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K Arita

Publications and source records attributed to K Arita.

At least 73 records · Page 4Linked to original sources
PubMed1999

[A case of cerebral juvenile pilocytic astrocytoma: observation of the development of the tumor].

A case with cerebral juvenile pilocytic astrocytoma (JPA) was reported. The patient was 33-month-old boy, who developed headache and loss of activity on December, 1994. Although he was indicated macrocephaly at the age of just 1 year, CT scan showed no abnormality at that time. On admission, MRI revealed multiple large cysts with an enhanced mural nodule in the left frontal lobe. The tumor was totally removed, and histologically diagnosed as JPA, because of alternating two types of structures of loose knit tissue composed of satellite astrocytes and compact tissue consisting of highly fibrillate cells. MIB-1 percent positivity was almost negative. We summarized and discussed the clinicopathological and proliferating characteristics of the cerebral JPA. These considerations suggested that the tumor already existed at the age of 1 year and developed during these 20 months, according to the theory that the growth rate of JPAs is programmed to slow down as the patient grows.

Astrocytoma↗
PubMed1999

[Significance and pitfall of diffusion weighted image in super acute cerebral ischemia: investigation by questionnaire study].

We investigated the findings in diffusion weighted image (DWI) of super acute ischemia examined within 6 hours after onset by questionnaire study. The magnitude of magnetic field of MR machine, method of diffusion weighted imaging, the total number of cases, the number of cases with high signal intensity area on DWI and the number of decrease or disappearance of signal intensity were investigated. Answers were obtained from 16 institutes (64%). Totally, 232 cases of super acute ischemia examined within 6 hours after onset were imaged by DWI. High signal intensity area were detected in 189 cases (81.5%) of all, which disappeared or decreased in 10 cases (4.3%). Follow up DWI revealed a decrease in the area of high signal intensity in 5 (17.9%) of 28 cases who underwent thrombolysis by endovascular treatment. However, 6 (21.4%) or 28 cases resulted in hemorrhagic infarction. We must recognize the diffusion anisotropy, apparent diffusion coefficient, and b value in reading the DWI. In conclusion, high signal intensity area on DWI include not only irreversible infarction but also the reversible ischemia.

Acute Disease↗
PubMed1999

[Study on antibiotics susceptibility and mechanism of carbapenem-resistance in clinical isolates of Pseudomonas aeruginosa].

The susceptibility of 260 strains of Pseudomonas aeruginosa to several antibiotics and the mechanism of resistance to carbapenems were investigated. The number of strains of P. aeruginosa moderately resistant or resistant to ofloxacin, ceftazidime and imipenem (IPM) were 76 (29.2%), 31 (11.9%) and 30 (11.5%), respectively. There was no clear relationship between the drug resistance of P. aeruginosa and serum type. Fourteen strains (46.6%) out of 30 IPM-resistant strains were susceptible to meropenem (MEPM). Twenty seven (90.0%) IPM-resistant strains showed cross resistant to panipenem (PAPM), and 12 strains (44.4%) out of the 27 strains showed high susceptibility to MEPM. P. aeruginosa becomes resistant to IPM and PAPM only by the decrease in the outer membrane permeability of these carbapenems. In contrast, P. aeruginosa becomes equally resistant to MEPM by concurrent occurrence of the increase in the efflux of the antibiotics and the decrease in the outer membrane permeability of the antibiotics. The possibility that both mechanisms are taken place concurrently in P. aeruginosa is considered to be low, and it was also supported by the results of the present study.

Anti-Infective Agents↗
PubMed1998

Adenovirus-mediated p16 gene transfer prevents drug-induced cell death through G1 arrest in human glioma cells.

This study examined the effects of full-length p16 gene transfer by recombinant adenovirus on cell growth and on sensitivity to CDDP or ACNU chemotherapies. We developed a recombinant adenovirus expressing the full-length human p16 gene (AxCA-hp16) by the COS-TPC method. AxCA-hp16 was infected into the p16-null human glioma cell line, U251MG. AxCA-hp16 infection inhibited proliferation of U251MG cells. A proliferation assay employing MTT showed that AxCA-hp16 infection induced chemoresistance, preventing CDDP-induced cell death (11- to 15-fold) and ACNU-induced cell death (80- to 92-fold). In the absence of AxCA-hp16, cell death was induced with CDDP or ACNU at 3 to 5 days after treatment, as demonstrated by Trypan-blue exclusion. Flow-cytometric analysis showed that CDDP or ACNU arrested cells in the G2 phase on day 1 and that cells re-entered the cycle on day 3. However, the cells infected with AxCA-hp16 after CDDP or ACNU treatment showed G1 arrest on day 5 after re-entering the cycle from G2 arrest on day 3. The cells infected with AxCA-hp16 before CDDP or ACNU treatment showed G1 arrest over the 5 days after the infection. This study demonstrated that G1 arrest induced with p16-gene expression prevents ACNU- or CDDP-induced cell death. The cell death induced by ACNU and CDDP therefore appears to occur in the phase after the G1/S check point.

Adenoviridae↗
PubMed1998

Suppression by topiramate of epileptiform burst discharges in hippocampal CA3 neurons of spontaneously epileptic rat in vitro.

Topiramate, a novel antiepileptic drug, inhibits the seizures of spontaneously epileptic rat (SER), a double mutant (zi/zi, tm/tm) which exhibits both tonic convulsion and absence-like seizures from the age of 8-weeks. Hippocampal CA3 pyramidal neurons in SER show a long-lasting depolarization shift with accompanying repetitive firing when a single electrostimulation is delivered to the mossy fibers in vitro. The effects of topiramate on the excitability of CA3 pyramidal neurons in SER were examined to elucidate the mechanism underlying the antiepileptic action. Intracellular recordings were performed in 23 hippocampal slice preparations of 16 SER aged 8-17 weeks. Topiramate (10-100 microM) dose-dependently inhibited the depolarizing shifts with repetitive firing induced by mossy fiber stimulation without affecting the first spike and resting membrane potentials in hippocampal CA3 neurons of SER. Higher dose of topiramate (100 microM) sometimes inhibited the first spike, and decreased excitatory postsynaptic potentials in the SER CA3 neurons. However, topiramate up to 100 microM did not affect the single action potential elicited by the stimulation in the hippocampal CA3 neurons of age-matched Wistar rat devoid of the seizure. Application of topiramate (100 microM) did not significantly affect the firing induced by depolarizing pulse applied in the CA3 neurons of the SER. In addition, topiramate (100 microM) had no effects on the Ca2+ spike induced by intracellularly applied depolarizing pulse in the presence of tetrodotoxin and tetraethylammonium. In contrast, a dose-dependent inhibition of depolarization and repetitive firing induced by bath application of glutamate in CA3 pyramidal neurons was obtained with topiramate (10-100 microM). Furthermore, topiramate (100 microM) decreased the number of miniature postsynaptic potential of CA3 pyramidal neurons of SER. In patch clamp whole cell recording using acutely dissociated hippocampal CA3 neurons from SER aged 8-weeks and age-matched normal Wistar rats, there were no remarkable effects on voltage dependent Ca2+ current with topiramate up to 300 microM in either animal; the current was completely blocked by Cd2+ at a concentration of 1 mM. These findings suggest that topiramate inhibits release of glutamate from the nerve terminals and/or abnormal firing of the CA3 pyramidal neurons of SER by mainly blocking glutamate receptors in the neurons.

Action Potentials↗
PubMed1998

Demonstration of the optic pathway in sellar/juxtasellar tumours with visual disturbance on MR imaging.

OBJECTIVE: To prospectively compare the demonstration of the intracranial optic pathway in patients with sellar/juxtasellar tumours and with clinical evidence of visual disturbance using either spoiled gradient recalled acquisition in steady state (SPGR) or conventional spin echo (CSE) T1-weighted imaging. MATERIALS AND METHODS: We studied 108 patients with sellar/juxtasellar tumours presenting visual disturbance. Visualization of the optic pathway (nerves, chiasm, tracts) was compared between CSE T1-weighted coronal image and SPGR coronal image. In 18 patients, SPGR imaging was performed before and after administration of Gd-DTPA and visualization of the optic pathway was compared. RESULTS: On CSE T1-weighted coronal images of 108 patients with visual disturbance, the rates for visualization of the optic nerves, chiasms and tracts were 50%, 77.8% and 89.8% respectively. In contrast, on SPGR coronal image the rates were 80.6%, 96.3% and 92.6% respectively. The rates of visualization of the optic pathway were greater in non-enhanced that in those with enhancement. The rates of visualization in patients with recurrent tumours were less than those in patients with primary tumours. The rate of visualization of optic nerves in patients with meningioma was less than in patients with pituitary adenoma, craniopharyngioma or Rathke cleft cyst. CONCLUSION: The rate of visualization of optic pathway structures on SPGR imaging (without enhancement) is greater than that on CSE T1-weighted imaging. It is important to understand the accurate position of the optic pathways with using new MR modality especially in surgical planning for lesions around the sella turcica.

Adolescent↗
PubMed1998

Spontaneous disappearance of a middle cranial fossa arachnoid cyst after suppurative meningitis.

BACKGROUND: Spontaneous disappearance of an arachnoid cyst is very rare, particularly after suppurative meningitis. CASE REPORT: A 2-month-old boy with a high fever was diagnosed with suppurative meningitis by cerebrospinal fluid examination. Computed tomography disclosed a large arachnoid cyst in the left middle cranial fossa. Two months later, the meningitis was cured. The arachnoid cyst disappeared with long-term antibiotic therapy alone. CONCLUSION: Although an infected arachnoid cyst may disappear with antibiotic treatment alone, careful observation and individualized patient management are essential.

Arachnoid Cysts↗
PubMed1998

Induction of convulsive seizures by acoustic priming in a new genetically defined model of epilepsy (Noda epileptic rat: NER).

Noda epileptic rat (NER) is a mutant rat, found in a Crj: Wistar colony, which exhibits a tonic clonic convulsion spontaneously about once per 30 h from 14 weeks of age. We performed modified acoustic priming, that is, repeated weekly sound stimulations from 3 weeks of age. In addition, characteristics of audiogenic seizure (AGS), and ictal/interictal electroencephalograms (EEGs) were examined. We also studied the effect of repeated weekly stimulations from 14 weeks of age on AGS susceptibility in another NER. From 9 weeks of age, the NER primed from 3 weeks of age had a high incidence (100%) of AGS: a typical seizure was composed of sudden wild running and/or jumping (WRJ) followed by clonic or tonic-clonic convulsion. The severity and the duration of the AGS were intensified and prolonged with an increase in age, respectively. By contrast, the NER repeatedly stimulated from the age of 14 weeks, rarely showed AGS (20-40(%). The majority of the seizures in this NER were WRJ. The cortical and hippocampal EEG during the tonic convulsion showed a low-voltage spike-wave (5-7 Hz). This evolved into a high-amplitude spike- or polyspike-waves associated with the clonic convulsion. Immediately after cessation of the seizures, the EEG showed a flattening or diffuse slowing. In interictal EEG analysis, sporadic spikes predominantly in the hippocampus and spike-wave bursts in both the cortex and hippocampus occurred from 11 and 20 weeks of age, respectively. These results indicate that AGS susceptibility in NER can be induced consistently by modified acoustic priming and this rat strain is a new genetic model useful for experimental studies of human epilepsy.

Acoustic Stimulation↗
PubMed1998

Trans-sellar color Doppler ultrasonography during transsphenoidal surgery.

OBJECTIVE: To improve the safety and efficacy of transsphenoidal pituitary adenoma surgery, we investigated transsphenoidal intraoperative color Doppler ultrasonography using a biplane transducer system. METHODS: We studied 23 patients with pituitary adenomas (18 patients with macroadenomas and 5 patients with microadenomas) who underwent transsphenoidal surgery. The Hitachi EUB555 color Doppler ultrasound system (Hitachi Medical, Tokyo, Japan) was used with a pediatric biplane transesophageal echo cardiography probe (EUP-ES533, 7.5 MHz, biplane phased array sector probe, 9.8-mm tip). The probe was inserted into the saline-filled sphenoid sinus after the sellar floor was opened. Intra- and suprasellar images were obtained just before dural incision and after the tumor removal was thought to have been accomplished. RESULTS: In all patients, the tumor was depicted as a slightly hyperechoic mass, as compared with the cerebrum. Using color Doppler imaging, major cerebral arteries were depicted clearly in 74% of patients. The pituitary glands, pituitary stalks, and optic chiasms were observed in patients with small adenomas, but not when large adenomas were present. Cavernous sinus invasion, concomitant aneurysm, and residual tumor were clearly visualized. In patients with large adenomas, the end point of surgery was decided when there was an ultrasonographically demonstrated collapsed tumor capsule, subcapsular total vacancy, and reappearance of the optic chiasm. CONCLUSION: Trans-sellar color Doppler ultrasonography seems to be a useful intraoperative guiding system that may improve the safety and efficacy of transsphenoidal surgery.

Adenoma↗
PubMed1998

Airway stenting in Japan.

Various types of outstanding airway stents have been made commercially available. In Japan, a total of 1004 airway stents (Dumon stents (Novatech, Aubagne, France), Gianturco Z stents (Cook Ins, Bloomington, USA), Ultraflex stents (Boston Scientific Corp, Natick, MA, USA), and Dynamic Y stents (Ruesch AG, Kernen, Germany)) were implanted from July 1991 until February 1998. Of all the various stents, the Dumon stent has become the standard worldwide. Also, the Dumon stent has been replacing the Gianturco Z stent as the preferred stent throughout Japan. The Dumon stent was the first stent covered by Japanese National Health Insurance. Therefore, we present our 5-year experience with the Dumon stent at our institution. In our experience, stenting is effective for the immediate and lasting relief of symptoms in patients with severe malignant obstruction of major airways.

Airway Obstruction↗
PubMed1998

Effects of successful adenomectomy on body composition in acromegaly.

The purpose of the present study was to investigate postsurgical change in body composition in patients who have undergone surgery for acromegaly. Eight patients with acromegaly had determination of serum GH, insulin-like growth factor-I (IGF-I), height, body weight, and bioelectric impedance before surgery and at 2 weeks, 1 month, 3 months, and 6 months after surgery. Body composition was analyzed by bioelectric impedance analysis (BIA). We analyzed body fat (BF), body lean mass (BLM), body cell mass (BCM), total body water (TBW), intracellular water (ICW) and extracellular water (ECW). The serum GH concentration and IGF-I had decreased significantly 2 weeks after surgery. Body weight had decreased significantly 1 month after surgery and recovered 3 months after surgery. BIA showed that TBW and BCM had decreased significantly 2 weeks after surgery. BF gradually increased up to 1 month after surgery and was increased significantly at 3 months after surgery. The percent ratio of TBW/body weight decreased and the percent ratio of BF/body weight increased during the 6 months after surgery. The percent ratio of ECW/TBW did not change during the 6 months following surgery. In conclusion, the rapid body weight loss which occurred within 2 weeks after surgery was caused by decreases in TBW and BCM. The recovery of body weight, which was seen later than 1 month after surgery, was caused by an increase in BF. The postoperative change in body composition in acromegaly ceased 3 months after surgery.

Acromegaly↗
PubMed1998

Subsidence of seizure induced by stereotactic radiation in a patient with hypothalamic hamartoma. Case report.

The authors report on a patient who exhibited intractable epilepsy due to an inaccessible hypothalamic hamartoma and subsequently underwent stereotactic radiosurgery. This 25-year-old man had a 24-year history of intractable gelastic and tonic-clonic seizures. Magnetic resonance (MR) imaging performed at examination as well as that performed 30 months earlier demonstrated a nonenhancing and nonprogressive spherical mass, approximately 10 mm in diameter, located on the patient's right side at the floor of the third ventricle. Focal radiation treatment performed with a gamma knife unit administered 36 Gy to the center and 18 Gy to the periphery of the lesion. This treatment resulted in an improvement in seizure control. Before the patient underwent radiosurgery, he suffered from three to six generalized seizures per month in spite of attentive compliance with an anticonvulsant medication regimen. After irradiation of the harmatoma, the frequency of the seizures transiently increased and then subsided 3 months posttreatment. The patient has been free of seizures for the last 21 months, with no neurological or endocrinological complications. Magnetic resonance imaging performed 12 months posttreatment demonstrated complete disappearance of the lesion.

Adult↗
PubMed1998

[Multivariate analysis of intentional temporary vessel occlusion in aneurysmal surgery].

Temporary vessel occlusion (TO) for aneurysmal clipping is an effective technique to facilitate dissection between aneurysm and parent vessels, and to place a permanent clip at the aneurysmal neck precisely. However, several unsolved problems remain regarding the overall safety and risk resulting from this technique. The authors examined a series of patients in whom mannitol 500 ml, tocopherol acetate 500 mg, and phenytoin 500 mg were administered intravenously as ischemic protection during TO for the aneurysmal clipping. The study comprises a nonconcurrent retrospective analysis of 144 consecutive aneurysm clippings performed with the aid of intentional TO at the Hiroshima Prefectural Hospital from 1985 to 1995. To identify technical and patient-specific risk factors for perioperative stroke, factors studied included duration, location of the temporary clip application, number of occlusive episodes, patient sex, age, and preoperative neurological status, timing of operation, as well as postoperative, temporary or permanent, neurological deficits (ND) due to TO were used. Overall frequency of postoperative ND due to TO manifested clinically and radiologically were 9.0% and 9.7%, respectively. In both univariate and multivariate analysis there were no significant factors relevant to the ND. However, duration of the temporary occlusion time over 20 minutes was the factor most influential on the ND due to TO. Duration of the temporary occlusion time was shown to have no link with outcome. Based on our findings the authors conclude that temporary vessel occlusion within 20 minutes with anti-ischemic drugs is a relatively safe adjunct to aneurysmal surgery.

Adult↗
PubMed1998

[A case of neurofibromatosis type I associated with basal meningocele and abnormal vessels].

A 21-year-old man with neurofibromatosis type 1 (NF 1) had many widespread cutaneous neurofibroma on his right face. Magnetic resonance imaging (MRI) revealed basal meningocele due to dysplasia of the skull base. Carotid and vertebral angiograms revealed occlusion of the right internal carotid artery, persistent primitive trigeminal artery. We have reviewed the clinical and radiographic features of this case of neurofibromatosis, meningocele and cerebral arterial abnormalities. NF associated with both intracranial vascular malformation and meningocele is very rare, and in our case both were thought to arise congenitally as a manifestation of mesodermal dysplasia. Careful follow up using MRI and MR angiography should be performed for such patients.

Adult↗
PubMed1998

[A guide for the timing of peripheral blood stem cell harvest in patients with lung cancer].

Harvest of peripheral blood stem cells (PBSC) was performed 57 times in 17 lung cancer patients after standard-dose chemotherapy (cisplatin, etoposide) supplemented with granulocyte-colony stimulating factor (G-CSF). In every case, more than 1.5 x 10(6)/kg CD 34+ cells were collected by 2-5 apheresis. Statistical significance was noted between peripheral leukocyte counts (WBC) and collected CD 34+ cell counts (p = 0.0298), between peripheral platelet counts and collected CD 34+ cell counts (p = 0.0009), and between the peripheral immature granulocyte ratio and collected CD 34+ cell counts (p < 0.0001). Because of the remarkable relationship between collected CD 34+ cell counts and peripheral WBC counts, peripheral platelet counts and the peripheral immature granulocyte ratio, these parameters were useful for determining the correct timing of PBSC harvest.

Adult↗
PubMed1998

[A case of Churg-Strauss syndrome overlapping with sarcoidosis].

We report a case of a 55-year-old woman with Churg-Strauss syndrome (CSS) overlapping with sarcoidosis. She had suffered from bronchial asthma since she was 42, then was diagnosed with sarcoidosis at the age of 50, with typical bilateral hilar lymphadenopathy and noncaseating granulomas in the specimen from the scalene lymph node biopsy. Five years later she was admitted to our hospital in a state of mild confusion. Since she had mononeuropathy multiplex and positive serum pANCA, in addition to bronchial asthma and marked eosinophilia, she was diagnosed as having CSS too. To the best of our knowledge, no case reports on CSS overlapping with sarcoidosis have yet been published. Although CSS can occur with sarcoidosis merely by chance, both disorders cause systemic granulomatous vasculitis and share several clinical features. Therefore, we speculate that CSS and sarcoidosis share pathogenesis in part and may present a clinical condition in which CSS overlaps with sarcoidosis. The disturbed state of consciousness in this case may be caused by a diffuse cerebral dysfunction from microangiopathy in the brain.

Churg-Strauss Syndrome↗