Biomedical subjects

M Ikeda

Publications and source records attributed to M Ikeda.

At least 91 records · Page 5Linked to original sources

PubMed2003

Effect of DRD2, 5-HT2A, and COMT genes on antipsychotic response to risperidone.

Risperidone is a widely used atypical antipsychotic with certain advantages over typical antipsychotics. Although variations in the efficacy of treatment with risperidone have been observed, no specific predictable marker has been identified as of yet. In all, 73 Japanese patients with schizophrenia were given risperidone for 8 weeks, and clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Six candidate polymorphisms (HTR2A -1438G>A, 102T>C, H452Y; DRD2 -141delC, Taq I A; COMT V158M) were genotyped. The diplotype configuration for each individual was estimated by the maximum-likelihood method. Multiple linear regressions were used to analyze the effects of these haplotypes/genotype and other prognostic factors on PANSS scale performance. After adjustment for the effects of patient-related variables, HTR2A diplotype and COMT genotype, as well as other potential prognostic factors, did not significantly influence the clinical performance. A DRD2 haplotype tended to correlate with better clinical performance. Compared with patients who had Ins-A2/Ins-A2 diplotype (n=25), PANSS total scores of patients with Ins-A2/Del-A1 diplotype (n=10) showed 40% greater improvement (P=0.03). The PANSS total scores of patients with HTR2A A-T/A-T diplotype (n=22) tended to show 15% worse improvement compared with A-T/G-C diplotype (n=33) (P=0.06). These results should be treated with caution because of limitations due to small sample size, heterogeneity of patients with respect to past antipsychotic use history, and no correction for multiple corrections. However, the present findings generate important hypotheses in a sample of Japanese schizophrenia patients that may lay the foundation for future pharmacogenomics investigations in other populations.

Adult↗

PubMed2003

Hypoplasia of primary and permanent teeth following osteitis and the implications of delayed diagnosis of a neonatal maxillary primary molar.

A 2-year-and-6-month-old Japanese girl with delayed eruption of a maxillary right primary canine and disturbance in the development of maxillary right primary molars was examined. The crown of the maxillary right first primary molar was severely decayed and hypoplastic. The periodontal tissues on the maxillary right posterior region were swollen and slight erythrogenic change was observed. Radiographic examination revealed a disturbance in the development of the permanent successor and the primary teeth in the maxillary right quadrant. According to the history, the maxillary right first primary molar had erupted on day seven after birth. It is suggested that the disturbance in development of the permanent successor and the primary teeth was secondary to osteitis caused by infection of the neonatal tooth. Appropriate dental treatment had not been administered for more than two years because the neonatal molar had not been diagnosed.

Child, Preschool↗

PubMed2003

Long-term survivors of advanced esophageal cancer without surgical treatment: a multicenter questionnaire survey in Kyushu, Japan.

Since the introduction of recent improvements in adjuvant therapy for esophageal cancer, some patients have demonstrated good prognosis. In the present study, we analyzed 3- and 5-year survivors of advanced esophageal cancer who did not undergo any surgical treatment. Between 1990 and 1998, 831 patients were admitted to 14 university hospitals and one cancer center associated with the membership of the Kyushu study group for adjuvant therapy of esophageal cancer. Twelve (1.4%) of the patients were 3-year survivors and 13 (1.6%) were 5-year survivors. The reasons for non-operation were refusal (eight patients), tumor-related factors (11 patients), and host-related factors (six patients). With a single exception, all patients had locally advanced tumors. Almost all long-term survivors had fewer than five lymph node metastases, in regions limited to the neck and/or mediastinum. Radiation therapy was combined with chemotherapy for 16 of the 25 patients, and chemotherapy-based cisplatin was used for 15 of these 16 patients. Fifteen of the patients remain alive; 10 died seven of them from esophageal cancer. Chemoradiation therapy was effective for some patients with locally advanced esophageal cancer, particularly in the absence of or with few lymph node metastases. To improve the prognosis of patients with advanced esophageal cancer who, for various causes, cannot undergo surgical treatment, a new protocol for adjuvant therapy is required.

Aged↗

PubMed2003

Retrosplenial cortex (BA 29/30) hypometabolism in mild cognitive impairment (prodromal Alzheimer's disease).

Previous group studies using positron emission tomography to assess resting cerebral glucose metabolism in very early Alzheimer's disease and mild cognitive impairment have identified the posterior cingulate and adjacent cingulo-parietal cortex as the first isocortical area to develop hypometabolism. We studied the profile of resting cerebral glucose metabolism in individuals with mild cognitive impairment to assess whether more specific and stereotyped regional hypometabolism would be evident across subjects. The study found that the most consistently hypometabolic region between individual subjects was a subregion of the posterior cingulate, the retrosplenial cortex (BA 29/30). This result is discussed in the context of regional connectivity, focal lesion evidence and functional activation studies of episodic memory paradigms in both normal and Alzheimer's disease groups. We propose that the retrosplenial cortex may represent a key junction between prefrontal areas involved in implementing retrieval strategies for episodic memory and hippocampal-based mnemonic processing; we therefore interpret the retrosplenial hypometabolism as a probable contributor to the memory impairment seen in mild cognitive impairment by disconnecting these two anatomical networks.

Aged↗

PubMed2003

Evaluation of left and right ventricular functional parameters with automatic edge detection program of ECG gated blood SPET.

An analysis program for ECG gated, blood pool, single photon emission tomography (SPET GBP) is available. This program permits the automatic evaluation of left and right ventricular function, but its reliability has not been thoroughly assessed. The objective of this investigation was to examine the reliability of the parameters derived from SPET GBP. Fifty-three patients who had undergone both SPET GBP and planar, ECG gated, blood pool scintigraphy (planar GBP) were enrolled in the study. Planar GBP was performed with a single-headed gamma camera. From a left anterior oblique projection, data were acquired at 24 frames/cardiac cycle with ECG gating during the equilibrium state. SPET GBP was carried out utilizing a triple-headed gamma camera, with 60 projection views over 360 degrees, with 60 s per view, in 16 frames/cardiac cycle. Left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) were calculated by using the analysis program. The reproducibility of these values and the correlation between SPET and planar GBP were assessed. To evaluate the effect of cut-off frequencies of a Butterworth filter, six different cut-off frequencies (order=8, 0.3-1.0 Nyquist) were tested with data obtained from 12 patients. The reproducibility of LVEF by SPET GBP was satisfactory (intra-observer, r=0.95; inter-observer, r=0.96), whereas reproducibility of RVEF by SPET GBP was fair (intra-observer, r=0.83; inter-observer, r=0.83). LVEF with SPET GBP was well correlated (y=1.1x+6.62, r=0.85, P<0.01) with LVEF readings of planar GBP. However, LVEF with SPET GBP was overestimated (mean difference of 12) in comparison with that of planar GBP. The RVEF derived from SPET GBP showed poor correlation (y=0.52x+33, r=0.53, P<0.01) with planar GBP. No significant effect of cut-off frequencies of Butterworth filters was evident in the calculation of LVEF and RVEF (P=0.48 and 0.67) with SPET GBP. It is concluded that SPET GBP with QBS is useful for the evaluation of LVEF. However, measurement of the RVEF showed lower reproducibility compared with measurement of the LVEF.

Adolescent↗

PubMed2003

Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates.

Between 1996 and 2000, we treated ten patients with severely comminuted fractures of the radial head using low-profile mini-plates. Their mean age was 42 years (24 to 71). Three fractures were Mason type III and seven were Mason-Johnston type IV. At a mean follow-up of 28.5 months (15 to 44), all fractures had united. The plates were removed in nine patients. No patient had difficulty with daily activities or symptoms of instability of the elbow. The mean range of flexion of the elbow was from 7 degrees to 135 degrees, with 74 degrees of supination and 85 degrees of pronation. According to the Broberg and Morrey functional elbow index, the mean score was 90.7 points (73 to 100), and the outcome was excellent in three patients, good in six and fair in one. These results compare favourably with those reported previously. The technique is applicable to severely comminuted fractures of the radial head which otherwise would require excision.

Adult↗

PubMed2003

[Telemanipulatory application of a magnetic coupler on the beating heart with the daVinci surgical system].

The construction of a coronary anastomosis on the beating heart under totally endoscopic conditions is technically demanding. In this study the potential benefits of an endoscopic magnetic vascular coupler (MVP, Ventrica, Inc, Fremont, CA) designed to facilitate construction of a coronary anastomosis with the help of the daVinci telemanipulator (Intuitive Surgical Inc., Sunnyvale, CA) were evaluated in a totally endoscopic coronary arterial bypass (TECAB) operation on the beating heart in eight dogs. The telemanipulated instruments were used to guide and place the endoscopic MVP-application platform (prototype). All animals underwent angiography, and gross inspection of the anastomotic site was done after excision of the hearts. The procedure was accomplished in 169 minutes (155-190). With the exception of one premature deployment, all MVP-anastomoses were accomplished in 3 minutes (1-28). The following adverse events were encountered: Bleeding from the right ventricle caused by occlusion tape (1), anastomotic leakage upon reperfusion requiring repair stitches (2), anastomotic occlusion due to a thrombus (1). All but one animal that died on reperfusion despite a patent graft and anastomosis, survived the procedure. Overall patency was 7 out of 8. The combination of telemanipulator technology allowing increased manipulation dexterity in a total endoscopic environment and the effective and time saving magnetic technique for anastomotic coupling has the potential to facilitate TECAB on the beating heart.

Anastomosis, Surgical↗

PubMed2003

[Thoracoscopic resection of localized fibrous tumor of the pleura; report of a case and review of the Japanese literature].

A 61-year-old female was admitted with abnormal shadow on chest X-ray. Chest computed tomography (CT) showed a clearly localized flat tumor at the peripheral region of the left lung. We suspected localized fibrous tumor of the pleura (LFTP) and performed video-assisted thoracic surgery (VATS). Under the thoracoscopy, the tumor was connected to the visceral pleura with a short pedicle and completely resected with safety margin. Pathological findings, including immunohistochemical examination, definitely revealed benign LFTP. VATS is a good indication for the diagnosis and treatment of LFTP. This case was reported together with some reviews of the literature.

Female↗

PubMed2003

[How much can off-pump coronary artery bypass grafting be performed for complete revascularization using only in situ arterial conduits?].

With the rapid advance of percutaneous catheter intervention, the direction taken by surgeons is not only to make coronary artery bypass grafting (CABG) less invasive but also to obtain better long-term results by using more arterial conduits. However, off-pump CABG (OPCAB) with only in situ arterial conduits such as the left and right internal thoracic arteries (ITAs) and the right gastroepiploic artery (RGEA) is technically demanding for the surgeon. The purpose of this study was to demonstrate the feasibility and safety of this technique. From January 2002 to December 2002, 57 patients underwent isolated CABG without cardiopulmonary bypass, excluding minimally invasive direct coronary artery bypass (MIDCAB) cases. There were 44 men and 13 women with a mean age of 64.1 years. Most of the patients (95%) underwent postoperative angiography within 1 month after surgery. The mean number of anastomoses was 3.8 +/- 1.4 (range 2-8). One patient suffered from mediastinitis and another from stroke. All patients were discharged from the hospital. Fifty patients (88%) received only in situ grafts for complete revascularization. Forty-one patients received bilateral ITAs and 27 received bilateral ITAs and RGEA. The mean number of anastomoses using bilateral ITAs and RGEA was 4.5 +/- 1.2 (range 3-8). The patency rate was 98%. Complete arterial revascularization with only in situ arterial conduits was associated with minimal operative risk and a high early graft patency rate, even in the off-pump situation. These results indicate that complete revascularization can be achieved in OPCAB with the exclusive use of in situ arterial conduits in patients with diffuse coronary arterial disease.

Adult↗

PubMed2003

[A resected case of malignant fibrous histiocytoma of the chest wall].

We report a 74-year-old woman with malignant fibrous histiocytoma (MFH), treated successfully by radiation and followed with chest wall resection and reconstruction. The patient suffered from right back pain and her chest X-ray showed a clear round shadow in the middle field of the right lung. Chest computed tomography (CT) showed a 5 x 5 cm tumor in diameter, involving the right 8 rib with destructive changes. After radiation therapy of total 30 Gy to the tumor to obtain the safety surgical margin, we widely resected 10 x 9 cm chest wall with 3 ribs in area under thoracoscopy and performed reconstruction using GORE-TEX Soft Tissue Patch. The pathological and immuno-histochemical diagnosis showed pleomorphic type of MFH. Final result of the tumor negative in surgical margin manifested that our technique of chest wall resection and reconstruction using thoracoscope after the irradiation to the tumor was very safe and useful.

Aged↗

PubMed2003

[Inflammatory pseudotumor diagnosed by thoracoscopic resections; report of a case].

A 65-year-old woman was referred to our hospital because of cough and sputum. Chest CT scan revealed a coin lesion (about 1.5 cm diameter) with slight speculation at the right upper lobe. We suspected a lung cancer and performed video assisted thoracic surgery (VATS). Under the thoracoscopy, the tumor was completely extirpated with safety margin by the partial resection of the right upper lobe. Pathological findings definitely revealed inflammatory pseudotumor, fibrohistiocytic variant type. VATS is a good indication for the diagnosis and treatment of inflammatory pseudotumor. This case was reported together with some reviews of the literature.

Aged↗

PubMed2002

Analysis for threshold levels of cadmium in urine that induce tubular dysfunction among women in non-polluted areas in Japan.

OBJECTIVE: To examine if there is a threshold in urinary cadmium concentration that induces elevation in urinary microglobulins. METHODS: The database developed in a previous field survey (Ezaki et al. 2002) was employed. In the survey conducted in 2000 and 2001, more than 10,000 middle-aged women (with no occupational exposure to Cd) in ten prefectures all over Japan gave morning spot urine samples, which were analyzed for cadmium (Cd-U), calcium (Ca-U), magnesium (Mg-U), zinc (Zn-U), alpha(1)- and beta(2)-microglobulins (alpha(1)- and beta(2)-MG-U), and creatinine (cr). The urinary analyte concentrations were corrected for cr concentration (to be expressed as, e.g., Cd-Ucr), and the data thus obtained were subjected to statistical evaluation. The largest geometric mean (GM) for Cd-Ucr among the ten prefecture was 3.2 microg Cd/g cr, and the maximum Cd-Ucr observed among the women studied was 20.9 microg Cd/g cr. RESULTS: Both alpha(1)-MG-Ucr and beta(2)-MG-Ucr increased as a function of the increase in Cd-Ucr among all the women and also in sub-populations of narrow age ranges (i.e., 41-50 and 51-60 years), with no apparent threshold Cd-Ucr. Comparison of the cases exceeding cut-off alpha(1)-MG-Ucr and beta(2)-MG-Ucr levels also indicated a Cd dose-dependent increase in the prevalence, similarly without a threshold Cd-Ucr. In addition, such findings were essentially reproducible when elevation in alpha(1)-MG-Ucr and beta(2)-MG-Ucr levels was examined with the three essential elements, especially with Ca-Ucr and Mg-Ucr, although less clearly with Zn-Ucr. The observations as a whole suggest a possibility that the dose-dependent increases in alpha(1)-MG-Ucr and beta(2)-MG-Ucr with no apparent threshold for element concentration is not specific to Cd-Ucr but common to other elements. CONCLUSIONS: No threshold Cd-Ucr was detected in relation to the increases in alpha(1)-MG-Ucr and beta(2)-MG-Ucr. The element dose-dependent increases in the two MGs with no threshold in the element concentration might be not limited to Cd, but common to other elements. Further studies are apparently necessary.

Adult↗

PubMed2002

Methyl isobutyl ketone and methyl ethyl ketone in urine as biological markers of occupational exposure to these solvents at low levels.

OBJECTIVE: To examine whether unmetabolized methyl isobutyl ketone in urine is a useful marker of low-level occupational exposure to this ketone solvent, as is the case for methyl ethyl ketone. METHODS: The study was conducted in the second half of a working week. In total, 27 furniture-making workers (19 men and eight women) and 11 non-exposed controls (six men and five women) volunteered to participate in the study. Time-weighted average (TWA; 8-h) concentration of vapors of several solvents in air, including methyl isobutyl ketone (MIBK-A) and methyl ethyl ketone (MEK-A) was monitored by diffusive sampling. Urine samples collected at the end of the shift were subjected to head-space gas chromatography (GC) analysis for the unmetabolized solvents (i.e., MIBK-U and MEK-U). The relationship between the concentration of the solvent vapor and the corresponding solvent level in urine was examined by simple as well as multiple regression analysis. RESULTS: The exposures to MIBK and MEK were well below the current occupational exposure limit levels, but the maximum levels of exposure to toluene and ethylbenzene were around the corresponding exposure limit. The correlation of the TWA concentration of the solvent in air with the concentration of the corresponding solvent in the end-of-shift urine sample was significant both for MIBK and for MEK, and the correlation coefficient was larger for MIBK than for MEK. The slope in the exposure-excretion regression line was almost twice as steep for MEK than for MIBK, possibly due to the difference in water solubility. Approximately 0.12% of MIBK absorbed in the lungs will be excreted into urine, whereas the yield for MEK was somewhat higher (0.19%). CONCLUSION: MIBK in urine is a good marker of exposure to MIBK, as in the case of MEK in urine for MEK exposure.

Adult↗

PubMed2002

Comparison of urinary bromide levels among people in East Asia, and the effects of dietary intakes of cereals and marine products.

Groups of people with no occupational exposure to Br-containing chemicals (29-54 year old, mostly women) in Japan, China and Korea, respectively, offered spot urine samples. Those in China and Korea offered 24 h duplicates of foods of the day. Urine samples were analyzed for Br by ECD-gas chromatography (ECD-GC) after derivatization to methyl bromide, and the Br-U was adjusted for a specific gravity of 1.016. Food intake data were based on national statistics and supplemented by the food duplicate data. Mean Br-U was 5.4 and 6.5 mg/l for Japanese men and women, respectively. Mean levels were in a range of 1.8-2.8 mg/l for four groups of Chinese, and 8-12 mg/l for the four groups of women in Korea. Br-U levels among Korean women were close levels reported for occupational exposure to 1- or 2-bromopropane, or methyl bromide. Regression analyses showed that Br-U levels were influenced by the intake of marine products (such as sea algae, sea fish and shellfish) and fruits, and inversely relate to intakes of cereals and potato.

Adult↗

PubMed2002

A phase I trial of weekly gemcitabine and concurrent radiotherapy in patients with locally advanced pancreatic cancer.

This study investigated the maximum-tolerated dose of gemcitabine based on the frequency of dose-limiting toxicities of weekly gemcitabine treatment with concurrent radiotherapy in patients with locally advanced pancreatic cancer. Fifteen patients with locally advanced pancreatic cancer that was histologically confirmed as adenocarcinoma were enrolled in this phase I trial of weekly gemcitabine (150-350 mg x m(-2)) with concurrent radiotherapy (50.4 Gy in 28 fractions). Gemcitabine was administered weekly as an intravenous 30-min infusion before radiotherapy for 6 weeks. Three of six patients at the dose of 350 mg x m(-2) of gemicitabine demonstrated dose-limiting toxicities involving neutropenia/ leukocytopenia and elevated transaminase, while nine patients at doses of 150 mg x m(-2) and 250 mg x m(-2) did not demonstrate any sign of dose-limiting toxicity. Of all 15 enrolled patients, six patients (40.0%) showed a partial response. More than 50% reduction of serum carbohydrate antigen 19-9 level was observed in 13 (92.9%) of 14 patients who had pretreatment carbohydrate antigen 19-9 levels of 100 U x ml(-1) or greater. The maximum-tolerated dose of weekly gemcitabine with concurrent radiotherapy was 250 mg x m(-2), and this regimen may have substantial antitumour activity for patients with locally advanced pancreatic cancer. A phase II trial of weekly gemcitabine at the dose of 250 mg x m(-2) with concurrent radiation in patients with locally advanced pancreatic cancer is now underway.

Aged↗

PubMed2002

Toluene, xylenes and xylene isomers in urine as biological indicators of low-level exposure to each solvent; a comparative study.

OBJECTIVE: To examine if xylenes and xylene isomers in end-of-shift urine are good biological indicators of low-level exposure to each solvent, similarly to toluene in urine. METHODS: The study was conducted in the latter half of a working week. Furniture makers, 86 subjects in total (76 men and ten women), participated in the study in combination with 11 non-exposed subjects. Time-weighted average (8-h TWA) exposures to mixtures of toluene (TOL-A), xylenes (XYLs-A), ethylbenzene (EB-A), acetone (ACE-A) etc. were monitored with diffusive samplers for lipophilic and hydrophilic solvents, respectively. Urine samples (i.e., TOL-U, XYLs-U, EB-U, ACE-U, etc.) were collected at the end of the shift and subjected to head-space gas chromatography analysis for each solvent. The exposure-excretion relationship was examined by simple as well as multiple regression analysis. RESULTS: The exposures to TOL and XYLs were around or below current occupational exposure limit levels. The exposures to other solvents [i.e., ACE, EB, methyl ethyl ketone (MEK), methyl isobutyl ketone (MIBK), etc.] were at substantially lower levels. The correlation of the TWA solvent exposure concentration with the concentration of the corresponding solvent in the end-of-shift urine sample was close for TOL, and also almost equally close in the case of XYLs and each of the three XYL isomers. Whereas the slope of the regression line for XYLs was significantly less steep than that for TOL when compared on an equi-molar basis, there was no difference among the three XYL isomers. No confounding effects of age, sex and co-exposure to other solvents were detected. The observation confirms previous reports that TOL-U is a good marker of TOL vapor exposure, indicates that XYL-U is also a reliable marker of exposure to vapors of XYLs or any of the three XYL isomers, and suggests that estimation of exposure to vapors of XYLs (i.e., three isomers in combination) is possible by the determination of one of the XYL isomers in urine, once the proportion of the isomers in air is known. Possible association of water solubility with solvent levels in urine is discussed. CONCLUSIONS: Biological monitoring of exposure by means of analysis of end-of-shift urine for mother solvent is possible, not only in the case of TOL as previously reported, but also in cases of XYLs, either for three isomers in combination or separately.

Adult↗

PubMed2002

A novel methodology employing Corynebacterium glutamicum genome information to generate a new L-lysine-producing mutant.

Classical whole-cell mutagenesis has achieved great success in development of many industrial fermentation strains, but has the serious disadvantage of accumulation of uncharacterized secondary mutations that are detrimental to their performance. In the post-genomic era, a novel methodology which avoids this drawback presents itself. This "genome-based strain reconstruction" involves identifying mutations by comparative genomic analysis, defining mutations beneficial for production, and assembling them in a single wild-type background. Described herein is an initial challenge involving reconstruction of classically derived L-lysine-producing Corynebacterium glutamicum. Comparative genomic analysis for the relevant terminal pathways, the efflux step, and the anaplerotic reactions between the wild-type and production strains identified a Val-59-->Ala mutation in the homoserine dehydrogenase gene (hom), a Thr-311-->Ile mutation in the aspartokinase gene (lysC), and a Pro-458-->Ser mutation in the pyruvate carboxylase gene (pyc). Introduction of the hom and lysC mutations into the wild-type strain by allelic replacement resulted in accumulation of 8 g and 55 g of L-lysine/l, respectively, indicating that both these specific mutations are relevant to production. The two mutations were then reconstituted in the wild-type genome, which led to a synergistic effect on production (75 g/l). Further introduction of the pyc mutation resulted in an additional contribution and accumulation of 80 g/l after only 27 h. This high-speed fermentation achieved the highest productivity (3.0 g l(-1) h(-1)) so far reported for microbes producing L-lysine in fed-batch fermentation.

Aspartate Kinase↗

PubMed2002

Uveitis in adult patients with poststreptococcal reactive arthritis: the first two cases reported associated with uveitis.

We describe two adult patients with poststreptococcal reactive arthritis (PSRA), both of whom concomitantly developed uveitis. These are the first two cases reported. Because uveitis may result in permanent damage to visual acuity, this complication should be widely recognised in patients with PSRA and antibiotic prophylaxis should be considered for those with recurrent streptococcal infection.

Adult↗