Biomedical subjects

K Arita

Publications and source records attributed to K Arita.

At least 109 records · Page 6Linked to original sources

PubMed1996

Mechanical properties of glass ionomers under static and dynamic loading.

OBJECTIVES: This study evaluated the mechanical properties under static and cyclic loading conditions of various types of glass ionomers used for bases and core build-ups under restorations. METHODS: Compressive strength and three-point flexural strength of two different glass ionomers and two metal-reinforced glass ionomers were determined 1 d after the start of mixing. The flexural fatigue resistance of these materials was measured in the load range of 650 g to 1050 g using a three-point bending machine, and fractured surfaces of the specimens were examined using SEM. RESULTS: All the glass ionomers exhibited similar compressive and flexural strengths. The results analyzed by Cox' proportional hazard model demonstrated that the admixed-type metal-reinforced glass ionomer had the highest fatigue resistance, while the water-hardening glass ionomer had the lowest fatigue resistance among the materials examined (p<0.5). SIGNIFICANCE: There was no significant improvement in the static mechanical properties from incorporating metal particles into the glass ionomers. However, the addition of metal particles as in the admixed-type metal-reinforced glass ionomer produced a material with increased fatigue resistance.

Cermet Cements↗

PubMed1996

Effect of surgery on gonadal function of premenopausal women with pituitary adenomas other than prolactinomas.

The effects of surgery on pituitary-gonadal function were investigated in women with pituitary adenomas other than prolactinomas. The subjects were 46 women of premenopausal age with a pituitary adenoma. Twenty tumors were GH producing, 19 were nonfunctioning, and 7 were adrenocorticotropin producing adenomas. The surgery was performed mainly via the transsphenoidal route, with the aim of eradicating the tumor and preserving pituitary function. The menstrual cycle was preserved postoperatively in 9 out of 10 (90%) patients with regular preoperative menstruation. Menstrual disturbance was seen in 36 (78.3%) cases preoperatively. The causative factors for menstrual disturbance were gonadotropin impairment and hyperprolactinemia in GH producing and nonfunctioning adenoma. Excessive hormonal secretion itself is a major causative factor for menstrual disturbance in GH and ACTH producing adenoma. Regular menstruation was restored following surgery in 20 out of 36 (55.6%) patients with menstrual problems. The predicting factors for postoperative recovery of menstruation are: size of adenoma less than 40 mm, period of amenorrhea less than 5 years, and preoperatively preserved gonadotropin secretion. In addition, preoperative hyperprolactinemia was also a predicting factor in women with nonfunctioning adenoma. Thus, even in patients with pituitary adenomas other than prolactinoma, the restoration of menstruation is highly achievable when surgery is performed with attention to preserving pituitary function.

Adenoma↗

PubMed1996

Effects of surgery on testosterone secretion in male patients with pituitary adenomas.

The purpose of this study was to assess the effect of surgery on gonadal function in 42 male patients with pituitary adenomas Gonadal functions were evaluated by measuring total serum testosterone concentrations pre- and postoperatively. The subjects of the study were 20 patients with GH secreting adenoma, 7 patients with prolactinoma and 15 patients with nonfunctioning (NF) adenoma. Their ages ranged from 18 to 60 years (mean +/- SEM, 41 +/- 1.9). The serum testosterone concentration was low at less than 300 ng/dl preoperatively in 14 of 20 patients (70%) with GH producing adenoma, 6 of 7 patients (86%) with prolactinoma, and 7 of 15 patients (47%) with NF adenoma. Postoperatively, the total serum testosterone concentration was normalized in 9 of 14 patients (64%) with GH producing adenoma, one of 6 patients (17%) with prolactinoma, and 5 of 7 patients (71%) with NF adenoma. The normalization of serum GH and prolactin concentrations is indispensable for the restoration of gonadal function. It is very important to preserve the normal preoperative gonadotropin secretion by means of gentle surgery.

Adenoma↗

PubMed1996

Parasellar chronic inflammatory disease presenting Tolosa-Hunt syndrome, hypopituitarism and diabetes insipidus: a case report.

We describe a 60-year-old man with a history of Tolosa-Hunt syndrome associated with intermittent painful ophthalmoplegia and a visual disturbance on the left side, who presented with signs and symptoms of severe hypoadrenalism and diabetes insipidus. Magnetic resonance imaging demonstrated enlargement of the hypophysis and infundibulum and left cavernous sinus. An endocrinologic study revealed anterior pituitary dysfunction and diabetes insipidus. The patient underwent a transsphenoidal biopsy which revealed chronic inflammation in the hypophysis, mucosa of the sphenoid sinus, and dura mater. The patient was treated with steroids that decreased the size of the hypophysis and infundibulum, but the symptoms of anterior pituitary insufficiency and diabetes insipidus have persisted. The chronic inflammation of the hypophysis and infundibulum is thought to have spread from the cavernous sinus.

Anti-Inflammatory Agents↗

PubMed1996

[A case of cranial hypertrophic pachymeningitis with intracranial hemorrhage].

A case of cranial hypertrophic pachymeningitis of unknown etiology in a patient with 15-year history of headaches, cranial nerve palsies, and gait disturbance is reported. A 77-year-old woman was brought to our institute in a coma. CT revealed intracerebral hemorrhage in the right temporal lobe and thickening of the falx and tentorium. Fifteen years previously the patient had undergone CT scanning because of headaches, cranial nerve palsies, and progressive gait disturbance and a thickened tentorium, mild hydrocephalus and edematous change in the right temporal lobe had been reported. Since the etiology of her symptoms was unclear at the time, she did not receive adequate treatment. Her symptoms gradually progressed thereafter, and her visual acuity and hearing deteriorated. MR imaging in 1994 showed the thickened tentorium as a hypointense area with hyperintense edges on Gd-DTPA enhanced images. Angiography revealed narrowing of posterior portion of the superior sagittal sinus. The patient's condition rapidly deteriorated due to the intracranial hypertension and she subsequently died. Autopsy revealed a thickened tentorium with xanthochromic surface. This hypertrophic change was also seen in the dura mater of the posterior and middle cranial fossa. Microscopic examination of the thickened tentorium revealed extensive fibrous tissue with a chronic inflammatory infiltrate, predominantly of lymphocytes. No specific lesions were revealed by staining with hematoxylin-eosin, PAS, Gram's or Ziehl-Neelsen stains. The patient had no inflammatory or infectious diseases of other organs, and a diagnosis of idiopathic cranial hypertrophic pachymeningitis of unknown etiology was made. Considering the above findings, the thickened tentorium depicted as a hypointense area on the T1- and T2-weighted images and the Gd-enhanced edges of the tentorium are thought to be represent fibrous tissue and inflammatory regions, respectively.

Aged↗

PubMed1996

[A case of subdural empyema with hemorrhage].

A rare case of subdural empyema accompanied by hemorrhage in a 2-year-old boy is reported. The patient was hospitalized on May 31, 1995 because of high fever. Lumbar puncture was performed, a diagnosis of suppurative meningitis was made, and streptococcus pneumoniae was cultured from the CSF. The next day, the patient experienced convulsions, and CT scans revealed left subdural empyema. Intensive antibiotic therapy was performed for 16 days from the onset of symptoms, but the patient's fever persisted, and the area of subdural empyema had grown larger on CT scan on June 15th. He was transferred to our institution the same day. Enhanced MRI clearly showed the capsule of the empyema in the left subdural space. Evacuation of the empyema and irrigation of the cavity were performed via a single burr hole. The old bloody fluid was found to be accompanied by a yellowish-white abscess in the subdural space. We concluded that the source of the bleeding was probably the fragile vessels in the capsule. The patient recovered after surgical treatment and a prolonged course of antibiotic therapy.

Child, Preschool↗

PubMed1996

[Two siblings with sarcoidosis diagnosed by younger sister's central nervous symptoms].

We report two siblings with sarcoidosis; the younger sister had symptoms of central nervous system, and both sisters had subcutaneous mass lesions in the gluteal region. Case 1. A 30-year-old woman presented with two episodes of right leg paresis. On admission, neurological examination revealed right leg weakness, spasticity of both legs, increased deep tendon reflexes in all extremities, urinary disturbance and hearing loss of the right ear, but she had no meningeal signs. Serological studies were normal including angiotensin converting enzyme. Cerebrospinal fluid revealed elevated protein to 340 mg/dl, mild pleocytosis, decreased glucose. CSF culture was negative, and cytology showed no malignant cells. Enhanced MR imaging showed diffuse leptomeningeal enhancement in both the brain around basal meninges and the whole spinal cord. Case 2. A 34-year-old woman (the elder sister of Case 1) presented with visual disturbance. She had been diagnosed to have bilateral iritis at Hiroshima Red Cross Hospital before visiting our hospital. Neurological examination and serological studies were normal. In both cases, left gluteal subcutaneous mass was detected and its biopsy revealed characteristic sarcoid nodules and confirmed the diagnosis of sarcoidosis. A tendency of familial occurrence and positive associations of the specific HLA antigens in sarcoidosis have been reported. Though the diagnosis of neurosarcoidosis has been difficult without extraneurological signs, sarcoidosis should be considered as a differential diagnosis in all the patients with myelopathy, and enhanced MRI and measure of CSF angiotensin converting enzyme seem to be useful for diagnosis and evaluation of drug effect during the course of steroid therapy.

Adult↗

PubMed1995

Cavernous sinus meningioma presenting as orbital apex syndrome. Diagnostic methods of dynamic MRI, spoiled GRASS (SPGR) image.

Orbital apex syndrome is a symptomatologic complex. In this paper, the usefulness of several clinical diagnostic MR methods in preparing for surgery is discussed. These include dynamic MRI and the spoiled GRASS (SPGR) image for a cavernous sinus meningioma presenting with orbital apex syndrome. A 53 year old man, who had right cavernous sinus tumor presenting with orbital apex syndrome, was examined by several new MRI techniques. The tumor was partially removed and fibroblastic meningioma was confirmed pathologically.

Humans↗

PubMed1995

Demonstration of the venous systems with gadolinium-enhanced three-dimensional phase-contrast MR venography.

The purpose of this study was to evaluate the usefulness and advantages of gadolinium-enhanced three-dimensional phase-contrast MR venography for demonstrating the venous systems. The three-dimensional phase-contrast MR venography was performed with a velocity encoding gradient settings from 5 to 20 cm/s on 22 normal subjects. In 8 of normal subjects, gadolinium-enhanced phase-contrast MR venography was performed. 22 subjects (100%) had detectable flow in the sphenoparietal sinus, transverse sinus, basal vein, and internal cerebral vein. With a VENC setting at 10 cm/s, venous system was visualized selectively and clearly. Detection ratio in inferior petrosal sinus, superior petrosal sinus, and superior ophthalmic vein increased from 0% to 25%, from 28.6% to 62.5%, and from 28.6% to 37.5%, respectively, after administration of gadopentate dimeglumine. In conclusion, gadolinium-enhanced three-dimensional phase-contrast MR venography was useful for demonstrating the venous systems.

Adolescent↗

PubMed1995

MRI of intracranial germ cell tumours.

We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77%): 7 of 12 patients with germinoma (58%) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45%) had multiple lesions.

Adolescent↗

PubMed1995

Surface anatomy scanning (SAS) in intracranial tumours: comparison with surgical findings.

We evaluated the usefulness of surface anatomy scanning (SAS) in intracranial tumours, comparing it with surgical findings. We examined 31 patients with brain tumours preoperatively. The tumours included 16 meningiomas, 8 gliomas, 4 metastases and 3 others. SAS clearly demonstrated the tumours, allowing them to be distinguished from the structures of the brain surface, including oedema, except in cases of metastasis. SAS clearly demonstrated large cortical veins. SAS is useful for three-dimensional delineation of the brain surface before surgery.

Brain↗

PubMed1995

MRI of pineal region tumours: relationship between tumours and adjacent structures.

A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71%) with germ cell tumours tectal compression was of the invasive type; 8 patients (57%) had multiple tumours and in 13 (93%) the tumor margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment.

Adolescent↗

PubMed1995

Analysis of the growth rate and cavernous sinus invasion of pituitary adenomas.

Pituitary adenomas generally are regarded as benign tumours, but a part of them can invade the cavernous sinus and recur. We examined 43 pituitary adenomas for the following factors: tumour volume, endocrinological function, cavernous sinus invasion, and growth rates examined by using anti-proliferating cell nuclear antigen (PCNA) and MIB1 (a novel anti-Ki-67) as markers. There was significant correlation between PCNA- and MIB1-positive cell rates and PCNA- and MIB1-positive cell rates were higher in the three cases with rapid regrowth than in the other cases. Staining was stronger and more distinct for MIB1 than for anti-PCNA; thus, MIB1-positive cells were easily distinguished by their intense immunoreactivity. MIB1 may be useful for detecting those rare cases with rapid regrowth even when initially regarded as benign tumours. Adenomas with cavernous sinus invasion were significantly larger than those demonstrating no invasion. However, no significant difference was found in the frequency of PCNA- or MIB1-positive cells between adenomas with and without cavernous sinus invasion. These findings suggest that cavernous sinus invasion and growth rate are independent biological factors. Therefore, cavernous sinus invasion may be due to chemical factors produced by the tumour itself rather than as a result of rapid tumour growth.

Adenoma↗

PubMed1995

Spontaneous disappearance of an aneurysmal malformation of the vein of Galen.

We describe spontaneous disappearance of an aneurysmal malformation of the vein of Galen (AMG), an anomaly that occurs most often in children, with a high mortality due to the accompanying severe cardiac failure. Spontaneous thrombosis of an AMG is rare. In this case, the AMG has been closed for about 5 years, without radiological evidence of thrombosis, and no active treatment. Proposed mechanisms of spontaneous thrombosis include slow flow shunts and severe obstruction of the venous outflow. However, in this case, the disappearance of the AMG without evidence of thrombosis indicates a different mechanisms, namely, obstruction of the feeding artery.

Cerebral Angiography↗

PubMed1995

Steal phenomenon in a traumatic carotid-cavernous fistula.

A patient with head injury presented with computed tomography findings of a diffuse severe infarction of the left cerebral hemisphere in which the cerebral hemodynamics can be evaluated by transcranial Doppler sonography. Serial angiograms revealed a carotid-cavernous fistula, with a complete steal phenomenon. The unusual complication of a traumatic carotidcavernous fistula is discussed.

Arteriovenous Fistula↗

PubMed1995

Transcranial magnetic coil stimulation of motor cortex in patients with central pain.

We report two patients with deafferentation pain secondary to central nervous system lesions who were evaluated by noninvasive magnetic coil stimulation of the motor cortex followed by electrical motor cortex stimulation with epidural electrode array implantation. Magnetic coil stimulation was very useful to estimate the effect of electrical stimulation. Our first patient was a 52-year-old man who experienced a left putamenal hemorrhage at the age of 48. Two years later, he had paresthesias and intractable pain in the extremities and face on the right side. Pain was resistant to barbiturates but responded to magnetic coil stimulation of the motor cortex. Electrical motor cortex stimulation provided excellent relief from the pain. The second patient was a 43-year-old man who was suffering from congenital cerebral palsy for which left thalamotomy was performed two times, at the ages of 9 and 13. He began to experience intractable pain on the right side 20 years later. Although barbiturate administration was effective for pain relief, neither magnetic coil stimulation nor electrical stimulation of the motor cortex gave relief from pain.

Adult↗

PubMed1995

In vivo effect of cabergoline, a dopamine agonist, on estrogen-induced rat pituitary tumors.

Cabergoline (CG) is a dopamine agonist that inhibits the secretion of prolactin (PRL) and growth hormone. In the present study, we evaluated the in vivo effect of CG on PRL secretion and the pituitary tumor induced by estrogen. Estrogen was administered by subcutaneous injection to 4-week-old Fischer 344 rats weekly for 10 weeks to induce tumors. On the last day of estrogen administration, doses of either CG or bromocriptine (BC), 0.6 mg/kg, were administered as a single oral route or chronically, given every third day. Sera and pituitary tumors were sampled on each treatment schedule. Serum levels of PRL were measured and the pituitary glands were weighed. Immunohistological evaluation was performed by optical and electron microscopy. A single dose of CG significantly inhibited the serum levels of PRL for 6 days. Following a single dose of BC, the PRL level was significantly inhibited only at 6 hours' postadministration. The continued oral administration of CG significantly reduced both the serum PRL level and the weight of the pituitary during 15 to 60 days of treatment as compared with BC. Morphologic studies revealed that CG reduced the size of the cells and of the granules, and increased the number of granules per unit area of the cytoplasm. These findings suggest that CG inhibits the maturation of PRL secretory granules and the secretion of PRL more than its synthesis. Thus, CG induced a prolonged lowering of PRL and had a good antitumor effect on rat pituitary tumors induced by estrogen.

Animals↗

PubMed1995

Characteristics of prolactin secretion in normal and estrogen-treated pituitaries of rats at the single cell level: analysis by reverse hemolytic plaque assay.

We studied PRL release from individual pituitary cells in normal and estrogen (E2)-treated female Fischer 344 rats by means of a reverse hemolytic plaque assay. In this assay, the area of the hemolytic plaque around a pituitary cell is proportional to the amount of hormone secreted from the cell. Multimodal distribution of the plaque area was observed in normal pituitary cells, and was unchanged in the course of aging. In E2-treated pituitary cells, bimodal distribution was found. The heterogeneity of the distribution pattern (functional heterogeneity) and PRL secretion from a single pituitary cell decreased in association with the length of E2 treatment. The mean plaque area for the E2-treated pituitary cells was smaller than that for the normal pituitary cells. These results suggest that in E2-treated pituitary cells, the functional heterogeneity and PRL release from a single cell decrease as tumorigenesis progresses.

Animals↗