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Biomedical subjects

K Kurisu

Publications and source records attributed to K Kurisu.

At least 127 records · Page 7Linked to original sources

Fluid-attenuated inversion recovery (FLAIR) in a patient with parasagittal white matter shearing injury.

We present a 32-year-old woman with a parasagittal white matter shearing injury of the left frontal lobe following a motor vehicle collision. There was monoplegia of the right lower extremity. Computed tomography failed to demonstrate the lesion which was visible on magnetic resonance images. In particular, fluid-attenuated inversion recovery images were useful to depict the shearing injury, since sulci were of low intensity on those images.

Adult↗

Evaluation of cerebral hemodynamics in a head-injured patient with hypovolemia using transcranial Doppler sonography.

A 20-year-old man presented with hypovolemic shock caused by abdominal injury. Cerebral hemodynamics were evaluated by transcranial Doppler (TCD) sonography. Middle cerebral artery flow velocities decreased, and the pulsatility indices increased markedly. Particularly, the waveform of the left middle cerebral artery showed a systolic peak, suggesting an increased intracranial pressure. Actual intracranial pressure was 7 mm Hg, and the cerebral perfusion pressure (CPP) was 51 mm Hg. These abnormal Doppler signals seemed to be caused by a compromise in CPP and to be aggravated by hypovolemia. The patient was discharged with a residual mild memory disturbance. Hypovolemia aggravates a reduced cerebral blood flow caused by a compromised CPP, and the waveform of TCD in a case of hypovolemic shock should be differentiated from intracranial hypertension.

Accidents, Traffic↗

Expression of epithelial cadherin and cavernous sinus invasion in human pituitary adenomas.

Pituitary adenomas generally are regarded as benign tumors, although some invade the cavernous sinus and recur. We examined the epithelial cadherin (E-CD) expression in 30 pituitary adenomas (6 with cavernous sinus invasion and 24 without). Immunoreactivity of E-CD were found in all pituitary adenomas but they were very various. The presence of an association between E-CD expression and cavernous sinus invasion was assessed. There were no significant differences in E-CD expression between invasive and noninvasive adenomas. These results suggest that E-CD expression is not associated with cavernous sinus invasion in pituitary adenomas.

Adenoma↗

Delayed hyperemia causing intracranial hypertension after cardiopulmonary resuscitation.

OBJECTIVE: To clarify whether early or delayed failure of cerebral perfusion after cardiopulmonary resuscitation (CPR) occurs in humans and contributes to secondary brain damage. DESIGN: Prospective, repeated-measures study. SETTING: Intensive care unit of Hiroshima University School of Medicine. PATIENTS: Eight comatose patients who had undergone successful resuscitation from cardiac arrest. INTERVENTIONS: All patients underwent transcranial Doppler sonography examination. The intracranial cerebral pressure (ICP) and jugular venous oxygen saturation (SO2) also were continuously monitored in five patients and three patients, respectively. MEASUREMENTS AND MAIN RESULTS: In each patient, we measured the mean flow velocity of the middle cerebral artery transcranially and the mean flow velocity of the internal carotid artery, high in the neck, using transcranial Doppler sonography. The pulsatility index for each measurement was also calculated. The first examinations were performed within 4 to 12 hrs of CPR, and repeat examinations were performed approximately every 12 hrs. The initial mean flow velocities of the middle cerebral artery and the initial mean flow velocities of the internal carotid artery were relatively low, with relatively high pulsatility indices. The mean flow velocities of the middle cerebral artery began to increase at 12 to 24 hrs after CPR and peaked 24 to 120 hrs after CPR. A simultaneous increase in mean flow velocities of the internal carotid artery was observed during this period. The pulsatility index in both arteries dropped significantly during peak mean flow velocity of the middle cerebral artery. In six of seven patients with an abnormal increase (> 100 cm/ sec) in peak mean flow velocity of the middle cerebral artery, the ratio of mean flow velocity of the middle cerebral artery to mean flow velocity of the internal carotid artery was < 3. This value tended to be lower in patients with poor outcomes. An increased mean flow velocity of the middle cerebral artery, with a ratio of < 3 for mean flow velocity of the middle cerebral artery to mean flow velocity of the internal carotid artery, was defined as hyperemia. Although the mean flow velocity of the internal carotid artery was not measured, another patient with an abnormal increase in mean flow velocity of the middle cerebral artery revealed a high jugular venous SO2 value of 83.5%, also representing hyperemia. All ICP values were within the normal range 4 to 12 hrs after CPR and tended to increase before peak mean flow velocity of the middle cerebral artery. The two patients with the lowest ratios of mean flow velocity of the middle cerebral artery to mean flow velocity of the internal carotid artery showed significant increases in ICP after the peak mean flow velocity of the middle cerebral artery. These two patients subsequently developed brain death. CONCLUSIONS: Delayed hyperemia occurs in humans after resuscitation from cardiac arrest. Our data suggest that this delayed hyperemia can lead to intracranial hypertension and occasionally acute brain swelling, contributing to a poor outcome. A high mean flow velocity of the middle cerebral artery with a low ratio of mean flow velocity of the middle cerebral artery to mean flow velocity of the internal carotid artery may be predictive of critical hyperemia. As an indirect method of measuring cerebral blood flow transcranial Doppler sonography can be used to adjust treatment for failure of cerebral perfusion after resuscitation.

Blood Flow Velocity↗

Usefulness of color Doppler sonography in a growing skull fracture: case report.

A case of an 11-month-old infant with a growing skull fracture is described. The patient was admitted with disturbance of consciousness and left hemiparesis after a severe head injury. A pulsating protrusion appeared over the fracture line 1 month later. Color Doppler sonography revealed cerebral herniation and cystic lesion via the bony defect, together with an intracranial arterial flow pattern detected in the extracranial space. Color Doppler sonography was very useful in the diagnosis of growing skull fracture and in the evaluation of the intracranial state, including hemodynamics in this case. Successful surgical treatment was performed on the basis of sonographic data and the patient was discharged 3 months later without motor deficits.

Female↗

Cerebral fat embolism studied by magnetic resonance imaging, transcranial Doppler sonography, and single photon emission computed tomography: case report.

Cerebral fat embolism syndrome is an uncommon complication of trauma. We present a patient who developed cerebral fat embolism syndrome secondary to long-bone fractures. Although computed tomography of the brain failed to show any intracranial lesion, magnetic resonance imaging (MRI) detected scattered, high-signal-intensity lesions on T2-weighted images. 99mTc-d, 1-hexamethyl-propylene amine oxine single photon emission computed tomography (99mTc-HMPAO SPECT) and transcranial Doppler sonography (TCD) demonstrated low cerebral blood flow in the acute stage. MRI, 99mTc-HMPAO SPECT, and TCD correlated well with the clinical course of cerebral fat embolism syndrome.

Adult↗

Human genes for dental anomalies.

The development of the tooth at gene level is beginning to be understood. This paper reviews current knowledge and the advances in research on human genes whose defect leads to dental anomalies. Amelogenesis imperfecta (AI) is a diverse group of hereditary disorders characterized by a variety of developmental enamel defects including hypoplasia and hypomineralization, some of which have been revealed to be associated with defective amelogenin genes. The human amelogenin genes on X and Y chromosomes have been cloned and investigated extensively. Although autosomally inherited forms of AI are more common than the X-linked forms, most studies on the genes causing AI have been performed on the genes of X-linked forms. Recently, the gene for the human tuftelin protein (an enamelin) has been cloned as a candidate gene for the autosomal forms of AI with another gene on chromosome 4 involved in some families. Dentinogenesis imperfecta (DI) may be associated with osteogenesis imperfecta (OI), which is an autosomal dominant bone disease. Most patients with OI have mutations in either the COLIA1 or COLIA2 genes, which encode the alpha 1(I) or alpha 2(I) subunits of type I collagen, the major organic component of bone and dentin. Gene defects causing isolated DI have not been identified. Recently, it was demonstrated that a missense mutation of MSXI, a human homeobox gene, causes autosomal dominant agenesis of second premolars and third molars. Data indicating an important function for MSXI, the mouse counterpart of the human MSXI gene, in mouse tooth development have been accumulating since 1991. Knockout mice lacking this gene exhibited multiple craniofacial anomalies including complete tooth agenesis. X-linked anhidrotic ectodermal dysplasia (EDA), characterized by abnormal hair, teeth, and sweat glands, was demonstrated to be caused by a mutation in a novel transmembrane protein gene that is expressed in epithelial cells and in other adult and fetal tissues. The predicted EDA protein may belong to a novel class of proteins with a role in epithelial-mesenchymal signaling. Several mutations have been reported in genes causing hypophosphatasia, which is characterized by defective mineralization of the skeletal and dental structures.

Adult↗

Antiepileptic effects of 20-hydroxyecdysone on convulsive seizures in spontaneously epileptic rats.

We examined the effect of 20-hydroxyecdysone (20-HE), a neurosteroid found in insects that is involved in their developmental process, on both tonic convulsion and absence-like seizure in spontaneously epileptic rat (SER). When 20-HE was given orally to SER at 25-200 mg/kg, significant decreases of the tonic convulsion were observed with 100 and 200 mg/kg. Pretreatment of the animal with bicuculline (1 mg/kg, i.p.) antagonized the inhibitory effects of 20-HE. However, absence-like seizures were not affected by 20-HE. These findings indicate that 20-HE produces antiepileptic effects on tonic convulsion by acting on the modulatory site of GABA(A) receptors.

Administration, Oral↗

Involvement of alpha5beta1 integrin in matrix interactions and proliferation of chondrocytes.

Integrins are cell surface receptors involved in cellular processes including adhesion, migration, and matrix assembly. In the present study, we analyzed the possible involvement of alpha 5 beta 1 integrin in the regulation of chondrocyte adhesion, spreading, and proliferation. We found that rabbit growth plate chondrocytes were able to attach to substrates coated with type I collagen, type II collagen, or fibronectin within 24 h of culture. During this time period, attachment to fibronectin appeared to be dependent on alpha 5 beta 1 integrin, whereas adhesion to collagens was not. By day 3 of culture, chondrocytes spread onto all the substrates tested. We found that regardless of the nature of the substrate, cell spreading was reversed by treatment with RGD peptide or antibodies against alpha 5 beta 1 or fibronectin, indicating that cell spreading involved alpha 5 beta 1 and fibronectin endogenously produced and deposited by the chondrocytes themselves. Colony formation by chondrocytes in soft agar was inhibited by treatment with RGD peptides or BIIG2, an antibody that interferes with alpha 5 beta 1 integrin-ligand interactions. Furthermore, DNA content was decreased by treatment with anti-fibronectin antibody in micromass culture of chondrocytes. Immunohistochemical analysis on tissue sections revealed that the alpha 5 subunit was particularly abundant in the proliferative and hypertrophic zones of growth plate. The results of the study indicate that alpha 5 beta 1 integrin plays multiple roles in chondrocyte behavior and function and appears to be involved in the regulation of both chondrocyte-matrix interactions and proliferation.

Animals↗

Immunohistochemical localization of connexin43 in the enamel organ of the rat upper incisor during ameloblast development.

We examined the localization of connexin (Cx)43 in the enamel organ during ameloblast development. The specificity of monoclonal anti-Cx43 antibody was elucidated by immunoblot analysis and immunoelectron microscopy. Gold particles for Cx43 were detected by immunoelectron microscopy on gap junctions but not on other structures such as desmosomes. Punctate and intense immunofluorescence for Cx43 was detected in all cell types of the enamel organ. Cx43 expression in ameloblasts showed a transient decrease and then increase during ameloblast development. Double staining of Cx43 and amelogenin, one of the enamel proteins, revealed that immunofluorescence for Cx43 markedly decreased in some late presecretory ameloblasts just prior to enamel formation. Moreover, the localization of Cx43 changed during enamel formation. Cx43 was distributed randomly on the lateral plasma membranes of presecretory ameloblasts, but tended to gather on those corresponding to the supranuclear regions of secretory ameloblasts. Immunofluorescence for Cx43 in maturation ameloblasts appeared linear rather than punctate. These results suggest that Cx43 in the late presecretory ameloblasts is degraded just before enamel formation and then newly synthesized Cx43 is redistributed during the secretory stage. These changes in Cx43 expression may be related to the cellular differentiation of ameloblasts.

Ameloblasts↗

[A novel epilepsy animal model (NER)].

A mutant showing convulsive seizures spontaneously in a CJ: Wistar colony was named the Noda epileptic rat (NER). The NER exhibits tonic-clonic convulsion without any external stimuli once every 30 h. However, we succeeded in inducing similar convulsive seizures by applying priming sound stimuli (95 dB, 8 kHz, 30 sec) from 3 weeks of age in all 24 NER examined. When the effects of clinically available antiepileptics were tested on the seizures of such primed NER, the most potent agents were carbamazepine, diazepam, valproate, phenobarbital and trimethadione, while phenytoin and zonisamide showed lower potency. Furthermore, ethosuximide was not effective in inhibiting the seizures. In hippocampal slices of NER with convulsive seizures, repetitive firing accompanied by long-lasting depolarization was observed when a single stimulation was delivered to the mossy fibers in the CA3 pyramidal cell. This depolarization shift was completely blocked with a Ca2+ antagonist (nicardipine 10 nM). The long-lasting hyperpolarization that followed the repetitive firing was also observed with mossy fiber stimulation in the hippocampal CA3 pyramidal cells of the NER. These findings suggest that Ca2+ channel abnormality of the hippocampal CA3 pyramidal cells may be involved in the convulsive seizures.

Animals↗

[A case of cerebral arteriovenous malformation with accidental migration of a microcatheter during endovascular procedure].

This is a report of a case of cerebral arteriovenous malformation with accidental breakaway of a microcatheter during endovascular embolization. A 25-year-old female suddenly suffered severe headache. CT scan demonstrated intraventricular hemorrhage, and the angiogram revealed right parieto-occipital AVM. We performed endovascular embolization using a flow-directed microcatheter (1.5F BALT MAGIC catheter) 2 weeks after onset, and the microcatheter broke accidentally and a fragment of the soft tip migrated to the distal posterior cerebral artery during the procedure. Although we tried to retrieve the catheter using several retrieval devices, we failed. Two days after the procedure we undertook surgical treatment. The migrated catheter was recognized in a small feeding artery which was stretched tightly, so retrieval was very risky. Using hemoclips for trapping the part of the catheter which remained in the feeder, we were able to retrieve it by cutting the feeder. Flow-directed microcatheters are very usefull in endovascular procedures, but it is necessary to handle them carefully in accord with sufficient knowledge of their use and handling methods.

Adult↗

[Cyclosporine as drug resistance modifiers; mechanism and clinical investigation].

Multidrug resistance(MDR), mediated by P-glycoprotein, is a well-understood mechanism of resistance to anticancer drugs. P-glycoprotein is thought to act as an efflux pump with broad specificity for variety of anticancer drugs. Cyclosporine and its analogue, SDZ PSC 833, have demonstrated ability to inhibit P-glycoprotein mediated transport function, restore accumulation defects for anticancer drugs, and reverse resistance in vitro and in vivo. The clinical trials of these drugs are on going. P-glycoprotein may also play a pivotal role in the evolution of pharmacological defence mechanisms, protecting organisms from cytotoxic agents. Approach to overcome resistance may result in serious challenges to the host's natural defenses. Clinical trials of MDR modulators, such as cyclosporine or SDZ PSC 833, should be designed with caution and with careful consideration for potential pharmacokinetic and pharmacodynamic interaction.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

[A case report of one-stage repair for transposition of the great arteries with intact ventricular septum and coarctation of the aorta in neonate].

We report a neonatal case of one-stage repair for transposition of the great arteries with intact ventricular septum (TGA with IVS) and coarctation of the aorta (CoA). The surgery was performed at 27 days of age when the patient, a male, weighed 3408 g. Preoperative cardiac catheterization and angiography confirmed the diagnosis of TGA with IVS, CoA, atrial septal defect, patent ductus arteriosus, persistent left superior vena cava, left sided juxta-positioning of appendages and dextrocardia. The procedure was simultaneous subclavian flap aortoplasty through a left thoracotomy and an arterial switch operation through a median sternotomy. The patient's postoperative course was uneventful and he has grown well. Postoperative cardiac catheterization revealed mild pulmonary stenosis (pressure gradient of 19 mmHg between the right ventricle and the pulmonary artery) and mild aortic arch kinking from the arterial switch maneuver. One-stage repair, the combination of subclavian flap aortoplasty and arterial switch operation, provides a good clinical result in this complex malformation.

Abnormalities, Multiple↗

The effects of peripheral nerve injury of the masseteric nerve on the levels of calcium binding proteins and neuropeptide Y, and their correlation in the mesencephalic trigeminal nucleus of the rat.

Combined retrograde neuronal tracing with FluoroGold (FG) and a double immunofluorescence method was performed to examine the effects of peripheral nerve injury of the masseteric nerve (MassN) on the levels of two calcium binding proteins (CaBPs), parvalbumin (PV) and calbindin D28k (CB), and neuropeptide Y (NPY) in the mesencephalic trigeminal nucleus (MesV) in the rat. In the normal MesV, many medium- to large-sized unipolar PV-like immunoreactive (-IR) cells were detected through the entire rostrocaudal extent, but CB-IR cells were rarely observed. No NPY-IR cells were observed in the normal MesV. The distributions of these three neurochemical markers in the MesV contralateral to the transection of Mass were almost identical to those observed in the normal MesV. Four days following transection and application of FG to the MassN, approximately 52% (572/1104) and 38% (414/1104) of FG-labeled cells (FG cells) in the MesV displayed PV-like immunoreactivity (-LI) and NPY-LI, respectively; Approximately 24% (265/1104) of FG cells showed both PV-LI and NPY-LI. Approximately 47% (265/572) of FG cells with PV-LI showed NPY-LI or 64% (265/414) of FG cells with NPY-LI displayed PV-LI. Fourteen days following transection and application of FG, the percentage of FG cells with PV-LI significantly decreased to 36% (365/1024) compared to that observed 4 days post-injury; approximately 44% (448/1024) of FG cells displayed NPY-LI; approximately 38% (141/365) of FG cells with PV-LI showed NPY-LI and approximately 31% (141/448) of FG cells with NPY-LI displayed PV-LI. In contrast, FG cells showing CB-LI were very rare on 4 days (1%; 15/1182) or 14 days (1%; 16/1085) following MassN transection. The present results indicate that the levels of PV in the MesV decreased 14 days following the MassN injury compared to those observed 4 days post-injury and rapid induction of NPY in the injured MesV neurons, and that the correlation between CaBP and NPY in the MesV following the MassN transection is different from that observed in the trigeminal ganglion, which is equivalent to the MesV, following peripheral nerve injury of the inferior alveolar nerve.

Animals↗

Calbindin D28k-like immunoreactivity in the gustatory epithelium in the rat.

The distribution of calbindin D28k (CB)-like immunoreactivity (-LI) in the gustatory epithelium was examined in the adult rat. In the circumvallate and foliate papillae, CB-like immunoreactive (-IR) nerve fibers were observed in the subgemmal region, and some of these penetrated the taste buds. Two or three spindle-shaped gustatory cells displayed CB-LI in each taste bud of these lingual papillae; the immunoreactivity was restricted to the cytoplasm. In the fungiform papilla, CB-IR nerve fibers were detected in the subgemmal region, but no CB-IR cells were observed in the taste buds of the fungiform papillae. In the taste buds of the incisive papillae, many CB-IR intragemmal nerve fibers were observed, but no apparent CB-IR cells were detected. In the soft palate, CB-IR nerve fibers associated with the taste buds were also observed, but no CB-IR cells were detected in the taste buds. The present findings indicate that CB-IR gustatory cells were only localized in the taste buds in the posterior lingual papillae (circumvallate and foliate papillae), but not in the taste buds in other gustatory epithelium.

Animals↗

Immunoelectron microscopic study on neuropeptide Y in the periodontal ligament of the incisor following peripheral nerve injury to the inferior alveolar nerve in the rat.

Immunoelectron microscopic analysis was carried out to examine whether neuropeptide Y (NPY)-like immunoreactivity (-LI) is localized in mechanoreceptors in the lingual periodontal ligament of the rat incisor following peripheral nerve injury to the inferior alveolar nerve (IAN). In the lingual periodontal ligament of normal animals, no NPY-like immunoreactive (-IR) primary afferents were observed, except for a very few sympathetic perivascular nerve fibers which showed NPY-LI. Fourteen days following chronic constriction injury to the IAN combined with sympathectomy of the superior cervical ganglion, thick NPY-IR nerve fibers showing tree-like raminifications were detected in the shear zone between the tooth-related part and alveolus-related part as well as in the alveolus-related part. Immunoelectron microscopy revealed that expanded NPY-IR nerve terminals were covered with several Schwann sheaths and that a part of the axoplasm expanded to the surrounding tissues. These ultrastructural features of NPY-IR structures were identical to those of periodontal Ruffini endings, categorized as slowly adapting mechanoreceptors. Thick (6-8 microns in diameter) NPY-IR axons were also observed without any apparent myelin sheath. The present results provide further evidence that NPY is closely associated with thick axons, probably myelinated nerves and Ruffini endings, following peripheral nerve injury.

Animals↗

Neuropeptide Y-like immunoreactive primary afferents in the periodontal tissues following dental injury in the rat.

The distribution of neuropeptide Y (NPY)-like immunoreactive (-IR) nerve fibers in the periodontal tissues following dental injury to the rat maxillary first molar was examined with a combination of dental injury and surgical sympathectomy of the superior cervical ganglion (SCGx). In normal animals, NPY-IR nerve fibers were observed around the blood vessels of the trigeminal ganglion, dental pulp and periodontal tissues. These nerve fibers completely disappeared following SCGx. Fourteen days following dental injury of the maxillary first molar combined with SCGx, a small number NPY-IR cells was observed in the dorsal to middle portion of the maxillary division of the trigeminal ganglion. These were mostly medium- to large-sized cells with a mean +/- SD cross-sectional area of 541.4 +/- 239.3 microns 2. Approx. 50% of these cells had the cross-sectional areas between 400-600 micron 2. In the periodontal tissues of injured first molar, thick NPY-IR nerve fibers showing an irregular appearance were detected in the apical region. Immunoelectron microscopy showed that most NPY-IR nerve fibers near the lower half of the injured periodontal ligament had an axonal diameter of approx. 7-8 microns, and lacked apparent myelin sheaths. Near NPY-IR nerve fibers, many macrophages with phagosomes containing debris of the myelin sheaths were observed. At the oral epithelium covering the injured roots of the maxillary first molar, thick NPY-IR nerve fibers were recognizable and some penetrated the epithelium. No NPY-IR nerve fibers were observed in the dental pulp or periodontal tissues in second and third molars, and ultrastructural views of nerve fibers were almost intact following combined SCGx and dental injury to the first molar. The present results indicate that NPY-IR primary afferents appeared in the periodontal tissues following dental injury, and that NPY may be closely associated with the regeneration process of injured primary afferents.

Animals↗