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Biomedical subjects

K Soma

Publications and source records attributed to K Soma.

At least 55 records · Page 3Linked to original sources

A giant intramural gastric hematoma successfully treated by transcatheter arterial embolization.

We describe a case of intramural gastric hematoma with hemorrhagic shock caused by the formation of a large hematoma. Computed tomographic and angiographic examinations confirmed the presence of active bleeding into the hematoma. Transcatheter arterial embolization (TAE) was performed for hemostasis. To our knowledge, although 21 cases of intramural gastric hematoma have been reported in the literature, this is apparently the first case treated by TAE. We conclude that TAE is a safe and effective treatment option for intramural gastric hematoma confirmed to be associated with active bleeding into the hematoma.

Aged↗

Massive noninflammatory periportal liver necrosis following concentrated acetic acid ingestion.

In a fatal occurrence of massive liver necrosis following ingestion of concentrated (90%) acetic acid, the patient showed evidence of hemolysis, disseminated intravascular coagulation, and liver dysfunction at only 45 minutes after exposure. With refractory to vigorous supportive care, the patient s condition deteriorated until death occurred 39 hours after ingestion, despite some improvement of coagulopathy. Autopsy revealed corrosive injuries in the upper gastrointestinal tract and massive hepatic necrosis in a periportal distribution without significant inflammation. A direct effect of the noxious agent on hepatocytes involving the portal circulation is suggested.

Acetic Acid↗

Myocardial infarction with acute insulin poisoning--a case report.

A 36-year-old woman without overt coronary risk factors was admitted to hospital with coma about 9 hours after mass self-injection of insulin (1,500 units). Laboratory investigation revealed severe hypoglycemia and hyperinsulinemia. During the treatment of her hypoglycemia, circulatory collapse occurred. The ECG, echocardiogram, and elevation in troponin T suggested a diagnosis of myocardial infarction. Although the patient became apallic and developed systemic spasticity due to hypoglycemic brain damage, her hemodynamics improved with supportive care alone. Coronary angiography and myocardial scintigraphy performed later demonstrated a broad area of myocardial damage despite intact coronary artery circulation. The authors hypothesize that temporary coronary arterial narrowing or coronary arterial vasospasm induced by severe hyperinsulinemia contributed to the pathogenesis of the myocardial infarction. The possibility of myocardial infarction should be considered in patients with acute insulin poisoning.

Adult↗

In situ hybridization for matrix metalloproteinase-1 and cathepsin K in rat root-resorbing tissue induced by tooth movement.

The movement of teeth during orthodontic treatment occasionally induces undesirable root resorption. Although high collagenolytic activity has been detected in resorbing tissue of deciduous teeth, the cellular origin of collagenolytic enzymes in root-resorbing tissue caused by tooth movement has not been identified. Here, rats were subject to 7 days of experimental tooth movement to induce root resorption. In situ hybridization with digoxigenin-labelled RNA probes was performed on sections of the maxillary bone to detect the mRNAs that encode matrix metalloproteinase-1 (MMP-1) and cathepsin K in root-resorbing tissue. MMP-1 mRNA was detected in fibroblastic cells, cementoblasts and osteoblasts, but not in odontoclasts nor osteoclasts. Moreover, MMP-1 mRNA was highly expressed in some cementocytes located near odontoclasts and in many osteocytes. In contrast, cathepsin K mRNA was expressed only in odontoclasts and osteoclasts. These results suggest that MMP-1 and cathepsin K are important in root resorption during tooth movement in a mode similar to bone resorption.

Animals↗

Energy-based evaluation of occlusion.

The purpose of this study was to establish an index for evaluating occlusal conditions using energy levels. For this purpose, first, the movement of mastication under five occlusal conditions in which the positional relationship varied mesiodistally was simulated and the energy applied to the food being masticated was calculated, based on theoretical values of computing mechanics using finite element static analysis. As a model experiment, the energy generated under each occlusal condition was then measured using the electrical output from an occlusion pressure sensor composed of pressure-sensitive rubber. By comparing the theoretical values of computing mechanics and the measured values, the changes in the energy level under occlusal conditions were consistent with the trends, and the maximum value of the energy was obtained under the occlusal condition of Angle Class I and consisting of rigid interdigitation. In conclusion, our results demonstrated that occlusal conditions can be evaluated using the energy level as an index.

Bite Force↗

Energy-based re-evaluation of Angle's class I molar relationship.

The energy used to break down food was calculated in Angle Class I and rigid interdigitation, as well as in various malocclusions using a computer simulation. As a result, the energy applied to the food was the highest in Angle's Class I molar relationship and rigid interdigitation, with a simple pattern of masticatory movement. This relationship also tended to produce maximum efficiency in the posterior teeth, including the premolars. Furthermore, energy decreased with the degree of malocclusion. Thus, we were able to provide an alternative definition of Angle's Class I molar relationship and rigid interdigitation. In addition, the extent of malocclusion could be evaluated quantitatively.

Biomechanical Phenomena↗

Effect of charcoal hemoperfusion on clearance of cibenzoline succinate (cifenline) poisoning.

BACKGROUND: Management of cibenzoline succinate (cifenline) poisoning by symptomatic treatment is recommended because it has been reported cibenzoline succinate is not effectively removed by hemodialysis. The use of charcoal hemoperfusion for patients with cibenzoline succinate poisoning has not been reported previously. CASE REPORT: An 80-year-old woman with permanent right ventricular pacing was admitted to our hospital with general fatigue and clouding of consciousness. She had been receiving cibenzoline succinate for 1 month. The patient was clearly in shock on admission. Electrocardiogram showed a prolonged QRS and QTc interval and pacing failure. Hemodynamic failure, electrocardiographic abnormalities including pacing failure, and liver and renal dysfunction were compatible with cibenzoline succinate poisoning. Symptomatic treatment was provided. On day 4, charcoal hemoperfusion was initiated because of the development of hypoglycemia accompanied by liver and renal dysfunction. After charcoal hemoperfusion, the hypoglycemia, liver and renal dysfunction, prolonged QRS and QTc interval, and pacing threshold resolved. She was discharged on digoxin. We present a case of cibenzoline succinate poisoning treated with charcoal hemoperfusion which resulted in a rapid reduction of cibenzoline plasma concentrations with a significant clinical improvement.

Aged↗

Rabbit syndrome following phenol ingestion.

CASE REPORT: An elderly Japanese woman ingested a massive quantity of phenol in a suicide attempt. She was admitted to the Emergency Department in respiratory arrest and deep coma. Duodenogastritis was evident endoscopically. With the return of spontaneous respiration and consciousness, fine, rapid rhythmic perioral movements developed together with Parkinsonian findings. The abnormal movements were aggravated by administration of a neuroleptic and ameliorated by discontinuing the drug; they disappeared completely by hospital day 15. In addition to neuroleptic drugs, phenol intoxication may cause the rabbit syndrome by inducing cholinergic dominance with relative dopamine hypofunction in the central nervous system.

Aged↗

Morphological changes in periodontal mechanoreceptors of mouse maxillary incisors after the experimental induction of anterior crossbite: a light and electron microscopic observation using immunohistochemistry for PGP 9.5.

Ruffini nerve endings (mechanoreceptors) in the periodontal ligament (PDL) of mouse incisors were examined to elucidate whether experimentally-induced crossbites cause any changes or abnormalities in their morphology and distribution. Anterior guiding planes were attached to the mandibular incisors of 3-week-old C3H/HeSlc mice. At 3 days and 1, 2, 4, 6, and 8 weeks post-attachment of the appliance, the mice were sacrificed by perfusion fixation. Frozen sagittal cryostat sections of the decalcified maxillary incisors were processed for immunohistochemistry of protein gene product 9.5, followed by histochemical determination of tartrate-resistant acid phosphatase activity to reveal sites of alveolar bone resorption. Despite the absence of bone resorption within the lingual PDL of control mice, distinct resorption sites were seen in the respective regions of the experimental animals. Unlike the controls, many Ruffini endings showing vague and swollen contours, with unusually long and pedunculated micro-projections were observed in the affected lingual PDL of the incisors in the experimental animals with short-term anterior crossbite induction. Club-shaped nerve terminations with few, if any, micro-projections were observed in the lingual PDL of experimental animals with long-term induction, as well as in aged control mouse incisors. Differences in the distribution of Ruffini endings were also observed. These results indicate that changing the direction of the force applied to the PDL results in rapid and prolonged changes in the morphology of Ruffini-like mechanoreceptors.

Acid Phosphatase↗

Hypokalemia with syncope caused by habitual drinking of oolong tea.

A 61-year-old woman developed hypokalemia, atrioventricular block and ventricular tachycardia with syncope after habitual drinking 2 to 3 liters of oolong tea per day. She had been suffering from rheumatoid arthritis and Sjögren's syndrome and her serum albumin was decreased (2.9 g/dl). Oolong tea contains caffeine at approximately 20 mg/dl. Great quantities of caffeine can induce hypokalemia. The serum protein binding caffeine is albumin. Accordingly, in patients with hypoalbuminemia, caffeine is apt to induce hypokalemia. This case suggested that great quantities of oolong tea, one of the so-called "healthy" drinks, result in serious symptoms for patients with hypoalbuminemia.

Binding Sites↗

An anatomical study of the muscles innervated by the masseteric nerve.

For an accurate assessment of jaw movement, it is critical to understand the comprehensive formation of the masseter. Detailed dissection was performed on fifteen head halves of eight Japanese cadavers in order to obtain precise anatomical information of the course and distribution of the masseteric nerve in the masseter, especially in the zygomaticomandibularis (ZM). Based on detailed innervation investigation, the main trunk of the masseteric nerve ran between ZM and the masseter, and the anterior region of ZM was closely related to the lateral layer of the masseter rather than the medial layer. Considering the positional relationships between the muscles and the innervating branches, it might be proposed that the muscle masses of ZM and the masseter migrate from the posterior side of the temporalis anterolateralward during development. This model is in agreement with the findings in that no nerve branch was observed between the temporalis and ZM.

Cadaver↗

[Adenosine deaminase activity in bronchoalveolar lavage fluid of sarcoidosis patients].

We studied adenosine deaminase (ADA) activity in bronchoalveolar lavage fluid (BALF) specimens from 24 patients with sarcoidosis. Mean BALF-ADA activity was significantly (p < 0.0001) elevated in patients with sarcoidosis (1.02 +/- 1.01 IU/L, mean +/- SD) compared to the subjects in a healthy control group (0.08 +/- 0.29 IU/L). In the sarcoidosis patients with high BALF-ADA activity (> or = 1.0 IU/L), AaDO2 was significantly (p < 0.0001) elevated compared to its level in patients with normal BALF-ADA activity (< 1.0 IU/L). BALF-ADA activity was significantly (p < 0.01) higher in patients who exhibited lung-field accumulations on 67Ga scintigrams compared to those with no accumulations, and significantly (p < 0.001) higher in patients undergoing corticosteroid treatment compared to in those patients who did not receive such treatment. These findings were similar to the results of studies using data on BALF-ADA/albumin ratios. Furthermore, they suggest that the localized production of ADA may increase in sarcoidosis patients displaying 67Ga scintigram lung-field accumulations with increased AaDO2, and that BALF-ADA activity may be a useful indicator of disease activity and the need for treatment.

Adenosine Deaminase↗

A case of serious organophosphate poisoning treated by percutaneus cardiopulmonary support.

We report a case of respiratory arrest, refractory circulatory collapse, and severe hypothermia following ingestion of an organophosphate insecticide. In addition to conventional management, including mechanical ventilation, administration of vasopressors, enteral lavage, charcoal hemoperfusion and administration of antidotes, extracorporeal cardiopulmonary support in the form of percutaneous cardiopulmonary support was successfully employed. Percutaneous cardiopulmonary support may be used for severe but potentially reversible pulmonary or cardiovascular toxicity induced by organophosphates as well as complicated severe hypothermia.

Extracorporeal Circulation↗

Severe rhabdomyolysis following massive ingestion of oolong tea: caffeine intoxication with coexisting hyponatremia.

A 36-y-o patient with schizophrenia, who had consumed gradually increasing quantities of oolong tea that eventually reached 15 L each day, became delirious and was admitted to a psychiatric hospital. After abstinence from oolong tea his delirium resolved. He was transferred to our hospital when he was discovered to have acute renal failure with hyponatremia (118 mEq/L) and severe rhabdomyolysis (creatine phosphokinase, 227,200 IU/L). On admission rhabdomyolysis had begun to improve despite a worsening of the hyponatremia (113 mEq/L). With aggressive supportive therapy, including hypertonic saline administration and hemodialysis, the patient fully recovered without detectable sequelae. The clinical course suggests that caffeine, which is present in oolong tea, was mainly responsible for the rhabdomyolysis as well as the delirium, although severe hyponatremia has been reported to cause rhabdomyolysis on rare occasions. We hypothesize that caffeine toxicity injured the muscle cells, which were fragile due to the potassium depletion induced by the coexisting hyponatremia, to result in unusually severe rhabdomyolysis. The possibility of severe rhabdomyolysis should be considered in a patient with water intoxication due to massive ingestion of caffeine-containing beverages.

Acute Kidney Injury↗

Effects of aging on oxytalan fibre in mouse periodontal ligament.

The reactions of periodontal tissues to the mechanical stimulation of teeth seem to be different in patients of different ages. Although the effects of aging on other structures of the periodontal tissues, i.e., collagen fibre, bone, and cementum, have been reported, there is very little information available concerning the effects of aging on periodontal oxytalan fibre, which is reportedly the only elastic element in the human periodontal ligament. The purpose of this research was to clarify the aging related changes in the distribution of oxytalan fibres in the periodontal ligament of mice. Histological sections of the periodontal ligament of the lower first molar of 10-week-old (control group) and 1-year-old (aged group) ICR mice were specifically stained for oxytalan fibres with aldehyde fuchsin after preoxidization, and observed by light microscopy and confocal laser scanning microscopy (CLSM). In the aged group, oxytalan fibres seemed to be more prevalent around blood vessels in comparison with the control group. Furthermore, CLSM clearly showed that oxytalan fibres in the aged group were relatively more tortuous and complex than those in the control group. This tortuosity and complexity might imply that the oxytalan fibres in aged mice have lost a considerable amount of their original elasticity. While further study of these changes is required, these results may help orthodontists to establish better treatment strategies and methods for adult orthodontic patients.

Adult↗

Innervation analysis of the small muscle bundles attached to the temporalis: truly new muscles or merely derivatives of the temporalis?

Detailed examinations were performed in ten temporal muscles from five cadavers to identify the muscle bundle arrangements of the temporalis and their innervation. Three additional muscle bundles were clearly observed in the main part of the fan-shaped temporalis: the anteromedial, anterolateral, and mid-lateral muscle bundles. Based on the origins, insertions and detailed innervation patterns, these bundles were considered as parts of the temporalis rather than independent muscles, although the anteromedial and anterolateral bundles had been recently reported as newly described muscles. A possible schematic model of the origins of these muscle bundles is proposed. We also report a branch from the posterior deep temporal nerve which was distributed to the temporal fascia and to the skin of the temporal region.

Cadaver↗

Confocal laser scanning-microscopic observations on the three-dimensional distribution of oxytalan fibres in mouse periodontal ligament.

The purpose was to improve confocal laser scanning-microscopic (CLSM) techniques to observe the three-dimensional (3-D) distribution of oxytalan fibres in mouse periodontal ligament and to clarify the 3-D relation between those fibres and blood vessels. As aldehyde fuchsin is a contrast agent and the specific wavelength affects the depth of penetration, CLSM reflectance imaging of oxytalan stained with aldehyde fuchsin after oxidization provides strong contrast. Oxytalan fibres, whose precise roles have not yet been clarified, are connective tissue fibres present in human periodontal ligament in addition to collagen fibres. Despite many studies on their arrangement and biomechanical characteristics, their 3-D distribution in relation to other structures has never been reported. Mandibular first molars of mice were sectioned mesiodistally, pre-oxidized by monopersulphate compound (Oxone), stained with aldehyde fuchsin and examined by CLSM. CLSM images clearly revealed the 3-D distribution, and relation of oxytalan fibres to blood vessels and other structures, as well as their branching patterns in the periodontal ligament. The marked anatomical correlations between the direction, distribution and branching patterns of oxytalan fibres and blood vessels suggest that they interact to perform a specialized physiological role in the periodontal ligament.

Animals↗