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Biomedical subjects

K Kimoto

Publications and source records attributed to K Kimoto.

At least 37 records · Page 2Linked to original sources
PubMed2000

A case of chronic iridocyclitis in young girls. Surgery for complicated cataract and effect of cyclosporin A

Purpose: To report a case of chronic iridocyclitis in young girls and the effect of systemic cyclosporin A for inflammation following surgery for complicated cataract.Case: A 6-year-old girl presented with white uveitis, complicated cataract, and band keratopathy in both eyes. We diagnosed her as having chronic iridocyclitis in young girls. Eight months later, the anterior chamber in the left eye became flat. Ultrasound biomicroscopy showed the presence of cyclitic membrane and adhesion of the ciliary body to the lens capsule. Phacoemulsification with pars plana vitrectomy was used to remove the lens, anterior vitreous, and cyclitic membrane. Severe inflammation and hypotony developed after surgery and persisted after systemic and topical corticosteroids. Systemic cyclosporin A induced rapid resolution of inflammation.Conclusion: Systemic cyclosporin A was useful for postoperative inflammation in this case of uveitis of young girls.

Journal Article↗
PubMed2000

Functional regulation of tactile sense by brain-derived neurotrophic factor in adult rats during acute inflammation.

Nerve growth factor is present in skin in limiting amounts and is known to regulate the plasticity and the sensitivity of nociceptive neurons. Recently, knock-out mouse studies showed that neurotrophin-3 and brain-derived neurotrophic factor are required for the postnatal survival and functional maturation, respectively, of tactile sensory neurons. However, the roles of neurotrophin-3 and brain-derived neurotrophic factor in adult sensory neurons have not been clarified. Here, we report an unexpected and marked acute loss of tactile sense in the rat hind paw after adjuvant-induced inflammation. This loss was shown to be closely correlated with decreases in the expression of brain-derived neurotrophic factor, and to a lesser extent of neurotrophin-3 in the inflamed skin. Administration of brain-derived neurotrophic factor, but not neurotrophin-3, after inflammation accelerated the recovery of tactile sense. These results suggested a role of brain-derived neurotrophic factor in the physiological regulation of tactile sense in adulthood.

Animals↗
PubMed2000

Predictors for the development of haemolytic uraemic syndrome with Escherichia coli O157:H7 infections: with focus on the day of illness.

A large outbreak of Escherichia coli O157 infections via school lunches occurred at primary schools in 1996 in Sakai City, Japan. As many as 10,000 patients suffered from diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome (HUS). Using data on 288 inpatient school children affected by this outbreak, of whom 36 presented complete HUS and the remaining 252 tested positive for E. coli O157 culture, we attempted to identify predictors for the progression to HUS. Within the first 5 days of illness, clinical features associated with inpatients who developed HUS compared with those without HUS included a C reactive protein (CRP) level higher than 1.2 mg/dl (OR 44.26; 95% CI 5.83-336.23), a white blood cell (WBC) count greater than 11.0 x 10(9)/l (OR 5.03; 95% CI 2.13-11.87) and a temperature higher than 38.0 degrees C (OR 5.00; 95% CI 2.25-11.08). It can be concluded that these three factors are predictive factors for the development of HUS in patients with E. coli O157 infection, and patients who have two or all of these factors should be observed closely.

C-Reactive Protein↗
PubMed2000

Asymmetry of masticatory muscle activity during the closing phase of mastication.

The purpose of this study was to investigate the asymmetry of masticatory muscle activity between working and nonworking sides in the closing phase during mastication. Fifty adult subjects displaying normal oral function and occlusion participated in this study. Electromyographic (EMG) activity of the anterior temporalis and the superficial masseter muscle were recorded during mastication, simultaneously with motion data of the mandible. EMG activities of elevator muscles and their Asymmetry Index (AI) were analyzed depending on the vertical deviation of the lower incisal point with a two mm gap from the intercuspal position (ICP). EMG activities of both the anterior temporalis and the masseter on the working side were significantly greater than those on the nonworking side. Masseter muscles tended to show greater AI than the anterior temporalis muscles. Thus, asymmetry of the elevator muscles during mastication was a common finding in normal subjects. The normal range of variability of EMG activity and AI was confirmed in each section.

Adult↗
PubMed2000

[A case of chronic hypertrophic cranial pachymeningitis causing cranial polyneuropathy and unilateral central retinal vein occlusion].

We presented a 70-year-old woman who developed unilateral visual loss due to central retinal vein occlusion caused by chronic hypertrophic cranial pachymeningitis. She had developed right blindness with optic atrophy due to chronic intracranial pachymeningitis one year before admission. In June 1999, she noticed visual loss of the left eye. On admission, neurological examination revealed left visual loss and sensory impairment in the first branch area of bilateral trigeminal nerves. Ophthalmological examination revealed central retinal vein occlusion of the left eye. Brain MRI showed dural thickening with gadolinium enhancement of the cavernous sinus near the left optic nerve and dilatation of the left supraorbital vein. There was no compression of the left optic nerve. We suggest that central retinal vein occlusion may be caused by compression of the supraorbital vein by dural thickening. This is the first case report of central retinal vein occlusion associated with chronic hypertrophic cranial pachymeningitis.

Aged↗
PubMed2000

[Complications with plasma exchange].

The value of plasma exchange in the treatment of Guillain-Barré syndrome is well established, but in Japan patients often receive double-filtration plasmapheresis or immunoadsorption therapy. In this study, we examined the frequency of complications with plasma exchange. The complications occurred in 55 of 197 sessions (28%) during plasma exchange. The most frequent complication was transient symptomatic hypotension (16%). There were fever (10%), nausea or vomiting (7%), chill (5%), headache (5%), tachycardia (2%) and thromboembolism (2%). No significant bleeding was seen in any of the patients. In this study, we clarified that the frequency of the complications tended to increase with the aging.

Adolescent↗
PubMed1999

Vascular remodeling in hypertensive transgenic mice.

We physiologically and histopathologically analyzed vascular damage due to hypertension and vascular remodeling in hypertensive transgenic mice (Tsukuba hypertensive mice; THM). Pubertal (6-week-old) THM already had hypertension similar to blood pressure in adult THM due to an enhanced renin angiotensin system (RAS). They progressively developed remarkable vascular hypertrophy composed of dedifferentiation of vascular smooth muscle cells (VSMCs) and extracellular matrix accumulation in the thoracic aorta, and VSMC hyperplasia was predominant in the abdominal aorta. THM are therefore a useful animal model for studying vascular remodeling mediated by enhanced RAS.

Aldosterone↗
PubMed1999

Effects of angiotensin I-converting enzyme inhibitor from Ashitaba (Angelica keiskei) on blood pressure of spontaneously hypertensive rats.

The inhibitory activity of angiotensin I-converting enzyme (ACE) was extracted with 80% ethanol from the leaves of Ashitaba (Angelica keiskei). The present ACE inhibitor was fractionated and separated with various chromatographies. The antihypertensive effects of the sample (G fraction) from Ashitaba on spontaneously hypertensive rats (SHR) were observed by long-term administration for 10 wk. Another sample (S fraction) from Ashitaba also had antihypertensive effects after a single intravenous administration to SHR. The sample was further purified by using several chromatographies. The ACE inhibitor fraction was characterized as follows: no significant absorbance, a zwitterion, a water-soluble substance and a positive ninhydrin reaction. According to a mass spectrum analysis, the molecular weight of the ACE inhibitor was determined to be 303 and Na-salt ions of carboxyl groups were detected. The ACE inhibitor from Ashitaba contained in the anti-hypertensive fraction was speculated to be very similar to authentic nicotianamine based on a comparative study of inhibitory activity, mass spectrum analysis and thin-layer chromatographies.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1999

[A case of chronic iridocyclitis in young girls--surgery for complicated cataract and effect of cyclosporin A].

PURPOSE: To report a case of chronic iridocyclitis in young girls and the effect of systemic cyclosporin A for inflammation following surgery for complicated cataract. CASE: A 6-year-old girl presented with white uveitis, complicated cataract, and band keratopathy in both eyes. We diagnosed her as having chronic iridocyclitis in young girls. Eight months later, the anterior chamber in the left eye became flat. Ultrasound biomicroscopy (UBM) showed the presence of cyclitic membrane and adhesion of the ciliary body to the lens capsule. Phacoemulsification with pars plana vitrectomy was used to remove the lens, anterior vitreous, and cyclitic membrane. Severe inflammation and hypotony developed after surgery and persisted after systemic and topical corticosteroids. Systemic cyclosporin A induced rapid resolution of inflammation. CONCLUSION: Systemic cyclosporin A was useful for postoperative inflammation in this case of uveitis of young girls.

Cataract Extraction↗
PubMed1999

Effect of early fosfomycin treatment on prevention of hemolytic uremic syndrome accompanying Escherichia coli O157:H7 infection.

OBJECTIVE: To clarify the effect of early fosfomycin treatment, an antimicrobial agent in common use in Japan, on children with E. coli O157 with the aim of preventing hemolytic uremic syndrome (HUS). PATIENTS AND METHODS DESIGN: Non-randomized prospective study for development of HUS among inpatients with E. coli O157. SETTING: The hospitals where the 292 inpatients were treated. CASES: A total of 292 inpatients aged six to eleven years with E. coli O157 infection, 36 (12.3%) of whom were HUS cases. RESULTS: Most of the HUS inpatients (91.7%) developed this complication between the sixth and ninth day of illness. We therefore analyzed the effects of antimicrobial therapy, especially that of fosfomycin, on prevention of HUS within the first five days of illness, because fosfomycin was the most frequently used (88.0%). To clarify the effect of fosfomycin alone on prevention of HUS, we carried out an analysis using the data for 130 inpatients who received fosfomycin alone or did not receive any antimicrobial agents, within the first five days of illness. multivariate analysis, controlled for age, gender and presence of fever, showed that all adjusted odds ratios for the development of HUS with the use of fosfomycin within the first three days of illness were less than 1.0, with the use of fosfomycin on the second day of illness achieving statistical significance (adjusted OR, 0.09; 95% CI, 0.01-0.79). Furthermore, inpatients who took fosfomycin within the first two days of illness developed HUS significantly less often than those who did not (adjusted OR, 0.15; 95% CI, 0.03-0.78). On the other hand, fosfomycin therapy on and after the third day of illness was not associated with the prevention of HUS. CONCLUSION: The early use of fosfomycin within the first two days of illness might prevent the development of HUS.

Anti-Bacterial Agents↗
PubMed1999

Comparison of 1-week and 2-week triple therapy with omeprazole, amoxicillin, and clarithromycin in peptic ulcer patients with Helicobacter pylori infection: results of a randomized controlled trial.

This study was a comparison of 1-week and 2-week triple therapies with omeprazole, amoxicillin, and clarithromycin (OAC) in patients with peptic ulcer disease and Helicobacter pylori infection. A total of 147 peptic ulcer patients with H. pylori infection assessed by histology and culture were randomly treated with omeprazole 20mg bid + amoxicillin 1000mg bid + clarithromycin 400mg bid for either 1 week (OAC1w) or 2 weeks (OAC2w). Both groups then received omeprazole 20mg daily for 2 weeks followed by ranitidine 300mg daily for 4 weeks. Eradication of H. pylori was assessed by histology, culture, and the 13C-urea breath test (13C-UBT) at least 6 weeks after cessation of antimicrobial therapy. Intention-to-treat eradication rates were 78.2% (95%CI 69%-87%) with OAC1w and 88.4% (95%CI 81%-96%) with OAC2w. Per-protocol eradication rates were 86.0% (95%CI 78%-94%) with OAC1w, 97.0% (95%CI 93%-100%) with OAC2w. There was no significant difference in the eradication rates between OAC1w and OAC2w. Side effects were mild and self-limiting in both groups. In conclusion, both 1- and 2-week triple therapy with OAC are well tolerated and provide good eradication rates in peptic ulcer patients in Japan. The eradication rate of the 2-week regimen was higher than that of the 1-week regimen, but the difference was not statistically significant. Further studies including long-term economic considerations are required to determine the optimal duration of treatment.

Adolescent↗
PubMed1998

Salt-sensitive aortic aneurysm and rupture in hypertensive transgenic mice that overproduce angiotensin II.

We studied the effect of excessive salt intake on vascular lesion development in hypertensive transgenic mice that overproduce angiotensin II, ie, Tsukuba hypertensive mice (THM). At 6 weeks of age, THM and C57BL/6J (controls) were given either 1% sodium chloride ("salt-loaded") drinking water or tap water for 30 days. Salt-loaded THM, but not controls, suffered frequent thoracic or abdominal cavity hemorrhage. THM mortality after 7 days of salt loading was 23%; after 30 days of salt loading, it rose to 67%. Hemorrhaging occurred due to the development of aortic aneurysm and rupture at the aortic arch and aorta near the renal arteries. Vascular lesions progressed with structural degeneration of the aortic media. Electronmicroscopic analysis revealed that intact THM already exhibited vascular remodeling consisting of vascular smooth muscle cells (VSMCs) with developed organelles and an increased extracellular matrix. Salt-loaded THM suffered aggravated vascular hypertrophy and vascular structure destruction by plasma material invasion, necrosis of VSMCs possessing extremely swollen cytoplasm and abundant organelles, and interlamellar bleeding, resulting in aortic aneurysm and eventual rupture. Interestingly, blood pressure levels and heart rates in salt-loaded THM did not differ significantly from those of controls; plasma renin activity between drinking regimens was also comparable between the two groups. Drinking volume and the concentration of atrial natriuretic peptide (ANP) in plasma, however, were significantly higher in salt-loaded THM than in intact THM. In addition to aneurysm localization, the findings regarding drinking volume and plasma ANP suggest that aortic aneurysm and rupture in salt-loaded THM occurred as the result of an unknown mechanical stress, other than blood pressure, on the aortic wall. High salt ingestion is involved in the development of thoracic and abdominal aortic aneurysm in the presence of hypertension in the activated renin-angiotensin system. THM should therefore serve as a useful animal model for studying the pathogenesis of aortic aneurysm accompanied by hypertension.

Angiotensin II↗
PubMed1998

[A sibling of delayed post-anoxic encephalopathy after strangulation].

A sibling of three year old girl and a year old boy, showed delayed post-anoxic encephlopathy after strangulation. After three days of the accident, the girl developed tetraplegia and choreo-athetosis. Her brother also developed choreo-athetosis two weeks after strangulation. T2 weighted MRI revealed a high signal intensity in the bilateral putamen and caudate nucleus. After hyperbaric oxygen therapy for two months, their symptoms diminished. We hypothesize that the functional damage of the neurons occurred in the bilateral basal ganglia as delayed neuronal death because of their vulnerability and peculiarity of the local circulation. Hyperbaric oxygen therapy may be effective in rescuing the neurons from hypoxia.

Asphyxia↗
PubMed1997

Amyotrophic lateral sclerosis with anti-acetylcholine receptor antibody.

We report a case of amyotrophic lateral sclerosis (ALS) with anti-acetylcholine receptor (AChR) antibody in a 73-year-old female patient. She showed the typical course of ALS. She had no clinical findings of myasthenia gravis and had never undergone neurotoxin therapy using snake venom. Anti-AChR antibody was positive with a titer of 0.50 nmol/l on admission. We traced the titers during the progression of ALS; the titer was positive when muscle weakness worsened, and it became negative when the general condition became stable. We suppose that the occurrence of anti-AChR antibody may be partially relevant with abnormalities at the neuromuscular junction during the progression of ALS.

Aged↗
PubMed1997

[Correlates and prognosis in relation to intellectual dysfunction in a community-residing elderly population].

To estimate the risk factors for intellectual dysfunction and examine its prognosis in a community-residing (non-institutionalized) elderly population, a randomly selected sample of 1,473 elderly people aged 65 years and over living in S city, Osaka Prefecture, was studied in October 1992, and data were obtained from 1,383, a response rate of 93.9%. A cohort of 1,383 was followed for 42 months and follow-up was completed for 1,300 (94.0%). The main results were as follows: 1) The prevalence of intellectual dysfunction did not differ significantly between sexes, and there was an increasing prevalence of intellectual dysfunction with age in both sexes. The prevalence of severe intellectual dysfunction was found to increase highly at age 85 and over. 2) By univariate analysis, odds ratios for age older than 75 years, low Activities of Daily Living (ADL), urinary and fecal incontinence, and no participation in social activities were significantly higher than 1 in any level of mild, moderate, and severe intellectual dysfunction. In the multivariate analysis using logistic regression, age older than 75 years and urinary and fecal incontinence showed significant higher odds ratios than 1 for severe intellectual dysfunction, and low ADL and treatment for hypertension also showed significant higher odds ratios than 1 for moderate intellectual dysfunction. 3) From analysis using the Kaplan-Meier method, the cumulative survival rates decreased with a decline in intellectual functioning in both age groups of 65-74 and 75 years and older. 4) Application of the Cox proportional hazards model resulted in adjusted hazard ratio for severe intellectual dysfunction of 1.79 (95% confidence interval, 1.02-3.12), controlling for other factors such as sex, age, general health status, incontinence and social activities.

Activities of Daily Living↗
PubMed1996

Tuberculous spondylitis (Pott's disease) with bilateral pleural effusion.

We report a case of tuberculous spondylitis (Pott's disease) with bilateral pleural effusion in a 25-year-old male patient. Left-pleural effusion was observed on admission. The initial diagnosis was tuberculous pleuritis. However, during anti-tuberculosis chemotherapy, back pain and right-pleural effusion appeared. by further examination, we diagnosed an active tuberculous spondylitis of the 11th and 12th thoracic vertebrae possibly by the dissemination of Mycobacterium tuberculosis through blood circulation or lymphatic circulation. In cases in which anti-tuberculosis chemotherapy is not so effective, the possibility of the rarely-appearing extra-pulmonary manifestation of tuberculous spondylitis must be considered.

Adult↗