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Biomedical subjects

N Kikuchi

Publications and source records attributed to N Kikuchi.

216 records · Page 12Linked to original sources
PubMed1979

[Clinical studies on PC-904 in biliary tract diseases (author's transl)].

The clinical effects of PC-904, a new semisynthetic penicillin, were studied in patients with biliary tract diseases, and the results were as follows: 1) PC-904 showed an average peak serum level of 40.7 +/- 11.6 microgram/ml 2 hours after an intravenous drip infusion of 1 g of the agent. The biliary level showed a peak value of 126.5 +/- 85.4 microgram/ml 2 hours to 3 hours after the infusion. 2) Isolated organisms from bile before the treatment were E. coli, Klebsiella, Proteus, Pseudomonas, Enterococcus and Bacteroides. MIC of PC-904 on 18 strains of isolated organisms was almost 6.25 microgram/ml or less. All isolated organisms except one strain of Klebsiella oxytoca disappeared after the treatment. 3) Six patients with cholelithiasis were medicated with PC-904 to prevent post-operative infections. The clinical effects were good in 4, poor in 1 and unknown in 1 case. 4) As to side effects no adverse reactions and allergic reactions were noted. Also no significant abnormalities of laboratory findings were observed.

Ampicillin↗
PubMed1977

[Therapy for severe anaerobic infections with clindamycin (author's transl)].

Ten adult patients with severe Bacteroides infections were treated with 0.9 approximately 1.8 g/day of parenteral or oral clindamycin, and a child was treated with 0.3 g/day orally. Remarkable responses and cures were obtained in all the patients, who had no underlying diseases and pure anaerobic infections; a case of sepsis, two cases of liver abscess, a case of subcutaneous abscess and a case of spinal epidural abscess. The other six patients who had ultimately fatal underlying diseases or mixed infections did not respond well to the combination of clindamycin and the other antibiotics therapy, althought bacteriological cures were obtained in all but two cases. Clindamycin was well tolerated and generally nontoxic, nevertheless it was administrated for long term (34 approximately 49 days). But transient development of transaminase was seen in a patient. The data suggested that clindamycin should be considered a first choice antibiotic for the treatment of an aerobic, especially, Bacteroides infections.

Abscess↗
PubMed1976

Studies on the relationship between the histological changes and liver cell function or plasma proteins in hepatic diseases.

Histological changes of liver biopsy specimens were compared with functioning liver cell mass estimated by an index, ICG capacity, and with plasma levels of various proteins, in 85 patients with liver diseases. IGC capacity was inversely proportional to the degrees of liver cell degeneration and lymphocyte infiltration in the portal tracts and parenchyma, in contrast to plasma disappearance rate of ICG (K), which was inversely proportional to the degrees of portal tract fibrosis and bridge formation. Among the plasma proteins synthesized in the liver, the plasma levels of prealbumin, and alpha1-acid glycoprotein showed the tendencies to decrease with the increase in the degrees of liver cell degeneration. The levels of ceruloplasmin, haptoglobin beta1A/C and transferrin were proportional to the degree of the degeneration. Plasma albumin had no correlation to any histological change. The plasma levels of gamma-globulin and IgG were both proportional to the degrees of portal tract fibrosis and bridge formation. IgM also paralleled to the degree of the fibrosis. The level of IgA was inversely proportional to the degree of liver cell swelling. It was concluded that quantitative estimations of some histological changes in the liver are valuable for the estimations of liver function and the grade of the diseases of the liver.

Blood Proteins↗
PubMedDate not supplied

CT and MR findings of torsion of greater omentum: a case report.

We report a case of torsion of the greater omentum, which occurred in a 39-year-old man with an adhesive inguinal hernia. Preoperative computed tomography and magnetic resonance (MR) imaging showed a characteristic whirling fatty mass occupying the middle and lower abdomen anteriorly. MR imaging also showed difference of intensities in the twisted omentum, suggesting the presence of the pathological conditions of edema or congestion.

Adult↗
PubMedDate not supplied

Do bone ingrowth processes produce a globally optimized structure?

A topology optimization program was applied to test the hypothesis that bone adaptation to porous coated implants produces a structure which minimizes the global strain energy density. The program was used to predict the optimal material layout around a porous coated tibial component with multiple cones [Goldstein et al., Trans. 37th ORS, p. 92 (1991)]. The sensitivity of the predicted adaptation to analysis assumptions was assessed and the predicted bone ingrowth and apposition were compared with the experimental findings of Goldstein et al. The results showed that apposition occurred consistently at the cone tips regardless of analysis assumptions. The specific topology of apposition at the cone tips was most sensitive to the assumed loading conditions. A comparison with the experimental results for 11 subdivisions showed that the general predicted location of material agreed with the experimental results (R2 > or = 0.59). However, the program predicted a consolidated bone greater than 1000 microns in thickness at the cone tips, which differed from the porous bone structure found experimentally. This discrepancy was reflected in a refined comparison over 31 subdivisions which did not produce a significant correlation (R2 < or = 0.3). The program also predicted little ingrowth (< 6-7%), indicating that ingrowth past the first bead layer contributed little to the overall bone-implant interface layer stiffness. Based on these results, we conclude, within limitations of a two-dimensional analysis, that bone adaptation to porous coated implants does not produce a structure solely optimized to minimize the global strain energy density. We hypothesize that the final bone structure reflects the need to meet both mechanical and nutritional demands.

Adaptation, Physiological↗
PubMedDate not supplied

Attachment of a balloon to a transesophageal echocardiographic transducer for improvement of contact with the esophageal wall.

We attached a water-inflated balloon to a transesophageal probe to improve contact of the transducer with the esophageal wall and used it in 26 patients with congenital heart disease. Balloons for this study were made for use in hemostatic therapy for esophageal varix. The contact of the transducer with the esophageal wall was successfully improved in all the patients, which resulted in improvement of the signal-to-noise ratio in both two-dimensional and Doppler echocardiography. The appropriate filling volume of water was within 5 ml to avoid compression of the left pulmonary vein and to avoid the artifact of multiple reflection.

Adolescent↗
PubMedDate not supplied

Alzheimer's disease and estrogen.

The preventive effect of estrogen on Alzheimer's disease (AD) has become clear with epidemiological data. Therapeutic effects of estrogen have not yet been established. In this presentation, we report our new basic and clinical data. The estrogen receptor, (ER)alpha, and ERbeta mRNA were investigated in rat brain. Estradiol-17beta (E(2)) treatment following OVX reduced the levels of ERalpha mRNA in the hypothalamus. In the substantia innominata (SI), the number of choline acetyltransferase immunoreacive cells increased significantly in the estrogen treatment rat. The neurons in SI projecting to the forebrain cortex contained ERalpha. Increasing amounts of intracellular calcium, peroxidation, and apoptosis with amyloid beta were suppressed in neuronal cells from rat pheochromocytoma (PC12) cells with E(2). ERalpha cDNA transfected PC 12 cells elaborated more neurite-like processes with E(2). In clinics, we are currently preparing vaginal progesterone tablets, which essentially may concentrate in the endometrium to prevent endometrial cancer, with few general circulation of progesterone inviting less depression. The therapeutic effects of cyclic estrogen, such as its preventive effect, are suggested in these studies, at least on mild AD.

Alzheimer Disease↗
PubMedDate not supplied

Atheroprotective effect of estriol and estrone sulfate on human vascular smooth muscle cells.

In patients with atherosclerosis, fibrosclerotic focuses are induced by multiplication of vascular smooth muscle cells (VSMC), and they are regulated by cytokines and regulators. There have been few reports about the atheroprotective effect of estriol (E(3)). Estrone sulfate (E(1)-S) is the predominant estrogen of conjugated equiline estrogens, which is commonly used in hormone replacement therapy, but it should be hydrolyzed by steroid sulfatase (STS) to enter the cells of target tissues. The purpose of this study was to detect STS in VSMC and to investigate whether E(3) and E(1)-S have atheroprotective effects like E(2). First, we detected the presence of STS mRNA in VSMC by in situ hybridization. We then examined the changes in the expression of mRNAs of cytokines, namely, PDGF-A chain, IL-1, IL-6 and TGF-beta, in VSMC, in the presence and absence of E(3) and estrogens. As a result, the expression of PDGF-A chain, IL-1 and IL-6 mRNAs was suppressed by E(3) (P<0.05 vs control) significantly like E(1)-S and E(2), but that of TGF-beta mRNA was not significantly affected by any estrogen. These results indicate that E(1)-S can be hydrolyzed by STS in VSMC, and that E(3) may regulate the cytokines by suppressing the production of mRNAs. It is suggested that there is a possibility of E(1)-S and E(3) having a direct effect on vessels in atherogenesis.

Arteriosclerosis↗
PubMedDate not supplied

The Batista operation in patients with dilated cardiomyopathy.

Between December 1996 and October 1998, 34 patients with nonischemic dilated cardiomyopathy (DCM) received cardiac volume reduction surgery. The patients' ages ranged from 14 to 67 years (mean = 48 years) and included 28 males and 6 females. Associated mitral regurgitation was present in 31 patients, tricuspid regurgitation in 19 patients, and aortic regurgitation in 4 patients. We performed a partial left ventriculectomy (PLV) using antegrade intermittent warm blood cardioplegia in 15 patients (group A), and in 19 patients (group B) PLV was performed using the on-pump beating heart technique. In group A, the mean aortic clamping time was 79+/-33 minutes and the total cardiopulmonary bypass time was 155+/-58 minutes. In group B the mean cardiopulmonary bypass time was 121+/-43 minutes. There were eight hospital deaths (five in group A and three in group B). Five of 10 survivors of group A required inotropic support for 13.8+/-25.3 days after the operation, while 5 of 12 survivors in group B required inotropes for 4.2+/-3.1 days. Hospital mortality was 86% in 7 emergent cases and 7% in 27 elective cases. Echocardiographic study showed that the left ventricular ejection fraction improved from a mean of 18.7% to 30.3% and the left ventricular diameter decreased from a mean of 80.2 mm to 62.3 mm after the operation. All 26 hospital survivors were followed for 1 to 20 months. Three patients died at early follow-up because of congestive heart failure, thrombosed valve, and hepatic failure, respectively. Nineteen patients were in New York Heart Association (NYHA) Class I or II and four were in NYHA Class III. In conclusion, cardiac volume reduction surgery is effective when the operative technique and proper judgment of patient selection are established, and emergent operation is avoided.

Adolescent↗
PubMedDate not supplied

Autonomic dysfunction on the affected side in Meniere's disease.

For ascertaining the existence of autonomic dysfunction on the affected side as being the cause of Meniere's disease, the mecholyl tests were conducted by means of conjunctival instillation in normal subjects as well as in patients with Meniere's disease, labyrinthitis and vestibular neuritis. The rate at which significant miosis (more than 10%) appeared in the mecholyl test was 3.1% among normal subjects, whereas the rate among Meniere's disease patients on the affected side was significantly higher during the attack, quasi-attack and interval stages. The appearance rate among Meniere's disease patients on the unaffected side was not different from that in normal subjects during any of the three stages. None of the patients with labyrinthitis or vestibular neuritis showed significant miosis on the affected side alone in the mecholyl test. This indicates that abnormality of vestibular-autonomic reflex in itself does not cause a positive reaction in the mecholyl test. Hence it can be concluded that the cause of Meniere's disease is related to the existence of autonomic dysfunction on the affected side.

Adult↗