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Biomedical subjects

M Ikeda

Publications and source records attributed to M Ikeda.

At least 379 records · Page 21Linked to original sources
PubMed2000

[Toxoplasma pericarditis without immunosuppressant disorder detected by polymerase chain reaction of pericardial fluid: a case report].

There have been several case reports, a total of 22 up to the present, of toxoplasma pericarditis. Out of them, in only a few cases the diagnosis was properly made with a proof of the microscopic presence of Toxoplasma gondii. This is the first report of toxoplasma pericarditis in which the presence of Toxoplasma gondii was detected by polymerase chain reaction of pericardial effusion. In addition, the previous reports will be reviewed, and compared to this present case. A 29-year-old woman, without immunosuppressant disorder, suffering from fever and orthopnea was admitted to our hospital. Blood chemistry findings indicated mild liver dysfunction and inflammation. Chest radiography showed cardiac enlargement. Electrocardiography showed sinus tachycardia and ST elevation. Echocardiography revealed a massive pericardial effusion. Pericardiocentesis demonstrated 638 ml of bloody fluid. Cytologic study of the fluid was class II for malignancy, and polymerase chain reaction to tuberculosis was negative. However, a high titer of the anti-toxoplasma antibody of 1: 20,480 (passive hemagglutination) indicated pericarditis caused by Toxoplasma gondii. Subsequently, Toxoplasma gondii was identified in the pericardial effusion by polymerase chain reaction. Clinical symptoms improved after pericardiocentesis, but 2 months later pericarditis recurred. Treatment was started with 800 mg acetylspiramycin daily but failed to improve the symptoms. Because of the development of pleuritis, treatment was changed to sulfadoxine 1,000 mg/pyrimethamine 50 mg. After the treatment with them, her symptoms improved. Only 22 cases of toxoplasma pericarditis have been reported worldwide and 15 of those cases were without immunosuppressant disorder. The usual symptoms at the onset of pericarditis without immunosuppressant disorder are fever, dyspnea and chest pain. Seven patients developed cardiac tamponade. Pericardiocentesis was performed in 8 cases and the pericardial fluid was hemorrhagic in 6. Pericardial thickening was detected in 5 cases. The diagnosis of toxoplasma infection is very difficult, because asymptomatic infection of Toxoplasma gondii is very common. Pericarditis is a disease difficult to confirm the etiology. Detection of Toxoplasma gondii in pericardial effusion by the polymerase chain reaction is very useful for its diagnosis.

Adult↗
PubMed2000

[Usefulness of selective cerebral angiography by transradial approach].

Transradial angiography has recently emerged as an alternative to the transfemoral or transbrachial approach, especially for coronary procedures. However, there have been few studies on cerebral angiography using the transradial approach. The purpose of this study was to assess the outcomes, complications, and limitations of selective cerebral angiography via the transradial approach. Selective cerebral angiography by the right transradial approach using 100-cm-long 4-F catheters was performed in 83 patients. Using five types of catheters, the success rates of selective catheterization to the right vertebral artery, right common carotid artery, left common carotid artery, and left vertebral artery were 40/44 (91%), 68/68 (100%), 62/62 (100%), and 14/25 (56%), respectively. Puncture failed in one patient, and a guidewire could not be introduced beyond the radial artery loop in one patient. Radial artery spasm occurred in one patient, but was relieved immediately after nitroglycerin injection through the sheath with side holes. Subcutaneous bleeding occurred in six patients, but no obvious hematomas were noted. Occlusion or stenosis of the radial artery occurred in five patients, but no ischemic symptoms were observed in any of the cases. This study suggested that selective cerebral angiography can be performed safely using the transradial approach.

Adolescent↗
PubMed2000

[Differential effects of ketamine enantiomers on anesthetic levels and glutamate release in the hippocampus].

The anesthetic effects of ketamine enantiomers (40 and 100 mg.kg-1, i.p.) were evaluated in the rat by behavioral parameters such as the orienting response, the tail-pinch test and the spontaneous motor behavior including stereotyped behavior (circling and nodding). The intercellular glutamate concentration in the dorsal hippocampus was measured by brain microdialysis method. The analgesic and sedative effects of the S(+)-ketamine were more potent than those of the R(-)-ketamine at each dose. The incidence of stereotyped behaviors in R(-)-ketamine groups was higher than that of S(+)-ketamine groups. The basal release of glutamate under perfusion with normal artificial cerebrospinal fluid (ACSF) was unchanged after the administration of these enantiomers. Repeat perfusion with high-potassium ACSF (100 mM K+) for 20 min increased the glutamate content in vehicle-treated rats. This depolarization-related glutamate release was suppressed by ketamine, except in the 100 mg R(-)-ketamine group in which the stimulated glutamate release tended to increase after the treatment. The inhibitory effect on this stimulated glutamate release was marked in S(+)-ketamine groups. These results suggest that the anesthetic effects of ketamine enantiomers may be mediated at least in part, via regulation of depolarization-released glutamate release.

Analgesics↗
PubMed2000

[Effect of radiotherapy for inoperable remnant and recurrent gastric cancer--focusing of improvement in quality of life].

We investigated six cases of inoperable remnant and recurrent gastric cancer treated with radiotherapy with regard to quality of life (QOL). The radiation dose was from 22 to 70 Gy, with a mean dose of 46 +/- 18 Gy. Four cases could be evaluated. Two were PR and two were NC. No patients could ingest food before radiotherapy, but two became able to eat whole gruel, one half gruel and three water. The mean survival time was 5.5 months and prognosis was not improved. Subjective symptoms such as food passage disturbance were decreased by radiotherapy and QOL was improved. Radiotherapy for patients with inoperable gastric cancer seemed to be effective in improving QOL.

Aged↗
PubMed2000

[Neuropsychology of frontal type dementia].

The clinical conceptual change in frontal type dementia is reviewed in discussing its relationships to several related concepts such as Pick's disease, frontotemporal dementia (FTD), semantic dementia (SD) and frontotemporal lobar degeneration. We analyzed frontal type dementia selected from a consecutive series of our outpatients as to the details of neuropsychological symptoms, psychiatric symptoms, and abnormal behaviors. In our series of 143 patients with primary degenerative dementia, there were 16 cases of FTD and 6 cases of SD. Patients with two types of FTD and patients with SD were not distinguishable by neuropsychological examinations, behavioral abnormalities and psychiatric symptoms assessed with the Neuropsychiatric Inventory except for aphasia. The clinical picture of frontal type dementia involves frontal lobe symptoms such as disinhibition, apathy and stereotypy. Semantic memory loss for words, objects or faces suggestive of temporal lobe involvement developed only in patients with SD, and not in patients with FTD. Certain behavioral symptoms seen in frontal type dementia may respond to selective serotonin reuptake inhibitors. In care for patients with frontal type dementia, behavioral disturbances can be diminished and the quality of life can be improved by using their preserved procedural memory, pathological stereotypic behavior and stimulus-bound behavior such as utilization behavior and environmental dependency syndrome.

Dementia↗
PubMed2000

Effects of N(G)-monomethyl-L-arginine on Ca(2+) current and nitric-oxide synthase in rat ventricular myocytes.

The effects of N(G)-monomethyl-L-arginine (L-NMMA), a nitric-oxide synthase (NOS) inhibitor, on the L-type Ca(2+) current (ICa) and NO effects on NOS were determined in rat ventricular myocytes. L-NMMA (10 and 100 microM) had no significant effect on basal ICa, but in a cAMP-stimulated condition due to forskolin (1 microM) or milrinone (10 microM), a cGMP-inhibited cAMP-phosphodiesterase (PDE), L-NMMA (10 and 100 microM) concentration dependently augmented ICa. The enhancing effects of L-NMMA (10 and 100 microM) on ICa were not seen in the presence of either a nonselective inhibitor of PDE, 3-isobutyl-1-methylxanthine (20 microM), resulting in a stimulated ICa condition or a cGMP-dependent protein kinase activator, 8-bromo-cGMP (200 microM). 8-Bromo-cGMP (200 microM) inhibited 100 microM L-NMMA-induced ICa increase in the simultaneous application of forskolin (1 microM). Acetylcholine (ACh; 1 and 3 microM) inhibited 1 microM forskolin-stimulated ICa in a concentration-dependent manner, but this inhibitory action of ACh was significantly attenuated by the additional application of L-NMMA (100 microM). In the continuing presence of both L-NMMA (100 microM) and forskolin (1 microM), ACh (6 microM) had no inhibitory effect on ICa. In another series of experiments with isolated ventricular myocytes, we obtained both the positive staining of NADPH-diaphorase activity and the expression of the endothelial isoform of NOS. These data suggest that the effect of L-NMMA on ICa in a cAMP-stimulated condition with or without cholinergic inhibition is due to inhibition (acute effects) of a cGMP-stimulated cAMP-PDE via inhibition of the endothelial isoform of NOS.

1-Methyl-3-isobutylxanthine↗
PubMed2000

Evaluation of the Space Collaboration System: its history, image quality and effectiveness for joint case conference.

A joint case-conference was conducted between the Departments of Radiology at Nagoya and Kobe Universities using the Space Collaboration System (SCS), which connects 39 national universities and institutes by communication satellite. In the conference, both sides presented cases using medical images such as those from CT, MRI, and DSA, and the cases were discussed between participants at the two universities. After the final conference, we distributed a questionnaire to solicit responses from the 43 participating radiologists on the quality of the transferred images and their overall impression of the conference. The responses showed that the CT, MRI, and DSA images were clear enough to allow discussion, whereas the plain X-ray images were not. Hence from the standpoint of image quality, the SCS may be unsuited for medical image diagnosis, but useful for presentation of case images in joint conferences and seminars.

Evaluation Studies as Topic↗
PubMed2000

[Clinical evaluation of cardiac valve surgery combined with coronary artery bypass grafting].

Between 1991 and 1999, 23 cases underwent cardiac valve surgery concomitant with myocardial revascularization at our institution. Twelve cases (group I) had a primary valvular disease combined with coronary atherosclerosis, and other 11 cases (group II) were due to ischemic mitral insufficiency. There were 2 hospital deaths in group I (17%) and 4 in group II (36%). Three deaths in group II underwent left ventricular volume reduction surgery. On the basis of this observation, we concluded severe mitral regurgitation with ischemic cardiomyopathy was a particularly difficult management problem with disappointing clinical results. On the other hands, we considered concomitant revascularization should be done in the case of primary valvular disease when angiographically significant coronary artery stenosis was present.

Aged↗
PubMed2000

Delayed onset pulmonary barotrauma or decompression sickness? A case report of decompression-related disorder.

A-24-yr-old male professional diver began to complain of substernal pain 3 h after a controlled ascent from a dive of less than 40 ft of sea water (fsw). The diving master who supervised his dive and the physicians who examined him on presentation suspected pulmonary barotrauma rather than decompression sickness (DCS) because he had only descended to a depth of 32 fsw. Hyperbaric oxygen therapy (HBO) by U.S. Navy treatment Table VI was implemented because of his progressively worsening pain. HBO was apparently effective and a relapse was not seen. The author cannot label his condition based on the conventional classification categories, such as decompression sickness (DCS), barotrauma or even decompression illness. This case report is offered as a topic for consideration in the controversy over decompression-related disorders.

Adult↗
PubMed2000

Inhibition of gelatinolytic activity in tumor tissues by synthetic matrix metalloproteinase inhibitor: application of film in situ zymography.

Inhibition of gelatinolytic activity in implanted tumor tissues by oral administration of N-biphenyl sulfonyl-phenylalanine hydroxamic acid (BPHA), a selective matrix metalloproteinase (MMP) inhibitor, was demonstrated by means of film in situ zymography (FIZ). Active-MMP-2 but not pro-MMP-2 showed gelatinolytic activity in FIZ, whereas both forms of MMP-2 were found to be active in conventional zymography. A mixture of either tissue inhibitors of metalloproteinase-2 or BPHA with active-MMP-2 resulted in inhibition of gelatinolytic activity in FIZ but not in zymography. Thus, FIZ, but not zymography, could detect net MMP activity in tumor tissues. When a specimen from Ma44 human lung cancer xenograft was subjected to FIZ, gelatinolytic activity was markedly detected with precise localization in the tumor tissues. The gelatinolytic activity detected in Ma44 tumor tissues was found to be mainly derived from MMPs because the gelatin-degrading activity was inhibited by pretreatment of the tumor specimen with MMP inhibitors. Oral administration of BPHA but not (-)BPHA, an enantiomer of BPHA lacking MMP inhibitory activity, successfully inhibited the MMP activity localized in Ma44 tumor tissues in both a dose-dependent and time-dependent manner. The data presented in this report showed for the first time that oral administration of synthetic MMP inhibitor could inhibit the net activity of MMP activity in tumor tissues, suggesting the usefulness of the FIZ technique for determining the effective dose of MMP inhibitor in clinical studies.

Animals↗
PubMed2000

Silastic interposition arthroplasty for osteoarthrosis of the carpometacarpal joint of the thumb.

We performed Ashworth's (1977) silastic interposition arthroplasty for painful osteoarthrosis of the carpometacarpal (CM) joint of the thumb. Recently, however, some unsuccessful cases treated by this method have been reported. We therefore reviewed the results of patients treated by Ashworth's method. We reviewed 16 patients operated on according to the original Ashworth method for osteoarthrosis of the first CM joint. The cases consisted of 8 males and 8 females, ranging in age from 32 to 76 years (average, 59.6 years). The patients were grouped according to Eaton's classification as follows: 1 patient was stage II, 6 were stage III, and 9 were stage IV. All patients were followed postoperatively for 1 to 12.5 years (average, 4.5 years). Twelve patients did not complain of any pain but 3 patients felt slight pain when moving their thumb. However, the degree of pain was much less than that experienced preoperatively. Only one patient complained of severe pain 2 years after the first operation. Her implant ruptured and required additional surgery. All except one showed either an increase or no change in grip strength. The range of motion (ROM) was full in all patients. Implants showed sinking in 3 patients, a partial rupture of the implant edge in 5 patients and a whole body failure in only 1 implant, roentogenographically. In spite of these troubles, only 3 patients complained of an unpleasant feeling and 2 reported slight pain. Implant trouble did not always cause the symptoms. The clinical results of this method were mostly satisfactory.

Adult↗
PubMed2000

MR imaging of the enlarged endolymphatic duct and sac syndrome by use of a 3D fast asymmetric spin-echo sequence: volume and signal-intensity measurement of the endolymphatic duct and sac and area measurement of the cochlear modiolus.

BACKGROUND AND PURPOSE: In enlarged endolymphatic duct (EED) and sac (EES) syndrome, deformity of the EED and EES is congenital; however, hearing loss is acquired. To investigate the pathophysiology of progressive sensorineural hearing loss in EED and EES syndrome, we measured the volume of the EED and EES, the diameter of the EED and EES, the area of the cochlear modiolus, and the signal intensity of the EES and compared our findings against degree of hearing loss. METHODS: Thin-section MR images of 33 ears in 17 patients with EED and EES syndrome were studied. All studies were obtained on a 1.5-T MR unit using a quadrature surface phased-array coil. Heavily T2-weighted 3D fast asymmetric spin-echo images were obtained with a voxel size of 0.3 x 0.3 x 0.8 mm without zero-fill interpolation. Two radiologists traced the areas of the EED and EES manually, and the volume was calculated. The area of the cochlear modiolus, diameter of the EED and EES, and signal intensity of the EES were also measured by drawing regions of interest manually. The signal intensity ratio of EES/CSF was calculated. These measured values were compared against audiographic data, and the degree of linear correlation was determined. RESULTS: The volume of the EED and EES, the area of the modiolus, the diameter of the EED and EES, and the signal intensity of the EES did not show significant correlation with degree of hearing loss. CONCLUSION: These findings suggest that there is a microscopic area of damage or fragility in the inner ear not visible even with thin-section heavily T2-weighted MR imaging.

Adolescent↗
PubMed2000

[A case report of successful transcatheter arterial embolization therapy for osseous metastasis of hepatocellular carcinoma].

A 74-year-old man was admitted to our hospital with a chief complaint of severe local pain of the hip joint. Radiological findings showed a metastasized lesion on the left side of the pelvic wall originated from hepatocellular carcinoma (HCC) in the anterior segment of the liver. Transcatheter arterial embolization (TAE) therapy using epirubicin, Lipiodol and Spongel was successfully performed twice for primary HCC, and four times for osseous metastasis of HCC. After TAE therapy, the size of the metastasized lesion decreased with relief of pain, and an improvement in performance status of 4 to 2 was achieved. In conclusion, TAE therapy is thought to be very useful in the treatment of osseous metastasis of HCC with severe local pain.

Aged↗