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Biomedical subjects

N Ishikawa

Publications and source records attributed to N Ishikawa.

At least 127 records · Page 7Linked to original sources
PubMed2000

[A case of spontaneous pneumothorax in pregnancy].

Spontaneous pneumothorax rarely happened in woman compared to man generally. Furthermore, it is said that spontaneous pneumothorax in the pregnancy is very rare. We experienced a case of spontaneous pneumothorax in 32 weeks gestation. She complains chest pain and dyspnea in hospital because of medication to urgent premature. Throcar catheter has been placed after delivery. Video assisted thoracoscopic bullectomy was performed on the next day of the delivery and discharged 5 days after operation. Treatment of spontaneous pneumothorax in pregnancy was believed to be difficult, but she delivered safely because of being under the tube drainage. We believed that the tube drainage during pregnancy or the operation were recommended for these cases because of security of mother and embryo.

Adult↗
PubMed2000

Effect of functional continuous magnetic stimulation for urinary incontinence.

PURPOSE: We evaluated the therapeutic efficacy of continuous magnetic stimulation on urinary incontinence by studying the urodynamic effect on urethral closure and bladder inhibition. MATERIALS AND METHODS: A total of 11 patients with stress incontinence and 12 with urge incontinence (7 males and 16 females, mean age 55.8 years) were evaluated. In the pilot study urethral pressure profile was performed before and after 20 Hz. 15-minute (with 1-minute on/30-second off cycles) stimulation, and maximum intraurethral pressure was recorded during stimulation in stress incontinence cases. Cystometry was performed before and during 15-minute stimulation at 10 Hz. in urge incontinence cases. In the therapeutic study 8 females with stress incontinence, and 3 males and 5 females with urge incontinence were treated with magnetic stimulation twice a week for 5 weeks. RESULTS: In the pilot study maximum intraurethral pressure increased by 34% during stimulation and maximum urethral closure pressure increased by 20.9% (p = 0.0409) after stimulation in stress incontinence cases. In urge incontinence cases significant increases in bladder capacities at first and maximum desire to void during stimulation were noted (p = 0.0164 and 0.0208, respectively). In the therapeutic study 86% of 7 patients with stress incontinence and 75% of 8 with urge incontinence were improved, and 1 dropped out of the study. CONCLUSIONS: Continuous magnetic stimulation was effective on urethral closure and bladder inhibition, and as treatment of urinary incontinence.

Female↗
PubMed2000

[The outcome of treatment with adjusted dose of 131I to thyroid weight for Graves' disease by estimation of effective half life using a single radioiodine uptake measurement].

In the determination of therapeutic 131I doses, it takes several days to measure effective half life (EHL) of radioiodine in thyroid glands (Ordinary method). We suggested the new method to estimate EHL by a single radioiodine uptake measurement (INDEX method). We evaluated the outcome of 131I treatment with these two methods in outpatients with Graves' disease. Eighty outpatients were treated with INDEX method (Group I) and 108 outpatients with Ordinary method (Group O). At the 5-yr follow up, the incidence of hypothyroidism in Group I was 22.5%, subclinical hypothyroidism 8.8%, euthyroidism 30.0%, subclinical hyperthyroidism 13.7% and hyperthyroidism 25.0%. In Group O, 17.6% of the patients were hypothyroid, 16.7% subclinical hypothyroid, 30.5% euthyroid, 9.3% subclinical hyperthyroid and 25.9% hyperthyroid. There were no significant differences between these two methods. We conclude that INDEX method surpasses Ordinary method in timesaver and is equal in effectiveness.

Adult↗
PubMed2000

[Epidemiology and control activities of tuberculosis in Japan].

Tuberculosis has declined in Japan for 50 years, however it is more prevalent than other developed countries and speed of decline is much slower recently in Japan than in European countries in 1950-80s when the incidence rate was almost the same as that in Japan now. Most of old cases were reactivation and most of young cases were those soon after new infection. Early case detection and treatment and cutting the chain of transmission is necessary for the reduction of young cases. The defaulter rate among smear positive new cases is 3.6% and is higher among non-skilled workers. DOT has not been widely done on outpatient clinic basis but should be considered for those who cannot stay in hospitals.

Age Factors↗
PubMed2000

[Quantitative evaluation of nystagmus by an image-analysis system].

PURPOSE: We attempted to apply a newly developed image-analysis system for measurement and analysis of nystagmus. METHOD: Eye movements were recorded by digital video through a head-mounted charge coupled device (CCD) camera. The recorded movie was converted into black and white in order to detect the area of the pupil. Horizontal and vertical eye positions were determined by calculating the centroid of the pupil. Torsional angle was calculated using the iris striate pattern around the pupillary margin. RESULTS: The parameters (amplitude, cycle, etc.) of nystagmus were calculated easily by the new image-analysis system from the recorded images. As examples, the foveation period was measured accurately in a case of jerky-type congenital nystagmus. Very regular cycles of intorsional attack period were revealed in a case of superior oblique myokymia. A case of cork-screw-like nystagmus showed a characteristic combination of large and small cycles unassociated with torsion. CONCLUSION: This image-analysis system was useful for quantitative analysis of nystagmus, and especially for measurement of torsion. Detailed waveforms and specific rhythms of nystagmus, which could not be recognized by observation, were demonstrated by this system.

Adult↗
PubMed2000

[Clinical study of 18 pediatric cadaveric renal transplantations: organ sharing in pediatric renal transplantation after enforcement of the organ transplant law in Japan].

Renal transplantation is considered to be the optimal replacement therapy for children with end-stage renal disease. However, the number of pediatric renal transplants in Japan is much lower than in the USA and/or Europe. Since October 1997, pediatric(< 15 years) recipients are given priority over adult recipients for organ sharing, only if one or two HLA-DR antigen(s) are matched between the recipient and pediatric(< 15 years) donor. However, the number of pediatric transplants is not increasing. One hundred and twenty-four pediatric renal transplantations were performed in Tokyo Women's Medical University between 1983 and 1999, of which 18(14.5%) were cadaveric transplants and the others (106, 85.5%) were living-related transplants. We examined 18 pediatric cadaveric renal transplantations. Seven patients received their graft from pediatric donors less than 15 years of age and 11 from adult donors. The mean age at transplantation was 13.2 years (range 4.5-18.7 years). Major etiologies of renal disease are hereditary renal disease(38.8%), chronic glomerulonephritis(33.3%), and focal segmental glomerulosclerosis[FSGS] (16.7%). Zero matches in HLA-DR locus were observed in 72.2%. Patient survival rate was 100%. Graft survival rates at 1 and 5 years after transplantation were 83% and 64% successively. There was no significant difference between the graft survival of cadaveric and living-related transplantation at 1 and 5 years. All 5 patients who received their graft between 1994 and 1998 have maintained normal graft function. Causes of their graft loss were chronic rejection in 3, recurrence of FSGS in 2, primary non-function in 1, and graft thrombosis in 1. Donor age and HLA-DR mismatching did not affect the outcome. We propose that pediatric renal grafts should be provided to children with priority, regardless of their HLA-A, B and HLA-DR matching.

Adolescent↗
PubMed2000

[Simultaneous abdominal aortic replacement and thoracic stent-graft placement for multiple aortic aneurysms: report of a case].

Patients with aneurysmal disease involving both the thoracic and abdominal aorta have historically required simultaneous or sequential conventional operations. Staged operations were generally preferred, but we experienced that a patient had rupture of the second aneurysm after he finished initial treatment for the first aneurysm. We have implemented simultaneous operation using thoracic stent-graft placement. A 78-year-old male who had multiple aortic aneurysm involving both the thoracic and abdominal aorta underwent conventional abdominal aortic replacement with endovascular stent-graft placement into the distal arch of the thoracic aorta under fluoroscopic guidance. The stent-graft was composed of two units of self-expanding stainless-steel Z stent covered with an thin wall woven Dacron graft. Postoperative aortography showed no stent migration and no endoleak. Simultaneous abdominal aortic replacement and deployment of a thoracic stent-graft may be a valuable treatment option for these patients. However, careful long term follow up is necessary to prove the value and the effects of the endovascular treatment.

Aged↗
PubMed2000

[CPT-11 (irinotecan)--evidence from molecular and pharmacological studies and clinical applications].

Irinotecan (CPT-11) is a derivative of the chemotherapeutic agent Camptothecin. CPT-11 inhibits the nuclear enzyme topoisomerase I. It has demonstrated a broad spectrum of antitumor activity in preclinical tumor model systems. Significant advances have been made toward the understanding of the pharmacokinetics and schedule dependency of this agent. The principal dose limiting toxicities are diarrhea and leukopenia. CPT-11 has been evaluated using a variety of dosing schedules. Two main schedules have been studied and produce similar activity and side-effects: the "Japanese-North American" one where CPT-11 is given at a weekly dose of 100-150 mg/m2 for 4 consecutive weeks followed by a 2 week rest period, and the "European" one-350 mg/m2 every 21 days. CPT-11 has demonstrated significant clinical activity in the treatment of patients with gastrointestinal, pulmonary, gynecologic, and lymphoid malignancies. A recent randomized trial demonstrated a survival advantage in metastatic non-small cell lung cancer and previously untreated metastatic colorectal cancer. Further study of this agent to determine its role in combination chemotherapeutic regimens is currently underway.

Antineoplastic Agents, Phytogenic↗
PubMed2000

[Evaluation of new TNM classification for lung cancer, especially T3N0M0, stage IIIA, stage IIIB, and pm].

The purpose of this study was to evaluate the results of new TNM staging system for lung cancer in 1997, especially T3N0M0, stage IIIA, stage IIIB, and pm. Five-year survival rates of the patients with stage IIIA and stage IIIB were 16% and 18% respectively (NS). Five-year survival rates of patients with T3N1M0, T1N2M0, T2N2M0, and T3N2M0 were 40%, 28%, 15%, and 3%, respectively. The prognosis of T3N2M0 was significantly worse than that of T3N1M0, T1N2M0, and T2N2M0. Five-year survival rates of the patients excluding pm 1 with T4N0M0, T4N1M0, T4N2M0, and T4N3M0 were 21%, 10%, 10%, and 0%, respectively. The prognosis of the patients with T4N0 was significantly better than that of T4N2 and T4N3. In the patients with pm, 5-year survival rates of the patients with pm 1 and pm 2 were 26% and 7%, respectively (p < 0.01). In the patients with pm 1, 5-year survival rates of the patients with N0 + N1 and N1 + N2 were 53% and 16%, respectively (p < 0.01). From our these results, we supported the new TNM system as putting T3N0M0 to stage IIB, putting pm 2 into stage IV. We proposed; 1) chest wall invasion with bone destruction stay in stage IIIA or is T4, 2) T3N1M0 is classified with stage IIB, 3) main stem bronchus invasion is classified with T2, 4) pm 1 is subdivide by N status. Furthermore, stage III seemed to be reasonably subdivided into T1-2N3M0, T4N0-1M0 as stage IIIA and T3-4N2, T1-4N3 as stage IIIB.

Humans↗
PubMed2000

[A case of panpleuropneumonectomy for diffuse pleural mesothelioma].

A 58-year-old man was admitted to our hospital because of chest pain and dyspnea on July 15, 1999. A chest X-ray showed left pleural effusion, and a chest CT revealed left pleural effusion and diffuse pleural thickening. Because pleural fluid cytology and percutaneous needle pleural biopsy were negative for malignancy, thoracoscopic biopsy was performed on July 28. The biopsied specimen revealed malignant pleural mesothelioma (epithelial type). An operation was performed on August 16. First, mediastinal lymph node dissection was performed and we identified that there was no lymph node metastasis by frozen section diagnosis. Then panpleuropneumonectomy with combined resection of the diaphragm and pericardium was performed.

Diaphragm↗
PubMed2000

Elevated tissue factor circulating levels in children with hemolytic uremic syndrome caused by verotoxin-producing E. coli.

BACKGROUND: Microvascular thrombosis in the kidney plays an important role in the pathogenesis of hemolytic uremic syndrome (HUS). Tissue factor (TF), present on the vascular surface of endothelial cells, binds factor VIIa. The complex initiates the coagulating cascade by activating factors X and IX. PATIENTS AND METHODS: In cases of HUS associated with verotoxin-producing E. coli (VTEC) infection, VTEC gastroenteritis without HUS and normal controls, we measured plasma concentrations of TF and tissue factor pathway inhibitor (TFPI) to evaluate their clinical significance. In children with non-HUS chronic renal failure (CRF), the TF levels were also measured as another control group. RESULTS: In the acute phase of HUS, plasma levels of TF and TFPI were significantly elevated, then returned to normal range in the recovery phase. The TF levels were closely correlated with the thrombin antithrombin-III complex, a marker of thrombin activity in circulating blood, and with creatinine clearance (Ccr). Furthermore, a positive correlation was noted between plasma TF levels and plasma soluble thrombomodulin (sTM) levels, which is a marker of endothelial cell injury. The influence of decreased excretion from damaged kidneys should be considered since a definite lot correlation was observed between plasma TF levels and Ccr in children with non-HUS CRF. CONCLUSION: From these findings, we concluded that elevated TF circulating levels may also play an important role in blood-clotting activation observed in VTEC-HUS patients, and may also be a useful marker for renal damage.

Case-Control Studies↗
PubMed1999

Protective role of nitric oxide synthase against ischemia-reperfusion injury in guinea pig myocardial mitochondria.

In guinea-pig myocardial mitochondria preparation, lowering the Ca2+ concentration or pH level in the perfusate rapidly elevated the fura-2 Ca2+ signal ([Ca2+]m). Pretreatment with 10(-4) M L-Arg inhibited the rapid [Ca2+]m influx, whereas administration of 10(-4) M L-NAME did not, suggesting some association between nitric oxide (NO*) synthase (NOS) activation and Ca2+ kinetics in mitochondria. Immunoblotting analysis showed that endothelial (e)-NOS was present in mitochondria, but not inducible (i)-NOS or brain (b)-NOS. Electron microscopy observations revealed that the e-NOS antibody-reactive site in the mitochondria was the inner cristae. The production of reactive oxygen species and NO* in isolated mitochondria was detected by the spin trapping technique with electron paramagnetic resonance (EPR) spectrometry. Pretreatment with 10(-5) M S-nitroso-N-acetyl-DL-penicillamine (SNAP) and 10(-5) M 3-[2-Hydroxy-1-(1-methylethyl)-2-nitrosohydrazino]-1-propananin e (NOC 5), which spontaneously generate NO*, completely inhibited the [Ca2+]m uptake. In addition, N-morpholino sydnonimine hydrochloride (SIN-1) (10(-5) M), which simultaneously generates NO* as well as *O2- and peroxynitrite anion (ONOO-), inhibited the increase in [Ca2+]m. ONOO- (3 x 10(-4) M) itself also inhibited this increase. Pretreatment with the *O2(-)-scavenger manganese superoxide dismutase or catalase (200 units/ml) completely inhibited the increase in [Ca2+]m caused by lowering of either the Ca2+ concentration or the pH in the perfusate. These results suggested that the formation of reactive oxygen species promoted the [Ca2+]m influx. The agents that inhibited the [Ca2+]m influx improved contractility even in Langendorff preparations after ischemia. Based on these findings, we concluded that e-NOS exists in mitochondria and that NO* may play an important protective role in reperfusion cardiac injury after ischemia, by inhibiting the Ca2+ influx into mitochondria which are otherwise damaged by *O2-.

Animals↗
PubMed1999

Surface strain distribution on thoracic and lumbar vertebrae under axial compression. The role in burst fractures.

STUDY DESIGN: The surface strain distribution on the thoracic and lumbar vertebrae during axial compressive loading was examined. OBJECTIVES: To examine the general mechanical behavior of the thoracic and lumbar vertebrae to evaluate their role in burst fractures. SUMMARY OF BACKGROUND DATA: Burst fractures are generally characterized by injury to the middle column and fracturing of the superior endplate. However, results in previous biomechanical investigations have not shown how these fractures are initiated during compression. METHODS: Twenty-one thoracic and lumbar vertebrae (5 T10, 10 L1, and 6 L4) with upper and lower vertebrae were studied. Three-axis rosette strain gauges were cemented to 11 sites on the vertebral surface. An axial compressive load was applied, and the strain was measured in each specimen. The strain recorded by each rosette gauge was converted into a tensile, compressive, and shear component. RESULTS: The highest tensile and compressive strain was recorded at the base of the pedicle. Shear strain in the vertebral body was significantly higher than that in the lamina at all three spinal levels. At L1 and L4, the tensile strain at the superior vertebral rim was higher than that at the inferior rim. CONCLUSIONS: The high tensile and compressive strains found at the base of the pedicle of T10, L1, and L4 indicate that the base of the pedicle is the site of fracture initiation. The higher tensile strain at the superior vertebral rim of L1 and L4 supports the clinical observation of the thoracolumbar burst fractures.

Aged↗
PubMed1999

Restriction fragment length polymorphisms analysis by pulsed-field gel electrophoresis for discrimination of Staphylococcus aureus isolates from foodborne outbreaks.

A number of outbreaks of disease due to Staphylococcus aureus occurring in Aichi-ken, Japan, have provided the opportunity to investigate aspects of the molecular epidemiology of this and related organisms. Coagulase types, enterotoxin types, phage types, and restriction fragment length polymorphisms (RFLPs) as assessed by pulsed-field gel electrophoresis (PFGE) was performed for S. aureus infections diagnosed in the area of Aichi-ken. Among the 56 isolates of S. aureus from 30 outbreaks, 15 distinctive RFLP types were found by digestion with the restriction enzyme, SmaI. A total of 32 isolates from patients, foodstuffs and cooks on six occasions had the same RFLP types, coagulase types, enterotoxin types and phage types in the same outbreaks. Moreover, the coagulase and phage types could be separated in terms of RFLP. In one outbreak, ten isolates, which were derived from six patients, two foodstuffs and two cooks, had the same coagulase type, enterotoxin type, phage type, and RFLP type. This PFGE method may therefore prove useful for subclassifying S. aureus and differentiating isolates of the same coagulase types and phage types derived from sporadic cases and those derived from foodborne outbreaks.

Bacteriophage Typing↗
PubMed1999

BQ788, an endothelin ET(B) receptor antagonist, attenuates stab wound injury-induced reactive astrocytes in rat brain.

Endothelins (ETs) are suggested to be involved in pathological or pathophysiological responses on brain injuries. In the present study, an involvement of ETs on activation of astrocytes in vivo was examined by using selective endothelin receptor antagonists. A stab wound injury on rat cerebral cortex increased immunoreactive ET-1 at the injured site. GFAP-positive [GFAP(+)] and vimentin-positive [Vim(+)] cells appeared at the injured site in 1 day to 2 weeks after the injury. A continuous infusion of BQ788, a selective ETB receptor antagonist, into cerebral ventricle (23 nmole/day) attenuated increase in the numbers of GFAP(+) and Vim(+) cells after the injury. FR139317, a selective ETA antagonist (23 nmole/day), slightly decreased the number of Vim(+) cells but not that of GFAP(+) cells. Increase in the number of microglia/macrophages by a stab wound injury, which was determined by Griffonia simplicifolia isolectin B4 staining, was not affected by BQ788 and FR139317. These results suggest that activation of glial ETB receptors is one of the signal cascades leading to reactive astrocytes on brain injuries.

Animals↗
PubMed1999

Induction of urethral closure and inhibition of bladder contraction by continuous magnetic stimulation.

Magnetic stimulation has been considered to be a technique for stimulating nervous system noninvasively and it has been used for experimental and clinical testings on the central and peripheral nervous systems. However, commercially available magnetic stimulators can only discharge single pulses for less than several minutes because the coil soon overheats. We newly devised a continuous magnetic stimulator assuring long-time stimulation, and this study was designed to confirm whether continuous magnetic stimulation would result in urethral closure and inhibition of bladder contraction in anesthetized canine models. Twelve female beagle dogs, weighing 9 to 12 kg, were anesthetized with a mixture of alpha-chloralose and urethane. In six beagles, a 4 F microtip transducer was inserted transurethrally, and maximum intraurethral pressure was monitored. In the remaining six animals, urethra was ligated at the bladder neck and a 4 F double lumen catheter was inserted from the dome of the bladder to infuse physiological saline, monitoring iso-volumetric rhythmic bladder contraction. The stimulating coil, of which temperature was kept at 20-25 degrees C by the built-in cooling system, was placed on the ishio-rectal fossa to stimulate the pudendal nerve at 10 Hz. The intraurethral pressure increased by 69.1 +/- 27.8 cm H(2)O, and iso-volumetric rhythmic bladder contraction was inhibited during the stimulation with 80% (240 Joule) of maximum output. In conclusion, continuous magnetic stimulator was found effective for urethral closure and inhibition of bladder contraction. Neurourol. Urodynam. 18:505-510, 1999.

Animals↗
PubMed1999

Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography.

To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP (12.8+/-1.4 degrees vs. 14.6+/-2.2 degrees, p < 0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9+/-23.7% whereas that in VAP patients was -9.1+/-17.3% (p < 0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients.

Adult↗