Search PubMed⌕ Search

Biomedical subjects

N Usui

Publications and source records attributed to N Usui.

At least 37 records · Page 2Linked to original sources

Acid fog damage of beech at Hinokiboramaru-Tanzawa, Japan.

Decline of Japanese beech forest has been obvious at the Tanzawa Mountains near Tokyo. Observations on fog, precipitation and stem flow were performed during June-October, 1994 on both, NE (with healthy beech) and S-SE (with unhealthy beech) slopes, collecting samples biweekly. Chemical species were determined by ion-chromatography and pH meter. The results show that the pH of the precipitation was between 4.4-5.2, with no clear differences in the concentrations of chemical species between both sites and seasons. The pH of the fog water was high from May to the middle of August and lower from mid-August to October at both sites. The concentrations of most chemical species were higher in fog samples than precipitation samples. The concentrations of potassium and magnesium ions in the stem flow of an unhealthy tree on the S-SE slope were higher than those on the NE slope. In June-October, 1995, ten pairs of event fog water samples were obtained with indicating that the pH was below 4.0 for five pairs of event fog water samples. Lower pH value was obtained on the S-SE slope than on the NE slope in every event. Concentrations of most chemical species were always higher in the fog samples from the S-SE slope than those from the NE slope. The equivalent ratio of NO3-/nssSO4(2-) was higher in the fogs of higher acidity. From the result of atmospheric current analysis using a model, it was suggested that the polluted air over the Tokyo Metropolitan Area affected the fog acidity directly and also indirectly, according to the pressure patterns.

Acid Rain↗

Laparoscopic ovarian cystectomy using a single umbilical puncture method.

To establish a minimally invasive technique to perform ovarian cystectomy, the authors applied a single umbilical puncture method. A 2-month old female infant was admitted to the hospital because of an ovarian cyst that showed no spontaneous shrinkage after her birth. An umbilical semicircular incision was made to insert a 10-mm trocar, into which a 3-mm laparoscope was inserted. The ovarian cyst was grasped using forceps inserted through an operating channel of the scope, and the cyst was removed through the incision. After aspiration of the cyst, the free cyst wall was resected, leaving the intact ovarian tissue. The operation was performed without difficulty or complication. The postoperative course was uneventful. The wound was inconspicuous, and the result was cosmetically excellent. The case demonstrated the feasibility of the minimally invasive technique using a single umbilical puncture for ovarian cystectomy in an infant.

Female↗

[Clinical features of epidemic nosocomial keratoconjunctivitis in 41 patients].

PURPOSE: To evaluate the clinical features of nosocomial epidemic keratoconjunctivitis (EKC) occurring in the ophthalmology ward of Tokyo Medical University Hospital. MATERIALS AND METHODS: We studied the symptoms and clinical course of 41 patients who had EKC caused by nosocomial infections in our hospital. We attempted to detect adenovirus antigen and viral DNA from conjunctival swabs and also to isolate the virus. RESULTS: The clinical symptoms of EKC, including postoperative cases, were not severe. In some cases, patients' complaints, for example, increase of lacrimation or appearance of a foreign body sensation, were contributory to diagnosis. Among the 41 patients, 31 out of 34 (91.2%) EKC patients who had undergone ophthalmic surgery had EKC in the operated eye. In cases receiving bilateral operations, EKC occurred first in the initially operated eye. The sensitivity of Adeno-check was 76.9%. Adenovirus type 19 was isolated from conjunctival swabs in 26 cases. CONCLUSIONS: The early diagnosis of EKC is extremely important to prevent the spread of nosocomial infections. Careful observation of operated eyes and close attention to patient complaints may aid in the early detection of EKC.

Adenoviridae Infections↗

New genome type of adenovirus serotype 19 causing nosocomial infections of epidemic keratoconjunctivitis in Japan.

Twelve strains of adenovirus serotype 19, isolated from cases of epidemic keratoconjunctivitis in Japan in 1992, 1993, 1997, and 1998, were analyzed by DNA restriction analysis, using restriction endonucleases BamHI, BglI, BglII, EcoRI, HindIII, KpnI, PstI, SacI, SalI, SmaI, and XhoI. Among these 11 restriction endonucleases, EcoRI, PstI, SacI, and SmaI were discriminative enzymes, showing restriction patterns different from those reported previously for the prototype and the variant 19a. This new genome type was isolated in 1997 and 1998, when an increase of epidemic keratoconjunctivitis cases caused by adenovirus serotype 19 was observed for both sporadic and nosocomial infections. Strains from 1992 and 1993 showed restriction patterns similar to those of the worldwide reported variant 19a for all enzymes used. The changes detected in strains from 1997 and 1998 could be the reason for the recent epidemic.

Adenovirus Infections, Human↗

Neuroradiologic findings in focal cortical dysplasia: histologic correlation with surgically resected specimens.

PURPOSE: We investigated the neuroradiologic characteristics of focal findings of surgically resected specimens obtained from 47 patients with focal cortical dysplasia (FCD). METHODS: Forty cases were detected by magnetic resonance imaging (MRI), and two cases were detected only by single-photon emission computed tomography (SPECT), but five cases could not be detected before operation. RESULTS: MRI revealed abnormal gyri and sulci in 34 patients (pachygyric in 18, polymicrogyric in 10, both in six), and blurring of the gray matter-white matter junction in 29 (72%) patients. Signal abnormalities were found in 36 (90%) patients, in the gray matter in 32, with white matter in 30, and at the gray matter-white matter junction in 13. Moreover, peculiar patterns of abnormal signals in the white matter were recognized, including remarkably abnormal subcortical signals of T2 hyperintensity and T1 hypointensity adjacent to the dysplastic cortex in 15 cases, high radiated T2 signals extending from the ependymal surface of the lateral ventricle to the overlying cortex in 11 cases, and widespread abnormal signals in the white matter with gray matter involvement in four cases. Histologically, these abnormal signals corresponded to various degrees of dyslamination and morphologic abnormalities of neurons and glial cells in the gray matter, and to dysmyelination, ectopic clustering of dysplastic neurons, glial proliferation, and necrotic change in the white matter. Regional cerebral blood flow SPECT showed interictal hypoperfusion in 29 (62%) of the 47 patients, interictal hyperperfusion in two, and ictal hyperperfusion in 28 of the 34 patients associated with FCD. [123I]iomazenil SPECT demonstrating the distribution of central benzodiazepine receptors showed low accumulations localized spatially corresponding to the epileptogenic foci associated with FCD in seven of eight patients. CONCLUSIONS: These results demonstrate that neuroimaging reflects various structural and functional changes closely related to epileptogenesis in FCD.

Adolescent↗

Pleasant odors attenuate the blood pressure increase during rhythmic handgrip in humans.

We have investigated the effects of inhaling odors of preference on physiological responses to physical exercise in college students. Rhythmic handgrip, maintaining a mercurial pressure by repetitive compression, increased blood pressure. In the participants exercised with inhaling odors of their choice, such as rose, jasmine and lavender, the increase in diastolic blood pressure during exercise was reduced by 24%. In contrast, the blood pressure increase during static handgrip, maintaining the power 30-40% of maximum, was not affected by the existence of favorite odors. Since the blood pressure increase during static handgrip is a lower brainstem reflex, the present result shows that the inhalation of favorite odors suppresses the muscle sympathetic vasoconstrictor activity and attenuates the blood pressure increase by affecting the central nervous system higher than the midbrain.

Adolescent↗

Meconium peritonitis in utero.

To clarify the relationship between clinical features in utero and postnatal prognosis, 20 fetuses who underwent ultrasonic (US) evaluation for meconium peritonitis (MP) over a 17-year period were reviewed. According to final US findings in utero, patients were classified into three types. Type I (massive meconium ascites) was noted is 5 cases, type II (giant pseudocyst) in 4, and the other 11 were classified as type III (calcification and/or small pseudocyst). Abdominal calcifications were identified in only 5 cases (2 type I, 1 type II, 2 type III). Seven fetuses who had associated polyhydramnios (1 Type I, 1 Type II, 2 Type III) and fetal hydrops (3 Type II) were delivered before 36 weeks' gestation. Cardiopulmonary resuscitation at birth was required in 9 cases (5 type I, 4 type II) who underwent abdominal drainage before delivery and/or immediately after birth. Although dilatation of the intestine was identified in 10 fetuses (2 type II, 8 Type III), 18 had intestinal atresia and 2 had fecal obstruction of the distal ileum. Four infants (2 type I, 1 type II, 1 type III) died of respiratory failure and postoperative complications. These results indicated that careful fetal US may be useful for perinatal management of MP.

Ascites↗

The effect of phospholipase A2 on bacterial translocation in a cell culture model.

The activity of phospholipase (PL)A2 is elevated in the intestinal epithelia of patients with inflammatory bowel disease (IBD). Recently, we reported that lysophosphatidylcholine (L-PC), the PLA2 hydrolysis product of phosphatidylcholine (PC), stimulates bacterial translocation (BT) in an enterocyte cell-culture model. These two observations stimulated us to examine the effects of extracellular PLA2 on intestinal epithelial permeability. Human Caco-2 enterocytes were grown to confluence on porous filters in the apical chamber of a two-chamber cell-culture system. Monolayer integrity and tight-junction permeability were measured by dextran blue (DB) permeability and transepithelial electric resistance (TEER). Monolayers were treated with PC, L-PC, or PLA2 with and without PC. The magnitude of BT was determined 2 h after treatment by adding Escherichia coli to the apical chamber followed by quantitatively culturing basal chamber samples. Thin-layer chromatography (TLC) was utilized to verify PLA2 hydrolysis of PC to L-PC. Statistical analysis was performed by one-way analysis of variance. The magnitude of BT across monolayers pretreated with PLA2 + PC significantly increased compared to either PC or PLA2 (6.83 +/- 0.069, 2.41 +/- 0.46, and 3.06 +/- 1.14 log10 colony forming units/ml, respectively, P < 0.05). Absence of DB-permeability in any group confirmed monolayer integrity. TLC of PL samples harvested from the apical monolayer surface confirmed PC hydrolysis. PLA2 mediates hydrolysis of PC to L-PC when both are applied to the apical surface of cultured enterocyte monolayers, resulting in increased BT and increased TEER with no damage to monolayer integrity. These observations may have implications in the pathogenesis and treatment strategies for IBD.

Bacterial Translocation↗

Pexis of the great vessels for patients with tracheobronchomalacia in infancy.

BACKGROUND/PURPOSE: Aortopexy has been established as a surgical treatment for tracheobronchomalacia in infancy. However, the effects in patients with bronchial involvement remain controversial. The authors performed aortopexy and pexis of the pulmonary artery trunk (PApexy) for patients with tracheobronchomalacia. METHODS: Between 1992 and 1997, 14 infants with tracheobronchomalacia were treated. Patients ranged in age from 4 months to 7 years (median, 3.5 years). Using patients' records, intraoperative bronchofiberscopic results and clinical outcomes were analyzed retrospectively. RESULTS: Concerning tracheomalacia, aortopexy eliminated airway collapse as shown by intraoperative fiberscopic results and clinical outcome in 4 patients. Regarding tracheobronchomalacia, aortopexy eliminated collapse of the trachea and the right main bronchus in 3 patients but did not improve collapse of the lower half of the left main bronchus in 3 patients, which was eliminated by PApexy. Aortopexy eliminated airway collapse of the left main bronchus in 1 of 3 patients with bronchomalacia. PApexy eliminated collapse of the lower half of the left main bronchus in 1 patient. CONCLUSIONS: These results indicate that intraoperative bronchofiberscopic results were closely correlated to the clinical outcome, and suggest that aortopexy is helpful for eliminating collapse of the right main bronchus and the proximal half of the left main bronchus and that PApexy eliminates collapse of the distal half of the left main bronchus.

Abnormalities, Multiple↗

Progressive outer retinal necrosis caused by herpes simplex virus type 1 in a patient with acquired immunodeficiency syndrome.

OBJECTIVE/BACKGROUND: To identify the etiologic agent of rapidly progressive outer retinal necrosis (PORN) in a 32-year-old man with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from cytomegalovirus (CMV). Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis, diagnosed clinically as PORN. Death occurred after failure of multiple organs. DESIGN: Case report. METHODS: Both globes were taken at autopsy, fixed in formalin, and examined histopathologically and immunohistochemically to identify causative agents in the retinal lesions. MAIN OUTCOME MEASURE: Immunohistochemistry. RESULTS: All layers of the retina were severely damaged and contained focal calcification. Cytomegalic inclusion bodies were found in cells in the damaged retina of the right eye. Immunohistochemical studies for herpesviruses revealed the presence of CMV antigens in the right retina at the posterior pole and herpes simplex virus type 1 (HSV-1)-specific antigen in the periphery of both retinas. No varicella-zoster virus (VZV) antigen was detected in either retina. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, HSV-1 can be an etiologic agent.

AIDS-Related Opportunistic Infections↗

Patent ductus venosus with a hypoplastic intrahepatic portal system presenting intrapulmonary shunt: a case treated with banding of the ductus venosus.

A case of patent ductus venosus (PDV) presenting intrapulmonary shunting is described. Although retrograde venography of ductus venosus showed few intrahepatic branches, banding of PDV resulted in increased intrahepatic portal branches and disappearance of symptoms 10 months after the operation. Banding of the ductus venosus may be effective in PDV even with hypoplastic intrahepatic portal system.

Child↗

Airway anomalies in patients with congenital diaphragmatic hernia.

PURPOSE: Congenital diaphragmatic hernias (CDH) sometimes are associated with airway anomalies such as congenital stenosis, abnormal branching of the bronchi, and pulmonary hypoplasia. The incidence of these associated airway anomalies has not been reported previously. METHODS: Bronchoscopy was performed in all neonates with CDH from 1987 to 1999. In addition to anatomic anomalies, bronchial hypoplasia was defined as narrowing and shortening of the bronchi at bronchoscopy. RESULTS: Anatomic anomalies were identified in 7 of 39 patients with CDH: 1 had congenital tracheal stenosis with pulmonary artery sling, 1 had a defect of the right upper lobe bronchus, 2 had a tracheal bronchus, and 3 had a trifurcated trachea. Bronchial hypoplasia on the affected side was identified in 15 patients and was seen in all patients with anatomic anomalies of the tracheobronchial tree except the 2 with tracheal bronchus. After excluding 5 patients with severe associated anomalies, 6 of 14 patients with an abnormal tracheobronchial tree died, whereas 1 of 20 patients without airway abnormalities died. CONCLUSIONS: Anatomic anomalies of the tracheobronchial tree and bronchial hypoplasia on the affected side were identified in 17.9% and 38.4% of patients with CDH, respectively. CDH patients who exhibited these abnormalities showed a poor outcome.

Bronchial Diseases↗

Two cases of persistent hyperinsulinemic hypoglycemia that showed spontaneous regression and maturation of the Langerhans islets.

Near-total pancreatectomy has been recommended as the treatment for persistent hyperinsulinemic hypoglycemia (PHH) in infants. However, recently there has been a report described that one third of 95% pancreatectomy failed to prevent hypoglycemia and more than two thirds had diabetes ultimately. The authors experienced 2 cases of PHH, which raise a query about the extensive pancreatectomy. Case 1: A female patient who manifested PHH shortly after birth underwent less extensive pancreatectomy twice at age 2 months and 8 years. After each operation, her clinical symptoms regressed, and she became free from the disease eventually. Histologic findings showed nesidioblastosis in which the islets clearly matured. Case 2: A male infant with PHH had an absolute indication for pancreatectomy. However, after a meticulous control of the blood glucose level with parenteral nutrition followed by continuous enteral nutrition feeding combined with medication, he became free from the disease. The current cases show there exist cases of PHH in which the islets mature and symptoms regress spontaneously. Therefore, we conclude near-total pancreatectomy is not always the treatment of choice. As an alternate strategy, long-term controlled feeding and medication combined with or without less extensive pancreatectomy should be considered with the expectation of spontaneous regression.

Adenoma, Islet Cell↗

IL-1 and TNF-alpha are important factors in the pathogenesis of murine recurrent herpetic stromal keratitis.

PURPOSE: To better understand the role of interleukin (IL)-1 and tumor necrosis factor (NF)alpha in recurrent herpetic stromal keratitis (HSK), the cytokine content and the effects of anti-cytokine antibodies on mouse corneas with the disease were examined. METHODS: Competitive reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent analyses of IL-1alpha and TNF-alpha content were performed on corneas removed 3, 5, 7, 10, 14, and 21 days after latently infected NIH mice were irradiated with UV-B light to reactivate herpes simplex virus (HSV). In separate experiments, mice were injected with anti-IL-1 or anti-TNF-a antibodies 1 day before and 7 days after reactivation. RESULTS: UV-B irradiation stimulated an increase in corneal IL-la mRNA in reactivated (virus shedding) mice. This increase persisted longer and was higher than in UV-B irradiated uninfected control animals. IL-1alpha and TNF-alpha protein in corneas of reactivated mice was significantly elevated on days 3 to 10 compared with day 0 levels, and exceeded levels in control corneas on the same days. Anti-IL-1 and anti-TNF-alpha antibody administration both resulted in significantly decreased virus-induced corneal opacity between 7 and 21 days after UV-B exposure. CONCLUSIONS: IL-1alpha and TNF-alpha are upregulated in corneas in mice experiencing recurrent HSK. Abrogation of virus-induced corneal disease by anti-cytokine antibodies suggests that these cytokines play important roles in the pathogenesis of recurrent disease. Therefore, neutralization of specific proinflammatory cytokines may have potential therapeutic value.

Animals↗

[Typing of herpes simplex virus in patients with uveitis].

AIM: To examine the type of herpes simplex virus (HSV) in cases with uveitis. MATERIALS AND METHODS: Intraocular fluid specimens obtained from 3 cases with herpetic iridocyclitis and 6 cases with acute retinal necrosis (ARN) were examined by polymerase chain reaction (PCR). HSV typing was performed by the restriction patterns of the PCR products. Serum samples obtained from these cases and 33 cases with uveitis were examined by neutralization test (NT) for the availability of the typing of HSV. RESULTS: The restriction patterns of the PCR products amplified from 3 specimens of iridocyclitis revealed HSV type 1 DNA. HSV type 2 DNA was identified in 5 of 6 cases of ARN and HSV type 1 DNA was found in only one case. The results of serum NT titers correlated with the typing of the amplicons. CONCLUSIONS: In the cases studied, HSV type 1 was the dominant etiological agent in herpetic iridocyclitis, while HSV type 2 played a similar role in HSV-associated ARN. The examination of the serum NT may be helpful for the identification of the etiological types of HSV in patients with uveitis.

Adult↗

[The role of daunorubicin in induction therapy for adult acute myeloid leukemia].

The relationship between the total dose of daunorubicin (DNR) in induction therapy and the treatment outcome were evaluated based upon individualized doses of DNR during induction therapy for patients with acute myeloid leukemia(AML). Ninety-two previously untreated adult AML patients admitted to our hospital were analyzed for the dose of DNR required for complete remission (CR), the CR rate, disease-free survival (DFS) and overall survival (OS). The induction therapy consisted of DNR (40 mg/m2/d, i.v., from D 1 until the marrow was hypoplastic), Ara-C, prednisolone, and/or 6-thioguanine. Eighty-three out of 92 patients were assessable. Sixty-three patients entered CR (76%), of whom 52 attained CR with the first course of induction therapy. The 10-year DFS and OS rates were 31.2% and 42.3%, respectively. The median total dose of DNR in the induction therapy was 280 mg/m2 (120-480 mg/m2), which was not influenced by initial WBC count, or FAB type. These results indicate that when the dose is linked to the observed tumor response, the optimal dose of DNR in the induction therapy is around 280 mg/m2 (40 mg/m2 x 7 times), which is higher than the conventional dose of 40-60 mg/m2 for 3 days. The higher dose of DNR in the induction therapy for adult AML should be selected when the feasibility of a new drug is evaluated in a randomized trial.

Adolescent↗

[Bacterial infection in the conjunctiva of patients with adenoviral conjunctivitis].

PURPOSE: We evaluate the microbiological features of mixed infection in adenovirus-infected conjunctiva. SUBJECTS: Isolation of bacteria was performed in 82 samples of adenoviral conjunctivitis at six eye clinics in Japan. METHODS: For microbiological diagnosis, we performed immunochromatography (IC) and polymerase chain reaction--restriction fragment length polymorphism (PCR-RFLP) analysis for detection and serotyping of adenovirus, and PCR for detection of herpes simplex virus (HSV) and Chlamydia trachomatis antigens out of 82 samples with adenoviral conjunctivitis. RESULTS: Pathogenic bacteria were isolated in 6 samples out of 82. Out of these 6 cases, 5 samples were gram-negative rods and most of them were Flavobacterium meningosepticum (4 samples). Adenovirus type 8 was isolated from all these mixed infection cases. However, HSV-1 and Chlamydia trachomatis were not found. CONCLUSIONS: From these results, it is suggested that gram-negative rods, especially F. meningosepticum, are the most common bacteria causing mixed bacterial infection in adenoviral conjunctivitis.

Adenovirus Infections, Human↗