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Biomedical subjects

M Nishikawa

Publications and source records attributed to M Nishikawa.

At least 271 records · Page 15Linked to original sources
PubMed1998

Embolic stroke in the territory of a cerebellar arteriovenous malformation--case report.

A 63-year-old male presented with an embolic stroke in the right medial inferior cerebellum. Angiography at 2 and 8 months after the stroke revealed arteriovenous shunts from the vermian branch of the right posterior inferior cerebellar artery of the right inferior vermian vein. The shunts mimicked the arteriovenous shunts of post-recanalization in acute ischemic stroke, but were finally diagnosed as a pre-existing congenital arteriovenous malformation based on their persistence. Arteriovenous shunts that persists more than 2 weeks after ictus should be differentiated from the post-recanalization arteriovenous shunts of ischemic stroke, as the different etiology may affect the ultimate prognosis and course of treatment.

Cerebellum↗
PubMed1998

Prospective analysis of complications of catheter cerebral angiography in the digital subtraction angiography and magnetic resonance era.

Permanent and temporary neurological complications of catheter cerebral angiography were prospectively evaluated in 500 consecutive diagnostic cerebral angiographic procedures, 268 performed on 213 males and 232 on 175 females. Complications were divided into permanent (> 1 week), reversible (< or = 1 week, > 24 hours), and temporary (< or = 24 hours). There were four permanent (0.8%), one reversible (0.2%), and nine temporary neurological complications (1.8%). There was no death. With the correct selection of patients, catheter cerebral angiography is considered to be safe with acceptable rates of complications.

Aged↗
PubMed1998

Cerebellar mutism after basilar artery occlusion--case report.

A 30-year-old female became comatose due to embolic occlusion of the basilar artery, caused by surgical injury to the origin of the vertebral artery during removal of a neurinoma in the upper thoracic paravertebral region. The basilar artery occlusion was treated by local fibrinolysis through a microcatheter. Two weeks later she recovered her consciousness but suffered mutism. Her speech disturbance was characterized by severe ataxic dysarthria known as "cerebellar mutism" but without cranial nerve paresis. The mutism gradually improved during the following 3 months. This is case of cerebellar mutism was apparently due to ischemic stroke. Disturbance by hypoperfusion of the cerebellum and brain stem may have been involved in the pathogenesis of cerebellar mutism.

Adult↗
PubMed1998

Rupture mechanism of a thrombosed slow-growing giant aneurysm of the vertebral artery--case report.

A 76-year-old male developed left hemiparesis in July 1991. The diagnosis was thrombosed giant vertebral artery aneurysm. He showed progressive symptoms and signs of brainstem compression, but refused surgery and was followed up without treatment. He died of rupture of the aneurysm and underwent autopsy in March 1995. Histological examination of the aneurysm revealed fresh clot in the aneurysmal lumen, old thrombus surrounding the aneurysmal lumen, and more recent hemorrhage between the old thrombus and the inner aneurysmal wall. The most important histological feature was the many clefts containing fresh blood clots in the old thrombus near the wall of the distal neck. These clefts were not lined with endothelial cells, and seemed to connect the lumen of the parent artery with the most peripheral fresh hemorrhage. However, the diameter of each of these clefts is apparently not large enough to transmit the blood pressure of the parent artery. Simple dissection of the aneurysmal wall by blood flow in the lumen through many clefts in the old thrombus of the distal neck may be involved in the growth and rupture of thrombosed giant aneurysms of the vertebral artery.

Aged↗
PubMed1998

Serum level of eosinophil cationic protein in patients with chronic cough: relationship to blood eosinophils and airway hyperresponsiveness.

We measured the serum level of eosinophil cationic protein (ECP), determined the blood eosinophil count, and assessed pulmonary function by spirometry and airway responsiveness to methacholine in 80 patients with a cough lasting longer than 3 weeks without an obvious cause. The serum level of ECP was above the cutoff value of 15.7 ng/mL (mean + 2 SD in 105 healthy control adults) in 30 (37.5%) of 80 patients (high-serum-ECP group). The blood eosinophil count was significantly higher in the high-serum-ECP group than in the normal-serum-ECP group (p < 0.01). The cumulative dose of methacholine causing a 35% decrease in respiratory conductance (PD35Grs) was significantly lower in the high-serum-ECP group than in the normal-serum-ECP group (p < 0.001). The serum concentration of ECP was correlated with the blood eosinophil count and the PD35Grs (r = 0.59, p < 0.001 and r = -0.48, p < 0.001, respectively). These findings suggest a possible role for serum level of ECP in management of patients with chronic cough.

Adult↗
PubMed1998

Disposition characteristics of glycosylated poly(amino acids) as liver cell-specific drug carrier.

Potentials of glycosylated poly(amino acids) as carriers of drugs and/or polynucleotides to the liver were studied in mice in detail. Poly-L-glutamic acid (PLGA) and poly-L-lysine (PLL) were selected as carrier backbones and modified with 2-imino-2-methoxyethyl 1-thiogalactoside or mannoside to obtain galactosylated and mannosylated derivatives. After intravenous injection in mice at a dose of 1 mg/kg, Gal-PLGA and Man-PLGA were selectively taken up by the liver parenchymal cells (PC) and liver nonparenchymal cells (NPC), respectively. Moreover, the uptake of Gal-PLGA and Man-PLGA by the liver were significantly inhibited by the presence of Gal-BSA and Man-BSA, respectively. On the other hand, PLL was targeted to the liver without glycosylation. However, Gal-PLL and Man-PLL showed higher accumulation in the liver than unmodified PLL. Although Gal-PLL and Man-PLL showed different distribution between PC and NPC from that of PLL, the effect of the modifications was less pronounced than the cases of PLGA derivatives. In addition, these glycosylated poly(amino acids) investigated, regardless of the type of amino acid or the sugar grafted, were rapidly degraded to be eluted in the low molecular weight fractions in a gel filtration chromatography. These results suggest that glycosylated PLGAs can be useful carriers of low molecular drugs to the liver cells through conjugation, while glycosylated PLLs could be targetable carriers to the cells after the reduction of their cationic charge by complex formation with polynucleotides.

Animals↗
PubMed1998

Multiple appearing and vanishing aneurysms: primary angiitis of the central nervous system. Case report.

The authors present the case of a patient with ischemic episodes and recurrent intracerebral hemorrhages probably caused by primary angiitis of the central nervous system (CNS). An initial angiogram revealed multiple cerebral artery aneurysms as well as vascular wall irregularity; a second angiogram obtained 2 years later, however, did not demonstrate the previous aneurysms but instead showed new ones together with stenosis. Based on the histopathological findings and clinical course in this case, the multiple aneurysms appear to have been induced by vascular wall fragility and subsequent self-repair resulting from primary angiitis of the CNS. The authors present the histological and clinical characteristics of this unusual case of granulomatous, necrotizing CNS vasculitis.

Central Nervous System Diseases↗
PubMed1998

Possible involvement of calcineurin in retinoic acid-induced inhibition of leukemic HL-60 cell proliferation.

Differentiation of leukemic HL-60 cells by all transretinoic acid (ATRA) resulted in a reduced rate of growth. Cyclosporin A and FK506, at concentrations that inhibited calcineurin activity, abrogated the ATRA-induced inhibition of HL-60 cell growth but these immunosuppressants had no effect on the ATRA-induced granulocytic differentiation. Treatment with 1 microM ATRA led to a progressive increase in calcineurin phosphatase activity of HL-60 cells; the increase in this activity appeared to parallel the functional change of HL-60 cells during granulocytic differentiation. Increase in calcineurin activity was concordant with the increased expressions of calcineurin A and calcineurin B subunit proteins. The FKBP12 expression increased during ATRA-induced differentiation and expression of cyclophilin A remained unchanged. We propose that the increased expression of calcineurin is involved in the ATRA-induced inhibition of HL-60 cell proliferation, as in the case with 1,25alpha-dihydroxy-vitamin D3.

Calcineurin↗
PubMed1998

Middle cerebral artery variations: duplicated and accessory arteries.

PURPOSE: Our goal was to analyze the anatomic similarity between the duplicated middle cerebral artery (MCA) and the accessory MCA and their relationship to the early branches of the MCA. METHODS: We reviewed stereoscopic angiograms of duplicated MCAs in four patients and accessory MCAs in four patients with reference to the origin, size, and cortical supply of these anomalous vessels, along with the presence of perforating arteries and the recurrent artery of Heubner (RAH). RESULTS: The duplicated MCAs supplied the cortical territory of the temporopolar and the anterior temporal and/or middle temporal arteries. The accessory MCAs supplied the cortical territory of the orbitofrontal and/or prefrontal arteries. The duplicated MCAs had perforating arteries in three of four cases and coexisted with the RAH in three of four cases, whereas the main MCA had perforating arteries in all four cases. The accessory MCA had perforating arteries in all four cases and coexisted with the RAH in three of four cases, whereas the main MCA had perforating arteries in one of four cases. CONCLUSION: A consistent cortical supply by the duplicated MCA and the accessory MCA to the anterior temporal lobe and the anterior frontal lobe, respectively, and its similarity to the cortical supply by the early branches of the MCA suggest that development of duplicated and/or accessory MCAs is an anomalously early ramification of the early branches of the MCA.

Adult↗
PubMed1998

[Investigation of swimming classes for school children with epilepsy--a questionnaire survey of school nursing teachers].

We obtained informations by means of questionnaires concerning swimming lessons for school children with epilepsy, which were sent to 391 school nursing teachers in Yamaguchi Prefecture. We obtained completed questionnaires from 278 of the 391 nursing teachers (71%). The percentage of 24.5% of the nursing teachers said that they made limitations to the attendance of swimming lessons. More than 20% answered that limitations were necessary for school children even if their attending physicians had permitted them to join the lessons. We suggest that the nursing teachers had more than a few misconceptions regarding epilepsy. For the comprehensive management of epilepsy, it is necessary for medical staffs to cooperate with nursing teachers.

Child↗
PubMed1998

[Indications for external ventricular drainage after clipping of ruptured aneurysms in the acute stage].

The indication for external ventricular drainage after clipping of ruptured aneurysms in the acute stage is evaluated. Since 1990, 234 patients who presented with subarachnoid hemorrhage (SAH) and underwent aneurysmal clipping in the acute stage were evaluated retrospectively. Patients with ventricular dilatation had intraoperative placement of a ventriculostomy to obtain intraoperative brain relaxation, but the ventricular catheter was removed at the end of the surgery. All these patients were managed postoperatively in a similar fashion with no ventricular drainage, avoidance of dehydration complemented by a course of sodium ozagrel and nicardipine or fasudil hydrochloride. Acute hydrocephalus was defined as clinically and radiographically demonstrated ventricular dilatation that developed within 2 weeks of the onset of SAH and that required ventricular drainage. Three surgical approaches were employed; pterional approach (PA) for the aneurysms of the anterior circulation and upper basilar artery in 207 patients, interhemispheric approach (IHA) for the aneurysms of the pericallosal artery in 11 patients and lateral suboccipital approach (LSA) for the aneurysms of the vertebral arteries in 16 patients. No significant differences were found among these three approach groups in Fisher CT classification and the Hunt & Kosnik gradings. Four patients developed acute hydrocephalus within two weeks of surgery: three patients were operated on via LSA and one through IHA. Compared to the IHA or LSA, PA was superior for reestablishing cerebrospinal fluid circulation, because it is possible to remove more subarachnoid clot in the basal cisterns than to do so in the other two approaches. Opening of the lamina terminalis and the Liliequist membrane are also possible using PA. In conclusion, PA can prevent development of acute hydrocephalus, whereas postoperative ventricular drainage may be necessary in patients operated upon via IHA or LSA.

Acute Disease↗
PubMed1998

[Coenzyme Q10].

Explore the source record for details and available documents.

Coenzymes↗
PubMed1998

[Effect of pharmacist's instruction on the treatment of asthmatics with inhaled steroid].

Pharmacist's instruction is provided to asthmatic patients who received an inhaled steroid in Hamamatsu University Hospital. We studied influences of pharmacist's instruction on the repeutic effects of an inhaled steroid, beclomethasone dipropionate (BDP). In 29 patients who had been treated with inhaled BDP under the physician's instruction for more than 3 months, we examined drug compliance, correctness of inhalation procedure and treatment score, symptom score, peak expiratory flow (PEF) values, and compared these before and after the instruction. The instruction was repeatedly provided at an interval of about one month. Patients who followed the indicated regimen were 55.2 and 93.1% before and after the instruction, respectively. An appropriate inhalation maneuver was respectively. An appropriate inhalation maneuver was performed in 24.1 and 93.1% of patients before and after the instruction, respectively. PEF values increased by 12.9 +/- 9.3% (mean +/- standard deviation, p < 0.01) after the instruction. In conclusion, pharmacist's repeated instruction enhanced the therapeutic effects of inhaled BDP in patients with asthma.

Administration, Inhalation↗
PubMed1998

Effects of diversion and reperfusion of pancreaticobiliary juice on amylase release from isolated rat pancreas.

Diversion of pancreaticobiliary juice from the small intestine results in resetting of the normal negative-feedback regulation of exocrine pancreatic secretion. The mechanism by which this process occurs is not well understood. To examine this regulatory process, we investigated the effects of pancreaticobiliary juice diversion and reperfusion on exocrine pancreas using isolated rat pancreatic acini. Two groups of rats were surgically prepared for pancreaticobiliary juice diversion and reperfusion. Both groups received a liquid diet via a duodenal cannula and saline by intravenous infusion for 24 hours following surgery. Forty-eight hours after the surgery and infusions, the rats were sacrificed, and acinar cells were quickly isolated from each pancreas. Amylase release from isolated acini was measured in response to doses of cholecystokinin octapeptide (CCK-8) and carbachol. Acinar cell receptor binding was measured by using CCK-8 labeled with iodine 125 and N-tritium-methscopolamine bromide as radioligands. Amylase release in response to both CCK-8 and carbachol was significantly decreased in the diversion group when compared with that of the reperfusion group. Receptor binding sites of CCK-8 and methscopolamine bromide were similar in the diversion and reperfusion groups. The results suggest that cholecystokinin- and carbachol-mediated amylase response is affected by pancreaticobiliary juice diversion through a process that most likely involves alteration of post-receptor-mediated intracellular signaling pathways.

Amylases↗
PubMed1998

[Correction of left handedness worsened mirror writing in a girl with spastic diplegia].

We experienced a 4-year-11-month old girl with right side dominant spastic diplegia caused by preterm birth and neonatal asphyxia. She tended to use the left hand but showed mirror writing on both hands, which was aggravated by correction of handedness to the right. Magnetic resonance T2-weighted imaging revealed a localized high intensity lesion in the white matter of her left parietal lobe, caused by hypoxic insult and suggested a damage of spatial orientation center. Wechsler Preschool and Primary Scale of Intelligence showed a total IQ of 76, VIQ of 86 and PIQ of 74, revealing borderline intelligence with insufficient visual perception. Frostig visual perception test revealed lower scores of position in space. Spatial confusion caused by a lesion in the left parietal lobe might have induced the mirror writing of this case. Forced correction to use the right hand with damaged left parietal lobe may aggravate spatial confusion and consequently worsen mirror writing.

Cerebral Palsy↗
PubMed1998

[Management of elderly patients with incidentally discovered unruptured aneurysms].

Long-term natural history of unruptured cerebral aneurysms is not found frequently. Hence, the indications for surgery on unruptured asymptomatic cerebral aneurysms are still unclear. The benefit of treatment ultimately depends on the relative risk of subsequent aneurysm rupture in untreated patients versus the risk involved in surgery. Clinical features of fourteen elderly patients aged over 70 years with incidentally discovered unruptured aneurysms were analyzed. Two were male and 12 were female, with ages ranging from 70 to 82 years (mean: 74.5 years). Aneurysms were located in the anterior circulation in 13 patients and in the posterior circulation in 1 patient. One patient had multiple aneurysms, that is, bilateral middle cerebral aneurysms. The size of all these aneurysms was less than 10 mm. The indication for surgery was determined case by case. General information about the natural history of incidentally discovered aneurysms was given to the patients and their relatives. Informed consent was based on the fact that subarachnoid hemorrhage was associated with a poor prognosis, while excellent operative results were common in patients with unruptured aneurysms. Five patients agreed to surgical treatment. Four of them, their ages being 70, 70, 72 and 72 years old, with aneurysms located on the middle cerebral arteries, underwent neck clipping of their aneurysms with no operative morbidity or mortality. However, the remaining one patient was not recommended for surgery in spite of her consent to having it, because of her high age (82 years) and the location of her aneurysm (intracavernous internal carotid artery). Consequently, 10 patients who didn't receive surgery were followed-up at periods ranging from 3 months to 7 years. Two patients developed rupture of the aneurysms, either proven (one patient) or presumed (one patient). The former patient made an uneventful recovery after surgery, but the latter died. None of the remaining eight patients have experienced rupture of the aneurysms. It is our clinical impression, however, that they harbor an unruptured aneurysm with at least mild trepidation. With the rapid aging of the population, withholding aneurysm surgery merely because a patient is elderly may not necessarily be the most appropriate decision. Our conclusions are as follows: (1) Elderly patients in their early seventies are apt to agree to having surgical treatment for their unruptured aneurysms. (2) The cases reported herein show that asymptomatic middle cerebral artery aneurysms were able to be clipped very safely. (3) Most patients have experienced a decrease in quality of life from knowing they are living with an unruptured aneurysm.

Age Factors↗