Thymoma associated with rheumatoid arthritis after D-penicillamine treatment.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
M Kase
Publications and source records attributed to M Kase.
Carbamazepine-induced sinus node dysfunction and atrioventricular block in elderly women.
We report on four elderly women in whom carbamazepine was suspected of inducing sinus node dysfunction (3 patients) and atrioventricular block (1 patient). Patients were treated with carbamazepine, 200 to 600 mg a day, for trigeminal neuralgia (n = 3) or epilepsy (n = 1). After 1 to 16 months of carbamazepine therapy, these patients were admitted to our emergency room because of bradyarrhythmia. Their conduction disturbances on electrocardiographic monitoring disappeared immediately after the cessation of carbamazepine intake. Provocation tests were performed on three patients. Because of renal insufficiency, one patient could not undergo the provocation test. Her carbamazepine clearance was markedly decreased. Carbamazepine induced sinus arrest in two patients within 48 hours after intake, but did not induce atrioventricular block in the remaining patient. In two patients, computer simulation of carbamazepine pharmacokinetics was performed and disclosed a clear-cut relationship between the plasma concentration of carbamazepine and the frequency of sinus arrest. During the test, the maximum plasma carbamazepine concentration in these two patients did not exceed the therapeutic range. However, it did exceed the range in the one with a negative test. Our results suggest that careful monitoring of ECG and plasma drug concentration is required with carbamazepine therapy, especially in elderly women.
Aged↗
Laminar organization of the intrinsic connection neurons and their axon terminals in the lateral suprasylvian cortex of the cat.
The lateral suprasylvian cortex (LS) of the cat has numerous interconnections with other visual cortical areas, as well as with subcortical structures implicated in visually-guided behavior. However, little data are available regarding connections within the LS itself. In order to investigate the intrinsic connections within LS, we have examined the laminar patterns of terminal and cellular labeling following injections of either the anterograde tracer biocytin, or the retrograde tracer, WGA-HRP, into the subregions of the LS (AMLS, PMLS, ALLS, and PLLS). Tracer deposits spanning all cortical layers in a LS subregion basically resulted in labeling of axons and terminals (biocytin cases) or cells of origin (WGA-HRP cases) in all layers, although intensity of the labeling seemed to be different among subregions. The present study demonstrated that the interconnections among LS subregions provide no clear evidence of simple hierarchial relationships between regions.
Animals↗
Cholinergic innervation of the lateralis medialis-suprageniculate nuclear complex (LM-Sg) of the cat's thalamus: a double labeling immunohistochemical study.
The purpose of this study was to investigate morphological characteristics of the synaptic relations of choline acetyltransferase (ChAT)-positive terminals that are made with a variety of post-synaptic profiles in the lateralis medialis-suprageniculate nuclear complex (LM-Sg) using ChAT, gamma-aminobutyric acid (GABA) and glutamate immunohistochemistry in combination with electron microscopical observations. The ChAT immunopositive profiles make asymmetrical synaptic contacts with glutamate immunopositive dendrites that are presumably derived from projection neurons, and/or GABA immunopositive interneurons. The present results indicate that ascending cholinergic mechanisms may be important for modifying information in both the extrinsic and intrinsic circuitries of LM-Sg.
Animals↗
Effect of enalapril maleate on cerebral blood flow in patients with chronic heart failure.
The effect of enalapril on cerebral blood flow (CBF) was studied in 11 patients with chronic heart failure (NYHA II or III, dilated cardiomyopathy in 6 and old myocardial infarction in 5). CBF was evaluated by analyzing the Patlak-Plot curve obtained from radionuclide angiography with technetium-99m hexamethylpropylene amine oxime (99mTC-HM-PAO). Cardiac index (CI) and stroke volume (SV) were simultaneously measured by impedance cardiography. These measurements were performed before and at four weeks after daily administration of 5 mg enalapril. The stroke volume, cardiac index, and heart rate were not significantly changed after four weeks of enalapril administration. However, CBF was increased by 6.5% from 36.72 +/- 4.66 to 39.13 +/- 5.65 mL/100g/min (P < 0.05). These results suggest that enalapril increased cerebral blood flow, which was not related to increased cardiac output in congestive heart failure. Patlak-Plot analysis of radionuclide angiography using 99mTC-HM-PAO may be available for quantitative assessment of brain perfusion.
Aged↗
[High-dose methylprednisolone pulse therapy for respiratory failure after open heart surgery].
After open-heart surgery, we sometime experience a patient whose respiratory function worsens extremely, though a heart function is improved. We experienced four such cases and treated with high-dose methylprednisolone. Then, we recognized that the respiratory function was improved at all cases. However, one case deteriorated again regarding the respiratory function, as a start of the treatment was delayed. There is a possibility that host resistance to infection is decreased by administration of corticosteroids. Therefore, we hesitate to treat with corticosteroids. Concerning respiratory failure after open heart surgery, however, we think that a respiratory function of a patient is improved if high-dose methylprednisolone pulse therapy is started in early stage.
Aged↗
Stability of ocular counterrolling and Listing's plane during static roll-tilts.
PURPOSE: To investigate whether habituation occurs in ocular counterrolling (OCR), how stable shifted Listing's plane is, and what effects visual stimulation and alertness exert on the OCR and on Listing's plane. METHODS: Two monkeys (Macaca fuscata) were engaged in this experiment. A dual scleral search coil method was used for recording three-dimensional eye movements. Spontaneous eye movements were recorded for 2 hours in dark and light, while each monkey was held in different static roll positions (up to +/-34 degrees) with its head fixed. Eye movements were also recorded during the monkeys' drowsy periods in the dark. RESULTS: In alert conditions, OCR gains showed some fluctuations but did not change consistently for 2 hours in seven of seven sessions in the dark and in seven of nine sessions in the light. The OCR gains in the light did not differ from those in the dark. The thickness of shifted Listing's plane during the static roll-tilt was also stable for 2 hours and was within the range of the thickness of Listing's plane in the upright position in the light. During drowsy periods, the thickness of Listing's plane increased, and the gain in OCR decreased. CONCLUSION: Ocular counterrolling shows no habituation for 2 hours of static roll-tilts in the alert monkey. In the same condition, Listing's plane consistently maintains its precision. Visual input does not affect OCR, but alertness is necessary to keep the stability of OCR and Listing's plane.
Adaptation, Ocular↗
Extrinsic and intrinsic connections of the cat's lateral suprasylvian visual area.
The lateral suprasylvian visual area (LS) is known to have numerous interconnections with visual cortical areas as well as with subcortical structures implicated in visually-guided behaviors. In contrast, little data is available regarding connections within the LS itself. In order to obtain information about intra-areal connections and to re-investigate LS connectivity with various cortical and subcortical areas, the traces (biocytin or WGA-HRP) was injected into various loci along the medial and lateral banks of the LS. The anterograde tracer, biocytin injections into both medial and lateral bank produced label contained within the respective bank that extended rostrally and caudally from the infection site. In addition, following medical bank injections, considerable label was distributed throughout the fundus and, to a lesser extent, in the lateral bank. In contrast, no label could be detected in the medial bank after lateral bank injections, and, although label was observed in the fundus, it was restricted to the most lateral aspects. Moderate labeling could be observed in the medial bank following the tracer injection into the most rostral aspect of the lateral bank. It is likely that input derived from various visual cortical areas which project to the medial bank of the LS has access to this intra-areal circuitry. This may provide a route by which visual cortical information can be relayed to other cortical and subcortical structures involved in visually-guided behaviors such as the anterior ectosylvian visual cortex, striatum, and the deep layers of the superior colliculus, despite the fact that these structures themselves do not receive substantial direct projections from the visual cortical areas that are associated with the medial bank. Examination of the laminar location of the cells-of-origin of striate and extrastriate projections to LS using retrograde trace, WGA-HRP, revealed that the supragranular laminae of areas 17, 18 and 19 were the source of LS afferents whereas afferents from the other cortical areas (e.g., 20a, 20b, 21a, 21b, 7 and anterior ectosylvian visual area) were from both supra- and infragranular laminae. In addition, all LS subregions received intra-areal afferent projections from all LS cortical laminae. Thus, although rather clear hierarchical relationship between LS and visual cortical areas appears to exist, the interconnections among LS subregions provide no clear evidence of simple hierarchical relationships between regions LS or may have feed-forward and feed-back pathways.
Animals↗
Morphologic alterations and cytokinetic studies of tracheal autograft epithelium in rabbits.
BACKGROUND: Although tracheobronchoplasty has been used widely in the field of thoracic surgery, few details of the morphologic changes in and cytokinetics of the graft epithelium have been reported. The aim of this study was to focus on these aspects in autografted rabbit tracheas. METHODS: Resected cervical tracheas were anastomosed immediately after removal, retrieved on postoperative days 1 through 28, and examined morphologically. Mitotic and bromodeoxyuridine-labeling indices of the graft epithelium were analyzed. RESULTS: On postoperative days 1 to 4, the graft epithelium showed focal desquamation at the anastomoses. Ciliated cells disappeared during postoperative days 4 to 7 and then increased gradually. Nonciliated cells retained a somewhat columnar shape on postoperative days 4 to 7, except at denuded foci. Thereafter, the grafts were covered completely with pseudostratified mucociliary epithelium. On postoperative day 4, both indices were maximal and appeared higher at the anastomotic than midgraft sites. CONCLUSIONS: Most of the graft epithelium was preserved during acute ischemia and then started to regenerate. The increased regenerative activity near the anastomoses may be attributable to mechanical damage or different nutritional conditions.
Anastomosis, Surgical↗
[Long-term prolongation of direct pupillary light reflex latency and P100 latency of pattern visual evoked potential in unilateral optic neuritis].
We evaluated the visual functions of visual acuity, color sense, direct pupillary light reflex and pattern visual evoked potentials (P100) in five patients with unilateral optic neuritis whose visual acuity improved to 1.0 or better in order to assess the recovery of the impaired optic nerve fibers from the inflammatory process. During follow-up periods the direct light pupillary reflex was electropupillographically recorded and the P100 latency of visual evoked potentials was examined in both eyes. The temporal course of their differences showed a biphasic curve: the acute stage showed a rapid decrease of the differences and the chronic stage showed a flat line analysis of Pearson's correlation coefficient revealed that latency differences were mutually altered although there was a tendency for differences of direct pupillary reflex latency to decrease more rapidly at the acute stage than those of P100 latency. The present study demonstrated that the two different classes of the optic nerve fibers originating from the retinal ganglion cells, pupillary reflex-related fibers and form vision-related fibers, were damaged to the same degree by the inflammation, in spite of their morphological differences.
Adult↗
Severe destruction of the neural integration mechanism for upward eye movements in bilateral internuclear ophthalmoplegia.
The visually elicited saccades and smooth pursuits of a 24-year-old man with bilateral internuclear ophthalmoplegia were recorded with an infrared limbus reflection technique. Although the amplitude-peak velocity relationship of saccades appeared to be normal, all the upward saccades were hypermetric and were followed by postsaccadic exponential drifts. The time constant of the postsaccadic exponential drifts was 248 +/- 19.5 ms (mean +/- SD). Upward pursuit eye movements were also severely disturbed, and only movements with a short duration (mean 113.8 ms) and low gain (mean 0.51) were frequently observed. Thus, the transformation of a pulse velocity signal for saccades and of a step velocity signal for smooth pursuits into step and ramp position commands, respectively, was almost completely lost for upward eye movements in this patient because of bilateral lesions of the medial longitudinal fasciculus.
Adult↗
[Vitreous surgery for mycotic endophthalmitis].
We treated eight eyes of five patients with mycotic endophthalmitis. Intraocular inflammatory changes in one of these eyes improved only by antifungal therapy with 21-day administration of miconazole and fluconazole. The other seven eyes underwent vitrectomy, and the preoperative periods between the onset of ocular complications and the operation ranged from one and a half months to three months, during which time fungi were isolated only in one case. Dense vitreous opacities caused by the colonies of the fungi were found in the all vitrectomized eyes. Vitrectomy in the three cases showing no retinal detachment was effective for the improvement of either visual acuity or ophthalmoscopic findings, whereas vitrectomy was not effective in the other two cases with the occurrence of the pre-retinal membrane causing traction retinal detachment. The present investigations suggest that persistent endophthalmitis and the appearance of total retinal detachment made the improvement of retinal changes difficult because of the inflammatory and fibrotic processes between the retina and the vitreous body. It, therefore, is shown that anti-fungal therapy should be initiated when mycotic endophthalmitis is suspected, but in cases without response to the drug, vitrectomy should be performed before retinal detachment occurs.
Aged↗
[A case of endocarditis caused by Candida glabrata].
A 45-year-old diabetic man had aortic valve replacement for Candida glabrata endocarditis. Postoperatively he was treated with fluconazole and amphotericin B. Despite therapy, C. glabrata was isolated from his blood. He collapsed suddenly and died of heart failure 70 days after operation. Autopsy revealed suture line insufficiency and perivalvular leakage. On histologic examination many colonies of fungi were found in the aortic valvular annulus and an embolus to the mesenteric artery.
Aortic Valve↗
[Pulmonary leiomyoma: a case report].
A case of pulmonary leiomyoma is presented. A 61-year-old asymptomatic woman underwent surgical resection of the lung for definite diagnosis of abnormal shadow on chest X-ray. Her history was hysterectomy and bilateral salpingo-oophorectomy performed 25 years previously because of uterine myoma. Histologic findings of pulmonary lesion was leiomyoma, and nuclear atypia and mitotic figures were not found. Pulmonary smooth muscle neoplasms are exceptionally rare. We review pulmonary leiomyoma reported in the Japanese literature, and also discuss the diagnostic problems in relation to metastasizing leiomyoma of the uterus.
Female↗
[A clinicopathologic study of thymomas: a review of 52 cases, with particular reference to results of treatment].
Clinicopathologic aspects of 52 thymomas were reviewed. Masaoka staging revealed stage I in 32, stage II in 2, stage III in 12, stage IV a in 3, and stage IV b in 3. Eleven patients (21%) had associated myasthenia gravis (MG), and three (6%) had pure red cell aplasia (PRCA). Operation was complete resection in 39 patients (stage I 32, stage II 2, stage III 2, and stage IV b 3), subtotal resection in 4 patients (stage III 2, stage IV a 2), partial resection or simple biopsy in 7 patients (stage III 6, stage IV a 1). Survival rates at 5 years and 10 years were 88%, 88% in noninvasive thymomas, and 65%, 45% in invasive thymomas, respectively. Statistical analysis indicated that patients with noninvasive thymomas had significantly longer survival than those with invasive thymomas. Significant difference was not found in survival on the basis of tumor cell type according to lymphocyte/epithelial cell ratio. Associated MG had no influence on the survival of thymoma patients, however, the presence of PRCA was an adverse factor in survival. In cases of invasive thymomas, there was statistically significant difference in the survival rates between the group of patients undergoing complete or subtotal resection and the group undergoing partial resection or only biopsy. Irradiation was of value in local control of thymoma, but lymphogeneous or hematogeneous recurrence occurred in 21% of patients with invasive thymomas from 3 months to 12 years postoperatively. Lifelong follow-up should be necessary in thymoma patients since late recurrence is not so rare.
Adolescent↗
Ocular torsion produced by unilateral chemical inactivation of the interstitial nucleus of Cajal in chronically labyrinthectomized cats.
Unilateral lesions of the rostral midbrain involving the interstitial nucleus of Cajal (INC) have been known to produce ocular torsion in alert animals including humans, which has been assumed to be the result of an impaired otolith-ocular reflex. We examined the effects of chemical deactivation of the INC using a gamma-aminobutyric acid (GABA) agonist (muscimol) in cats that had received bilateral labyrinthectomy, and compared the results with those in normal cats. Ocular torsion with a magnitude similar to that observed in normal cats appeared in chronically labyrinthectomized cats after unilateral muscimol infusion into the INC, indicating that ocular torsion following unilateral INC deactivation can be produced by a mechanism independent of the otolith-ocular reflex.
Animals↗
[Pulmonary arteriovenous malformation with systemic blood supply].
A forty-eight year-old woman who had suffered from exertional dyspnea and cyanosis since her youth was found to have abnormal shadow in her right lower lung at the roentgenographic examination. Pulmonary angiography showed cavernous network between pulmonary artery and vein of the 8th, 9th, and 10th segments. Bronchial artery was dilated, supplying the cavernous lesion. From these findings this lesion was diagnosed as pulmonary arteriovenous malformation feeded by bronchial artery. Right lower lobectomy was performed. The effect of resection was confirmed by intraoperative arterial gas analysis before and after the excision. She has been doing well without any signs of recurrence for 3 years after the surgery.
Arteries↗