No major complications occurred and no massive hemorrhage recurred until death from the cancer. TAE was an effective treatment for massive hemorrhage caused by tumor invasion to ICA. Assessment of rSO2 was a simple and useful neurologic test predicting the cerebral blood flow to prevent complications of TAE.
Aneurysm, False↗
Three patients with hemophagocytic syndrome who developed acute organic brain syndrome.
INTRODUCTION: We describe three patients with hemophagocytic syndrome (HPS) who developed acute organic brain syndrome. All three presented with high-grade fever and twilight state, and were admitted to our hospital. After admission, delirium developed in all three. As delirium improved, various other psychiatric symptoms, including hallucinations, agitation, hypoactivity, affective lability and insomnia, were noted. DISCUSSION: When treated with steroid hormones, immunoglobulin and neuroleptics, all patients demonstrated improvement in their psychiatric symptoms, as well as in their general condition and laboratory findings. Ultimately, they all recovered and were discharged. CONCLUSION: It needs to be noted that organic brain syndrome might be observed at the onset of HPS. Consequently, early diagnosis and treatment for psychiatric symptoms, as well as for HPS, are crucial.
Acute Disease↗
Postictal psychosis coexisting with forced thinking.
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Adult↗
Korsakoff syndrome following chronic subdural hematoma.
We describe a patient who developed Korsakoff syndrome following a spontaneous chronic subdural hematoma. The present case demonstrates persistence of both amnesia and confabulation long after recovery from the acute phase of spontaneous chronic subdural hematoma. There are few reports describing persistent amnesia with confabulation following brain damage. We considered that chronic subdural hematoma in the bilateral frontal and temporal lobes caused amnesia and confabulations, and these conditions persisted as a result of organic atrophic changes of both the frontal and temporal lobes due to long-term compression by chronic subdural hematoma.
Atrophy↗
Technical innovation of cardiac multirow detector CT using multisector reconstruction.
Multisector reconstruction is a newly developed algorithm for multirow detector CT in cardiac study. Using volume data sets obtained by ECG-gated scanning, we can reconstruct cardiac images at any desired phase of the cardiac cycle retrospectively. In retro-processing multiplanar and three-dimensional images, thin-slice images with overlapping increment have a great advantage due to increasing z-axis resolution. In this article, we present principles of the algorithm, a phantom study, clinical applications and perspectives for the future.
Adult↗
Coronary artery calcium scoring using multicardiac computed tomography.
OBJECTIVES: To test the hypothesis that multicardiac-phase computed tomography (CT) improves the quantification of coronary artery calcium. METHODS: Calcium-phosphate on a cardiac phantom and 108 calcified plaques from 50 patients were scanned, and multicardiac-phase images were obtained. Motion artifacts and calcium scores of the calcified plaques were compared between cardiac phases and CT scanners. RESULTS: In the phantom images, motion artifacts differed between cardiac phases; thus, the calcium scores were either higher or lower than the score from the static state. In the patient study, motion artifacts of calcifications on the various coronary branches varied with the cardiac cycle, which profoundly influenced the calcium scores. CONCLUSION: Multicardiac-phase CT has the potential to improve the quantification of coronary artery calcium by determining the cardiac phase where motion artifacts are the least on individual calcified plaques.
Aged↗
Endovascular therapy of pulmonary arteriovenous malformations: Utility of 16-detector-row computed tomography pulmonary angiography as a pre-embolization survey.
The utility of computed tomography pulmonary angiography (CTPA) for coil embolization therapy of pulmonary arteriovenous malformations (PAVMs) was considered. Three consecutive patients (group A) with PAVMs underwent CTPA and coil embolization. The CTPA was performed using a 16-detector-row computed tomography scanner. After careful selection of pulmonary vessel trees, each feeding artery, nidus, and drainage vein was colored using different codes. By using the colored images, a 5-French catheter was shaped to fit to each feeding artery, the best fluoroscopic angle to select each feeding artery was chosen, and interlocking detachable coils (IDCs) were used in embolization. The procedure time and contrast material dose of group A were compared with those of the previous 3 patients (group B) who were treated by the conventional method. All PAVMs of both groups were completely embolized without coil migration. The average procedure time per lesion was 48.4 minutes for group A and 124.0 minutes for group B (P < 0.05). The average contrast material dose per lesion was 37.5 mL in group A and 76.0 mL in group B (P < 0.05). Using CTPA and IDCs, procedure time and contrast material dose were statistically significantly reduced. This combination therapy is useful in treating PAVMs less invasively.
Adult↗