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Biomedical subjects

K Ishida

Publications and source records attributed to K Ishida.

At least 505 records · Page 28Linked to original sources

Idiopathic thoraco-lumbar spinal epidural hematoma. Case report and review of literature.

The authors report a case of a 71-year-old man, who had thoracic pain, flaccid paraplegia, sensory loss below the level of Th10, and disturbance of the sphincter control. CT myelography disclosed an isodensity epidural mass lesion from Th10 to L2, which compressed the spinal cord ventrolaterally. Laminectomy was immediately performed and an epidural hematoma was verified. The literatures of spinal epidural hematoma located in the thoraco-lumber region were reviewed.

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[Clinical effects of lipo-prostaglandin E1 in patients with delayed cerebral vasospasm].

Prostaglandin (PG) E1 is a potent vasodilator on the peripheral vessels and also has an inhibitory action of platelet aggregation. Thus it is expected that PGE1 may be used for the treatment of cerebral vasospasm in aneurysmal subarachnoid hemorrhage. Lipo-PGE1, the lipid emulsified PGE1, is not destroyed in the lung, has much longer half life in the circulation than PGE1 which is rapidly inactivated in the lung. The effects of intravenous injection of lipo-PGE1 on the cerebral hemodynamics and the central conduction time (CCT) of the sensory evoked potential under vasospastic conditions has been studied in eight patients. All these 8 patients demonstrated severe angiographic vasospasm and signs of cerebral ischemia. The 15-20 micrograms of lipo-PGE1 was administered every eight hours for 5 to 7 days. Within 6 hours of the first lipo-PGE1 treatment, the regional cerebral blood flow (rCBF) and the CCT measurements were reported to document the effect of treatment. The average pretreatment of rCBF on the right anterior, middle and posterior cerebral artery were 46.6 +/- 6.8, 56.4 +/- 7.3 and 58.8 +/- 8.9 ml/100 g/min and on the left side were 52.1 +/- 9.2, 49.1 +/- 10.8 and 56.1 +/- 9.2 ml/100 g/min respectively. With treatment these flows increased to 53.0 +/- 6.9, 64.3 +/- 5.3 and 63.0 +/- 4.6 ml/100 g/min respectively on the right side and 60.8 +/- 9.4, 60.6 +/- 9.7 and 60.6 +/- 7.2 ml/100 g/min respectively on the left. The CCT also demonstrated the improvement from 6.36 msec to 6.21 msec by the initial PGE1 treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

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Eosinophil responses of permissive and nonpermissive hosts to the young adult worms of Angiostrongylus cantonensis.

Blood and bone marrow eosinophilia was assessed in nonpermissive (guinea pigs) and permissive (rats) hosts following the pulmonary arterial transfers of live or dead young adult worms of Angiostrongylus cantonensis. Guinea pigs showed a marked eosinophilic response to live worms but only a slight response to dead worms. Neither IgE nor haemagglutinating antibodies correlated with the induction of this eosinophilia. In contrast, the rat responded to neither form of the young adult worm. When the guinea pig and the rat were injected with whole worm extract (WWE) of the young adult worms either by an osmotic mini-pump connected to the jugular vein or by intermittent intravenous injections, the former animal showed blood eosinophilia but the latter failed to do so. Guinea pigs also developed blood eosinophilia after continuous exposure to the excretory and secretory products of the young adult worms, administered by the mini-pump. Eosinophil responses to WWE could be induced both in athymic CD-1 (ICR) nude mice and in its heterozygous litter mates, suggesting that T cell-independent mechanism(s) could be involved in the induction of blood eosinophilia in the nonpermissive, mouse host. These data clearly indicate that the eosinophilia-inducing factor(s) and the mechanism of eosinophilia are different in permissive and nonpermissive hosts.

Angiostrongylus↗

Tobramycin therapy for lethal sepsis in the dog.

Antimicrobial effectiveness and effect on survival of single-dose vs. multiple-dose aminoglycoside antibiotic therapy (with and without steroid) for lethal sepsis were evaluated. Adult dogs of either sex were anesthetized, divided into five groups, and infused iv for one hour with Escherichia coli. Group A was given no drug. Group B was given a 45-mg/kg, 10-min iv injection of tobramycin (TOB) at 65 min. Group C was given a 3-mg/kg, 10-min TOB injection at 65 min, followed by an 8.25-mg/kg iv infusion for 285 min, and three 11.25-mg/kg intramuscular injections at 6, 12, and 18 h (total 45 mg/kg). Group D was given the same TOB regimen as B, plus a 30-mg/kg iv injection and 30-mg/kg iv infusion of methylprednisolone sodium succinate (MPSS) from 15 to 360 min. Group E was given the same TOB regimen as C, plus the same MPSS regimen as D. Treated dogs also received 11.25 mg/kg of TOB daily for 4 days. The percent surviving more than 7 days was 0, 0, 17%, 83%, and 83%, for groups A through E, respectively. By 4 h, TOB-treated groups had significantly (p less than .05) lower E. coli blood levels than group A. Also E. coli levels in group B were significantly (p less than .05) lower than those in groups C, D, or E. High trough serum TOB concentrations were associated with death and very low levels with recovery. Serum urea nitrogen and creatinine concentrations increased in all groups, but returned to normal by 7 days in survivors.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Follow-up study of patients with vibration syndrome in Japan.

This study was performed on 187 patients with vibration syndrome treated and followed for more than five years in 10 hospitals in Japan. The subjects had disturbances of circulation and sensation in their fingers and of joint movements in their upper extremities. Most of the patients received treatment combining physical and drug therapy. Data were analyzed to determine the effective treatment period for improving the disturbances. The blanching attack Raynaud's phenomenon) and abnormal cold and tingling sensations in the fingers were significantly improved only during the first two years of treatment. A temperature test and plethysmography suggested improvement in finger circulation only during the first three years and one year of treatment, respectively. Spontaneous numbness and pain in the fingers did not improve. The pin-prick and vibratory sensations showed recovery only during the first three and two years of treatment, respectively. Lowered conduction velocities of the ulnar and median nerves improved only during the first year. Limited movements in the wrist and elbow joints did not improve at all despite long-term treatment. Similar results were seen in an overall evaluation of the data. It was concluded that there is a limitation in the treatment of disturbances related to the vibration syndrome.

Fingers↗

Successful use of continuous ambulatory peritoneal dialysis (CAPD) in the treatment of patients with renal and cardiac failure.

This report described successful uses of continuous ambulatory peritoneal dialysis (CAPD) in the treatment of two patients with renal and cardiac failure. Case 1 was a 46-year-old woman with renal failure and mitral regurgitation. There were some predictable disadvantages to make a blood access and to increase the cardiovascular stress for her condition. Therefore, we treated her using CAPD and succeeded in improving her condition. Case 2. was a 62-year-old man with renal failure and aortic insufficiency. Beside having renal failure, he showed intractable cardiac failure. He was initially treated using in full ECUM (extracorporeal ultrafiltration method) and CAPD. Two week after admission he was successfully treated only by CAPD. It is suggested that CAPD will be the first choice of treatment in patients with renal and cardiac failure.

Aortic Valve Insufficiency↗

Changes of plasma gastrointestinal glucagon concentrations following lethal infusions of E. coli.

We have determined the effect of lethal E. coli infusions in dogs on plasma concentrations of pancreatic and gastrointestinal-derived glucagon and have explored the contributions of each source of glucagon during the early and recovery phases of shock. We examined 18 adult dogs in three protocols: group I received LD100 E. coli alone, group II received LD100 E. coli + tobramycin (TOB), and group III received LD100 E. coli + TOB + methylprednisolone sodium succinate (MPSS). E. coli organisms were infused intravenously during a 1-hour period and each animal was monitored for 6 hours and observed for a 7-day recovery period. Plasma concentrations of pancreatic and gastrointestinal glucagon were determined by specific RIAs. The survival percentages (greater than 7 days) were 0% in group I, 17% in group II, and 83% in group III. Early progressive increases in plasma concentrations of pancreatic and gastrointestinal-derived glucagon, reaching statistical significance by 6 hours following the onset of E. coli administration, were seen in the three groups. The increase in gastrointestinal-derived glucagon was of a greater magnitude than that from the pancreas. Attenuation of the increase appeared to be achieved by corticosteroid infusion during its time of administration (6 hours). Recovery from shock was characterized by an exceptionally slow return (greater than or equal to 7 days) to control levels of glucagon in all recovering animals.

Animals↗

[Pseudoaneurysm of the left ventricle serially demonstrated from on-set using two-dimensional echocardiography: a case report].

A case of so-called pseudoaneurysm of the left ventricle without pericardial adhesion, serially demonstrated by two-dimensional echocardiography, was reported. A 76-year-old man developed congestive heart failure 10 hours after gastrectomy, and was diagnosed as having acute myocardial infarction. Two-dimensional echocardiography on the 21st day after onset revealed moderate pericardial effusion and an echo-free space in the posterolateral myocardium of the left ventricle. The echo-free space gradually expanded exteriorly and formed an aneurysm, which remained unchanged after the resolution of the pericardial effusion. Clinical diagnosis of pseudoaneurysm of the left ventricle was made by left ventriculography and coronary angiography. At autopsy, there was an aneurysm measuring 2.3 X 3.0 X 5.0 cm which communicated with the left ventricle via two small ostia, 5 mm each in diameter. There was a loose fibrous adhesion between the pericardium and the epicardium. The wall of the aneurysm consisted of organized fibrous tissue without any elements of the myocardium. Both myocardium and fibrous tissue were located at the junction of the left ventricular wall and the aneurysm. It is surmised that dissection of the infarcted myocardium expanded so greatly as to form an aneurysmal cavity, resulting in the formation of a so-called pseudoaneurysm of the left ventricle after fibrous changes of the outer wall in the infarcted myocardium. Therefore, this aneurysm might be termed a "dissecting" aneurysm of the left ventricle. The hypothesis that a pseudoaneurysm is derived from a localized hemopericardium should be reconsidered.

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[Closing volume].

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Closing Volume↗

Meningioma in the interpeduncular cistern in a child.

The authors describe an 8-year-old boy who presented with progressive oculomotor palsy on the left side. The diagnostic evaluation with computerized transmission tomography (CTT), metrizamide CTT cisternography, and angiography indicated an extra-axial tumor in the left interpeduncular cistern, extending into the suprasellar and prepontine cisterns. A meningioma was demonstrated with attachment only to the interpeduncular portion of the left oculomotor nerve. The patient was treated successfully by complete removal through a pterional approach.

Brain↗