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Biomedical subjects

M Tanabe

Publications and source records attributed to M Tanabe.

At least 145 records · Page 8Linked to original sources

Endoscopic retrograde cholangiopancreatography (ERCP) in biliary tract disease of infants less than one year old.

We performed a total of 75 examinations with endoscopic retrograde chlangiopancreatography (ERCP) in 73 infants aged from 8 days to 300 days (mean 71 days) between 1977 and 1995. ERCP examination was performed with a prototype duodenoscope and was successful in 47 of 52 examinations in biliary atresia, 9 of 11 in neonatal hepatitis, all 4 in paucity of intra-hepatic bile duct, 4 of 5 in congenital biliary dilatation, 1 of 2 in duodenal stricture, and 1 case of in postoperative jaundice of hepatoblastoma. In 46 infants with biliary atresia, excluding one in whom the findings could not be evaluated due to poor x-ray image quality, we distinguished the following four patterns of ERCP findings: Pattern 1, only the pancreatic duct could be demonstrated and no bile duct was visualized (76%); Pattern 2, only a part of the distal common bile duct with the pancreatic duct was visualized (2%); Pattern 3, the entire length of the common bile duct with the pancreatic duct was visualized without the gallbladder and the common hepatic duct (4%); and Pattern 4, the common bile duct and the gallbladder with the pancreatic duct were visualized without the common hepatic duct (18%). In all of these 46 patients, laparotomy, an operative cholangiogram, and histological evaluation of the biliary duct were performed. In 9 neonates with neonatal hepatitis, the biliary tract was opacified and biliary atresia was excluded. Laparotomy was thus avoided in these neonates. There was no complication caused by either ERCP or by anesthesia.

Anesthesia↗

The role of three-dimensional computed tomography in the management of maxillofacial bone fractures.

The findings of three-dimensional computed tomography (3DCT) and two-dimensional computed tomography (2DCT) with helical CT scanning were compared for 21 patients with maxillofacial bone fractures. The results of this study suggest that the 3DCT evaluation can be divided into 3 groups. The first group, in which 3DCT is superior to 2DCT, includes severe complicated midface fractures, for example, tripod fractures and complicated maxillary bone fractures. The second group, in which 3DCT is equal to 2DCT, includes simple fractures, for example, nasal bone fractures and isolated zygomatic fractures. In this group, patients and their families could easily understand the nature of the fracture and clinical course shown by 3DCT as compared with conventional X-ray and 2DCT. The third group, in which 3DCT is inferior to 2DCT, includes blowout fractures. Although 3DCT does not provide additional information is blowout fractures, helical scanning permits clear observation of multiplanar images without artifacts arising from metal prostheses by excluding lower slices during image reconstruction. We conclude that 3DCT provides useful information, especially in regard to the extent of complex fracture lines, as in tripod fractures.

Fractures, Bone↗

Detection of subependymal veins using high-resolution magnetic resonance venography.

High-resolution magnetic resonance venography (HR-MRV) of intracranial subependymal veins using a two-dimensional Fourier-transform time-of-flight technique was performed on normal volunteers and clinical cases of cerebral disease. For the pulse sequence, fast-field-echo sequence was used with the following parameters: TR/TE/flip angle = 34 ms/12 ms/50 deg., 256 x 256 matrix, 1 mm effective slice thickness, 150 mm field of view, and one signal acquisition. Sequential vertical coronal sections were taken against the skull base. The anterior septal vein, the medial atrial vein, the anterior caudate vein and thalamostriate vein were detected in all subjects. In all clinical cases, HR-MRV was equal in diagnostic capability to conventional cerebral angiography.

Adult↗

Use of fluid-attenuated inversion recovery (FLAIR) pulse sequences for differential diagnosis of hepatic hemangiomas and hepatic cysts.

Fluid-attenuated inversion recovery (FLAIR) imaging of hepatic hemangiomas (10 patients, 16 lesions) and hepatic cysts (8 patients, 10 lesions) was performed. All hemangiomas were hypointense on T1-weighted images and hyperintense on T2-weighted images. With Gd-DTPA (0.1 mmol/kg), all hemangiomas were enhanced but not all cysts. It was necessary to perform contrast enhanced imaging to differentiate hepatic hemangiomas from hepatic cysts. However, on FLAIR imaging, hepatic hemangiomas were strongly hyperintense and 9 of the 10 hepatic cysts were isointense. One of the hepatic cysts was slightly hyperintense. FLAIR images were useful in differential diagnosis of hepatic hemangiomas and hepatic cysts without using Gd-DTPA.

Cysts↗

[An autopsy case of anti-neutrophil cytoplasmic antibodies associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma].

Here we report an autopsy case with anti-neutrophil antibodies (ANCA) associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma. A 69-year-old woman was admitted to Tokyo Metropolitan Ohtsuka Hospital in October 1995 because of leg edema. She had presented cough in 1990 and diagnosed as interstitial pneumonia, esophageal varices and liver chirosis. On admission, laboratory data showed mild anemia, hypoproteinemia, and marked gammagloblinemia. IgM-HA antibody, HBs antigen, HBs antibody, HCV antibody and HDV antibody were negative. Anti-nuclear antibody, anticentromere antibody, anti-neutrophil cytoplasmic antibody against myeloperoxidase and cathepsin G (MPO-ANCA and cathepsin G), rheumatoid factor and direct coombs test were positive. Serum level of AFP and CEA were elevated. Ultrasonography and computed tomography of abdomen scowed liver chirosis and tumor in left lobe of liver. The diagnosis of liver chirosis based on autoimmune hepatitis and Interstitial pneumonia was made with clinical course, laboratory findings and radiographic findings although liver biopsy was not performed. She complained of bloody stool due to ulcer of the large intestine, and died of liver failure which progressed rapidly. The autopsy findings detected that pulmonary fibrosis, liver fibrosis with multiple hepatocellular carcinoma, necrotizing crescentic glomerulonephritis, and vasculitis of small artery inn colon. This was the first report of MPO-ANCA associated vasuculitis complicated with autoimmune hepatitis and hepatocellular carcinoma. Clinical significance of ANCA and immunogenetic background of these diseases were discussed.

Aged↗

Influence of the upper respiratory tract infection on tubal compliance in children with otitis media with effusion.

To clarify the influence of inflammation on tubal compliance in children with otitis media with effusion (OME), we investigated the change of compliance of the ET by upper respiratory tract infection (URTI) in 18 children (23 ears) with OME using the forced response test. The tubal compliance index (TCI), the ratio of passive tubal resistances at two different airflow rates, significantly increased during URTI represented by acute rhinitis or paranasal sinusitis in comparison with non-URTI periods (paired t-test: t = 4.14, p < 0.001). In nine ears, the TCI could be followed for some months after that, during which the children had had URTI several times. A clear reproducible correlation was found between the presence or absence of URTI and the TCI values; the TCI values increased again during URTI and decreased after the URTI periods. These results seemed to support our hypothesis that compliance of the ET may depend not only on the property of the cartilaginous framework of the ET but also upon the mucosal condition.

Child↗

[131I SPECT-imaging with body outline using convenient lightweight source].

In order to make the body outline clearly in SPECT images, we devised a simple line source holder with the objectives to have a lightweight line source, to reduce the radiation exposure to the staff and to make the system readily available. This technique was applied to evaluate the localizing lesions in patients with radioiodine treatment of thyroid cancer. 131I-SPECT imaging with body outline was found to be effective in 86.7 percent (13/15) of the cases compared with planar imaging. Clinically, the results significantly helped in the discrimination between cervical lymph node metastasis and thyroid bed, and between mediastinal lymph node metastasis and bone metastasis. In the case of multiple lung metastasis demonstrating diffuse accumulation in the lung fields, 131I-SPECT imaging with body outline did not provide an increase in sensitivity compared with planar imaging. This method is easy to perform and it is considered to be useful for localization of abnormal accumulation, relative to the body outline.

Aged↗

Intraarterial infusion of papaverine in experimental cerebral vasospasm.

PURPOSE: To determine the effectiveness of intraarterial infusion of papaverine hydrochloride (PPV) in an experimental model of cerebral vasospasm and to measure the mean blood flow velocity of the middle cerebral artery (MCA). METHODS: Seven Japanese monkeys were divided into three groups: those studied 3 days-after surgery (the third-day group, n = 3); those studied 7 days after surgery (the seventh-day group, n = 3); and a control group (n = 1). Vasospasm was induced in the experimental groups by placing a blood clot in the subarachnoid space around the top of the internal carotid siphon. PPV (5 mg/kg) was infused (over 60 minutes) into the internal carotid artery (ICA). The vascular diameters of the ICA and MCA were measured on angiograms before and after infusion. The mean blood flow velocity in the MCA was measured on transcranial Doppler sonograms before and 24 hours after infusion. After fixation, the MCA was dissected out, stained, and examined microscopically. RESULTS: After vasospasm induction, both arteries were narrowed more than 30% in the third-day group and more than 50% in the seventh-day group. After PPV infusion in both groups, vascular dilatation of about 20% was seen. The mean increase in blood flow velocity in the third-day group (30%) was smaller than in the seventh-day group (70%). The mean blood flow velocity in the MCA decreased by about 30% in both groups, but increased again after 24 hours nearly to the level before PPV infusion. The intimal layer was more corrugated in the seventh-day group, and hypertrophy in the smooth muscle layer was also seen. Clinical examination showed no neurologic deficit in the third-day group 24 hours after PPV infusion; neurologic deficits were observed in the seventh-day group. CONCLUSION: PPV infusion may be more effective in early stages of vasospasm when vascular walls have fewer histologic changes.

Animals↗

Benign osteoblastoma of the temporal bone.

We report a case of benign osteoblastoma arising in the temporal bone of a 28-year-old woman. Plain radiography showed a mass with an amorphous calcified matrix and a thin radiolucent marginal zone. CT and MR imaging were useful in delineating the extent of the tumor, and angiography showed its hypervascularity. Preoperative transarterial embolization was effective in reducing bleeding during surgery.

Adult↗

[Effect of glucose-insulin infusion on thallium-201 chloride tumor imaging].

Thallium-201 chloride (201Tl) kinetics, may be affected by serum insulin levels like potassium kinetics. The purpose of the present study was to use glucose and insulin to improve 201Tl accumulation in the tumor. The results showed that the tumor-to-normal tissue ratio after simultaneous injection of 201Tl, glucose and insulin was significantly higher than that after the injection of only 201Tl, and that a ring appearance seemed to occur after glucose and insulin injection. This preliminary study suggests that 201Tl accumulation in the tumor is enhanced by glucose and insulin administration.

Animals↗

[Effectiveness of percutaneous transluminal angioplasty and intra-arterial papaverine infusion for symptomatic vasospasm after subarachnoid hemorrhage].

PURPOSE: To evaluate the clinical effectiveness of PTA and/ or intra-arterial infusion of papaverine (PPV) for the treatment of symptomatic vasospasm after subarachnoid hemorrhage. MATERIALS AND METHODS: From September 1989 to March 1996, twenty patients with symptomatic vasospasm were treated by PTA and/or intra-arterial infusion of PPV. Nine of the patients were treated by only PTA, eight by only PPV infusion, and three by both PTA and PPV infusion. Early clinical results were evaluated within 48 hours after treatment. Changes in the mean flow velocity (MFV) of the M1 segment as determined by TCD before and after treatment were also evaluated. RESULTS: Six of the nine patients (66.7%) treated only by PTA, six of the eight patients (75%) treated only by PPV, and all three patients (100%) treated by both PTA and PPV infusion showed improvement of neurological deficits within 48 hours after treatments. CONCLUSION: PTA was effective for main trunk vasospasm, while PPV infusion was more effective for peripheral severe vasospasm in recovery from neurological deterioration after subarachnoid hemorrhage. Use of both treatments further increased the effectiveness.

Adult↗

[Construction of pulmonary time-volume curve using MR: comparison with lung volume measurements using CT].

This study was conducted to investigate the effectiveness of dynamic pulmonary ventilation using MR and to compare it with lung volume measurements using CT. MR images during tidal breathing and CT images at resting expiratory level were obtained in 7 normal volunteers. The correlation between lung volume using CT and that using MR at resting expiratory level was significant (r = 0.993, p < 0.001). Pulmonary time-volume curves for each lobe were constructed by applying a Fourier series. The technique used in this study appears to be potentially useful to assess lobar lung function non-invasively and quantitatively.

Adult↗

Technetium-99m-MIBI and thallium-201 scintigraphy of primary lung cancer.

UNLABELLED: We evaluated the usefulness of 99mTc-MIBI scintigraphy in primary lung cancer in comparison with 201Tl-chloride scintigraphy. METHODS: There were 45 patients with primary lung cancer. All patients underwent dual-isotope imaging with 201Tl-chloride and 99mTc-MIBI. Regions of interest were placed over the tumors (T) and contralateral normal lung tissue (N) on one coronal view in the SPECT, and T/N ratio and retention index were calculated. RESULTS: The positive rate was 98% in both the early and delayed images for 201Tl-chloride and 96% in the early and 89% in the delayed image for 99mTc-MIBI. Both early and delayed T/N ratios for 201Tl-chloride were higher than those for 99mTc-MIBI. There was no significant correlation between T/N ratio and histological type of tumor in both images. However, in both images, there was a tendency for the early and delayed ratios to increase as the tumor diameter became larger. The retention index of 201Tl-chloride was higher than that of 99mTc-MIBI. There were no significant differences in the retention index with respect to the histological type and tumor size. CONCLUSION: The results of this preliminary clinical study suggest that 99mTl-MIBI can depict primary lung cancer similar to 201Tl-chloride. However, T/N ratio and retention index of 99mTc-MIBI in the tumor areas are significantly lower compared with those of 201Tl-chloride.

Adult↗

[A case of microscopic polyangitis accompanied by hearing loss as the initial sign of the disease].

Here we report a case of microscopic polyangitis (MPA) with anti-neutrophil cytoplasmic antibodies against myeloperoxidase (MPO-ANCA) accompanied by perceptive dominant hearing loss as the initial sign of the disease. A 52-year-old woman was admitted to Tokyo Metropolitan Ohtsuka Hospital in April 1996 because of bilateral progressive hearing loss. On admission, she had presented bilateral perceptive hearing loss, fever, myalgia, and weight loss. Laboratory data showed accelerated erythrocyte sedimentation rate, proteinuria, microscopic hematuria, leukocytosis, hypoproteinemia, and elevated creatinine level. Serum level of MPO-ANCA was elevated. Chest X-ray and computed tomography showed mild pleural effusion and interstitial shadow in bilateral lung fields. The biopsy findings detected that focal glomerulonephritis, and necrotizing angitis of small artery in kidney. The diagnosis of MPA was made with clinical course, laboratory findings, radiographic findings, and biopsy finding. Treatment was initiated with 45 mg of prednisolone, followed by marked improvement of hearing loss and decreased titer of serum MPO-ANCA. There are only seven reports showing hearing loss as the initial sign of the disease occurred in polyarteritis nodosa and MPA. The present case suggests the possibility that hearing loss may be the symptom of MPO-ANCA associated vasculitis.

Anti-Inflammatory Agents↗

Reperfusion causes significant activation of heat shock transcription factor 1 in ischemic rat heart.

BACKGROUND: The myocardial protective role of heat shock protein (HSP) has been demonstrated, and there has been increasing interest in stress response in the heart. We examined the DNA-binding activity of heat shock transcription factor (HSF), by which the transcription of heat shock genes is mainly regulated, during heat shock or ischemia/reperfusion in isolated rat heart. METHODS AND RESULTS: Rat hearts were isolated and perfused with Krebs-Henseleit buffer by the Langendorff method. Whole-cell extracts were prepared for gel mobility shift assay using oligonucleotides containing the heat shock element, which is present upstream of all heat shock genes. Induction of mRNAs for HSP70, HSP90, and GRP78 (glucose-regulated protein) was examined by Northern blot analysis. Although the activation of HSF during global ischemia was weak and rapidly attenuated, postischemic reperfusion induced a significant activation of HSF. In addition, although HSP70 mRNA was hardly induced during ischemia, its burst induction was detected during postischemic reperfusion. Supershift assays using specific antisera for HSF1 and HSF2 revealed that ischemia/reperfusion as well as heat shock induced the activation of HSF1 in hearts. Although the expression of HSP70 mRNA during heat shock was more vigorous than the expression during ischemia/reperfusion, the induction of HSP90 mRNA in postischemic reperfusion was significantly greater than that in heat shock. CONCLUSIONS: Our findings demonstrated that reperfusion causes a significant activation of HSF1 in ischemia-reperfused heart. The striking contrast between the induction of HSP70 mRNA and that of HSP90 mRNA suggests the presence of regulatory mechanisms other than HSF.

Animals↗

Preferential enhancement of inhibitory synaptic transmission by CS-722 in the ventral horn neurons of neonatal rat spinal cord.

We studied the modulatory effect of (R)-4-chloro-2-(2-hydroxy-3-morpholinopropyl)-5-phenyl-4-isoxaz olin-3-one hydrochloride (CS-722), a centrally acting muscle relaxant, on synaptic transmission in the ventral horn neurons of neonatal rat lumbar spinal cord in slices using whole cell recording techniques. Pharmacologically isolated excitatory or inhibitory postsynaptic currents (EPSCs and IPSCs) were evoked by stimulating neighboring neurons. CS-722 preferentially enhanced IPSCs with little effects on EPSCs. Moreover, CS-722 reduced paired pulse facilitation of gamma-aminobutyric acid (GABA)-mediated IPSCs, suggesting its action on the presynaptic terminal. Preferential facilitatory effects on inhibitory synaptic transmission seem to be one of the mechanisms underlying muscle relaxation of this compound.

Animals↗

Paired pulse facilitation of GABAergic IPSCs in ventral horn neurons in neonatal rat spinal cord.

Whole-cell patch-clamp recording of GABAergic inhibitory postsynaptic currents (IPSCs) were made in ventral horn neurons of neonatal rat lumbar spinal cord in slice. In contrast to the hippocampus where paired pulse depression is reported to be observed for GABAergic IPSCs, double pulse stimulation of GABAergic inputs resulted in enhancement in the amplitude of the second IPSC in the spinal ventral horn. The facilitation ratio was decreased during enhanced synaptic transmission by increasing Ca2+ concentration in the external recording solution. Baclofen and adenosine. which are reported to depress synaptic transmission by presynaptic mechanisms, depressed IPSCs and increased the facilitation ratio. A postsynaptic manipulation such as application of bicuculline or changing the driving force did not affect the facilitation ratio. These results suggest that paired pulse facilitation of GABAergic IPSCs observed in neonatal rat spinal ventral horn appears to be based upon a mechanism similar to that underlying frequency-dependent facilitation of excitatory synaptic transmission, and is sensitive to presynaptic changes in synaptic strength.

Adenosine↗