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Biomedical subjects

S Ishikawa

Publications and source records attributed to S Ishikawa.

At least 91 records · Page 5Linked to original sources
PubMed2001

[Software development for calculation of molecular surface area and its application to hydrophobic interaction].

A novel method of calculating the water-accessible molecular surface area from the number of points generated on the molecular surface was developed. This method yielded a molecular surface area with high accuracy and speed. The molecular surface area of lecithin shows an excellent linear correlation with the logarithm of the critical micelle concentration for many lecithins having different acyl chains. The solution structure of oxyphenonium bromide estimated from the molecular surface area approach was close to that obtained from NMR. Furthermore, the change of molecular surface area, delta S(HG), with docking of host and guest was defined and its calculation method was developed. Because both the host and the guest generally consist of hydrophilic and hydrophobic atomic groups, delta S(HG) was divided into such four terms as delta Soo(HG), delta Sow(HG), delta Swo(HG), and delta Sww(HG). For instance, delta Soo(HG) is the decrease in surface area with contact between the hydrophobic surfaces of the host and the guest. When the guest molecule was moved along the symmetry axis of cyclodextrin (CyD), the structure of a complex having the maximum value of delta Soo(HG) corresponds with the crystal structure. The solution structures of several inclusion systems were predicted by this method. For various systems including alpha-CyD, beta-CyD, gamma-CyD, and aromatic and aliphatic guests, the maximum values of delta Soo(HG) showed a good correlation with the logarithms of the binding constants. This relationship will be used for the prediction of the binding constants for CyD and other host-guest systems.

Cyclodextrins↗
PubMed2001

Clinical implication of serial leptin measurement in subjects with type 2 diabetes mellitus.

Plasma leptin concentration is closely associated with body fat in humans, with energy restriction inducing a greater decrease in plasma leptin than in body fat. Since adequate energy restriction is mandatory in diet therapy of diabetes mellitus especially in obese subjects, the present study was undertaken to evaluate the clinical implication of serial leptin measurement in the management of diabetic patients. Fifty-four consecutive subjects with type 2 diabetes, who were subjected to adjusted energy restriction during hospitalization, were enrolled in the study. During their hospitalization period (24+/-4 days), plasma leptin concentrations decreased from 6.9+/-0.7 to 5.7+/-0.6 microg/l (P<0.0001) in the overall subjects, and the %change in plasma leptin (-13.9%) was greater than the %changes in body mass index (BMI) and percent body fat (-1.7% and -4.7%, respectively). The %change in plasma leptin was positively correlated with the %changes in BMI and plasma C-peptide (r=0.526, P<0.0001 and r=0.446, P<0.002, respectively) and negatively with a %change in plasma ketone bodies (r=-0.516, P<0.005). Multiple regression analysis revealed that the %changes in BMI and plasma C-peptide were independent determinants of the %change in plasma leptin. In addition, 38 subjects were followed up after discharge. Three months after discharge, plasma leptin concentrations significantly increased by 25.6%, which was again much greater than the %change in BMI (+0.9%). In 28 subjects who showed increase in plasma leptin levels after discharge, BMI was also increased. In contrast, the remaining 10 subjects without the increase in plasma leptin kept their BMI unchanged. Throughout the observation period, the changes in plasma leptin were prominent in the subjects with BMI greater than 25 kg/m2. In conclusion, plasma leptin concentrations showed greater changes than the alterations in anthropometric indexes during the observation period. Serial leptin measurement may be useful to estimate adherence to energy restriction especially in obese subjects with type 2 diabetes.

Adipose Tissue↗
PubMed2001

Urinary aquaporin-2 excretion in nocturnal enuresis.

OBJECTIVE: To evaluate the role of the arginine vasopressin (AVP)-aquaporin-2 (AQP-2) axis in the pathogenesis of nocturnal enuresis. STUDY PARTICIPANTS: Twelve children (seven male and five female), aged 11.6+/-4.3 (6.7-15.6) years, suffering from primary monosymptomatic nocturnal enuresis and 12 healthy children, matched for sex and age. Enuretic children were further subdivided into responders and non-responders to treatment with 1-desamino-8-d-AVP (DDAVP). METHODS: Serum concentrations of AVP, and plasma and urine osmolality were measured at night (0100, 0400 and 0700 h), together with nocturnal urinary excretion of AQP-2 (2000-0800 h). Magnetic resonance imaging (MRI) of the pituitary gland was carried out to evaluate the amount of AVP stored in the posthypophysis. RESULTS: Mean AVP serum concentrations were similar in patients and controls. Urinary AQP-2 was also similar in patients and controls, but responders had a significantly lower level of AQP-2 than non-responders (P<0.005). Plasma osmolality was greater in patients than in controls (P<0.001), whereas urinary osmolality was similar in both groups. No difference in the ratio of the signal intensity of the posterior lobe of the hypophysis to that of the pons (AVP content) was found between patients and controls or between responders and non-responders. CONCLUSION: A decreased urinary excretion of AQP-2 is associated with, and seems to have a role in, nocturnal enuresis, at least in some children, and this could also explain why only some of them respond to DDAVP treatment.

Adolescent↗
PubMed2001

Reconstruction of heavily calcified aorta and its visceral branches without extracorporeal circulation.

A 61-year-old Japanese female was referred to our hospital for surgical treatment of a localized heavily calcified abdominal aorta. Preoperative angiograms and computed tomograms revealed severe stenosis of the aorta, resembling a slit. Bypass grafting between the thoracic and abdominal aorta was successfully performed together with the reconstruction of the celiac artery, superior mesenteric artery, and bilateral renal arteries without extracorporeal circulation. Postoperative angiograms showed patency of the graft and branches. A localized heavily calcified abdominal aorta is relatively rare, and the cause of this entity might be Takayasu's aortitis.

Aged↗
PubMed2001

Anxiety and depressive states in multiple chemical sensitivity.

Cases with multiple chemical sensitivity (MCS) frequently present mental symptoms. This study discusses the characteristics of the anxiety and depressive state of MCS by comparing patients of MCS with a gender and age-matched control group. In this investigation, MCS cases were selected among those satisfying the diagnostic criteria of Cullen after ruling out other physical diseases. Patients visiting ophthalmologists with other diseases were designated as the control. Evaluation of the anxiety and depressive state was performed in 48 cases of MCS and 48 controls using the Japanese version of the State-Trait Anxiety Inventory, the Self-rating Depression Scale (SDS), and the Hamilton Rating Scale for Depression. Significantly higher mean values of subjective anxiety and a depressive state were obtained in 18 MCS cases than in 18 controls for the follow-up patients, while no significant difference was observed between MCS and controls of 30 new patients for each group. Therefore, anxiety in MCS is characterized by the continuous high anxiety level. MCS is also characterized by a continuance of depressive state at a "neurotic level" category by SDS. The anxiety scores and depressive levels were highly correlated in MCS and controls at the first and subsequent appearances, except those in the follow-up control cases. In conclusion, both anxiety and a depressive state in MCS remained at high level until the subsequent examination, when those in controls decreased to a normal level.

Adult↗
PubMed2001

Hypothalamic encephalitis with bradycardia.

A 74-year-old man developed fever, somnolence, hyponatremia, and life-threatening sinus bradycardia for three weeks. He showed a slight elevation of lymphocyte count and protein level in the cerebrospinal fluid. A brain CT scan revealed a diffuse low density area around the hypothalamus which was identified as a high intensity signal by flair MR imaging. Marked sinus bradycardia developed with no abnormality in the echocardiograph or cardiac enzymes. Over the next 6 weeks he became alert and normal sinus rhythm resumed. The results of endocrine tests were compatible with hypothalamic insufficiency with partial hypopituitarism and the syndrome of inappropriate secretion of ADH.

Aged↗
PubMed2001

Lupus anticoagulant in myasthenia gravis associated with IgM gammopathy.

The plasma of a patient with myasthenia gravis had strong lupus anticoagulant activity and his IgM paraprotein displayed non-specific inhibition to coagulation factors IX, XI, XII, prekallikrein, and high molecular weight kininogen. He was placed on prednisolone, which resulted in improvement in his myasthenic symptoms, but the prolongation of APTT and macroglobulinemia remained. Double filtration plasmapheresis successfully decreased the serum IgM level from 1,190 mg/dl to 375 mg/dl and APTT improved from 58 s to 38 s. Myasthenia gravis is frequently associated with other autoimmune diseases, but the association with lupus anticoagulant and IgM gammopathy is rare.

Humans↗
PubMed2001

Accidents associated with bathing in home care services for the aged in Japan.

OBJECTIVES: To reveal what kinds of accidents happen associated with bathing in home care services for the aged in Japan. METHODS: The study was cross-sectional in design. In November 1999, a postal questionnaire survey was conducted of 828 councils selected from the list of the National Council of Social Welfare of Japan by a systematic sampling method (extraction rate was 25%). The main outcome measures were characteristics of cases of accidents associated with bathing service for the aged, including patient age, sex, time of occurrence, symptoms, and results of accidents. RESULTS: Replies were received from 683 (82%) councils. Of the councils that replied, 430 (63%) reported providing bathing service for the aged. Of these 430 councils, 108 (25%) have experienced accidents, and 130 cases were analyzed. Affected patients had a mean age of 80.7 years (SD: 9.0 years), and 71 were females (55%). Sixty-two (48%) had symptoms of a disease or had accidents after bathing, and 42 (32%) presented with loss of consciousness. In results of accidents, 14 (11%) were reported to have died. CONCLUSION: This study revealed that there were not a few accidents associated with bathing in home care services for the aged in Japan, the most frequent symptom was loss of consciousness, most accidents occurred after bathing, and that some patients died as a result of bathing provided by home care services.

Accidents, Home↗
PubMed2001

Osteoporosis, bone turnover and hypogonadism in elderly men with treated leprosy.

In male hypogonadism associated with bone loss, it is important to determine whether bone loss continues with ageing and an increased risk of fracture. We studied bone metabolism in 86 male leprosy patients, who were classified according to the presence or absence of osteoporosis. Osteoporosis was present when men had lumbar compression fractures or a mean BMD-2SD that of normal Japanese men in each age decade. Four men had fractures. Serum concentrations of 1,25-dihydroxyvitamin D and high-sensitivity parathyroid hormone were almost normal in both groups, whereas free testosterone and oestradiol were significantly lower in the osteoporosis group than in the non-osteoporosis group (free testosterone: P < 0.01, oestradiol: P < 0.05). The urinary concentrations of pyridinoline and deoxypyridinoline, as a marker of bone absorption, were significantly higher in the osteoporosis group than in the non-osteoporosis group (pyridinoline: P < 0.01, deoxypyridinoline: P < 0.01). The serum concentration of osteocalcin, a marker of bone formation, was significantly higher in the osteoporosis group than in the non-osteoporosis group (P < 0.01). Elevated concentration means that bone repair is increased possibly because of compensation mechanisms for increased bone loss. In the osteoporosis group, hypogonadism occurred, and high bone turnover continued even in older men. We recommend clinical studies of treatment such as replacement therapy to prevent bone loss and increasing risk of fractures in older men with leprosy.

24,25-Dihydroxyvitamin D 3↗
PubMed2001

Improvement of ureteroileal anastomosis in orthotopic ileal neobladder with modified le duc procedure: short submucosal tunnel technique.

PURPOSE: A modified Le Duc procedure with a short submucosal tunnel was applied for ureteroileal implantation in ileal orthotopic neobladder and bladder augmentation with the ileum. We assessed the rate of stenosis and ureteral reflux at the ureteroileal anastomosis after this procedure. MATERIALS AND METHODS: Two women and 22 men underwent radical cystectomy and creation of a Hautmann ileal neobladder for invasive bladder cancer. Another woman underwent ileal bladder augmentation with bilateral ureteral reimplantation into the ileal segment. Ureteroileal anastomosis was performed using the modified Le Duc technique in 48 renoureteral units. Followup in all patients included retrograde cystography done before discharge home and excretory urography, renal ultrasonography or abdominal computerized tomography every 4 to 6 months. Followup was 11 to 39 months in 23 of the 25 cases. RESULTS: Retrograde cystography before discharge home revealed no urinary reflux in any reimplanted ureter. There was no ureteral stenosis or reflux in 20 male and 3 female patients (44 renoureteral units) who voided successfully without catheterization. A unilateral ureteral stricture at the ureteroileal anastomotic site in 1 man who voided successfully was treated with endoscopic surgery. Bilateral slight upper urinary tract dilatation caused by ureteral reflux was present in another man who did not void successfully. CONCLUSIONS: The modified Le Duc technique is simple and safe for forming an ureteroileal anastomosis in ileal orthotopic neobladder creation. It appears to have a low ureteral stenosis and reflux complication rate in patients who successfully void postoperatively.

Adult↗
PubMed2001

[A case of hookworm infestation with dissociation values between FDP-E and FDP-D dimer].

We previously reported a five-year-old girl showing bleeding tendency and transient morphological and functional platelet abnormalities probably due to a hookworm, Necator Americanus, infestation. In this report, we describe the rarely accelerated fibrinogenolysis and/or fibrinolysis in this patient whose value of fibrinogen and/or fibrin degradation products(FDP) determined with an FDP-E assay was much higher than that determined with a D-dimer assay. Namely, on day-1 and day-13 of hospitalization, her D-dimer values were only 10 to 20% of the prospected values from FDP-E values. We speculated this phenomenon was induced by circulating protease(-like) agent(s) produced by hookworm, because the only slightly participation of plasmin and/or granulocyte elastase was evaluated by the determination of enzyme-inhibitor complexes. And the other possibility of fibrinogen degradation by blast- or tumor-associated protease was excluded by the clinical manifestations and primary disorders. In conclusion, we report a very rare case with the accelerated fibrinogenolysis and/or fibrinolysis in a patient with the hookworm infestation. We are interested in the mechanism that manifested the patient's bleeding tendency accompanied with morphological and functional platelet abnormalities.

Child, Preschool↗
PubMed2001

Mediastinal lymph node evaluation by computed tomographic scan in lung cancer.

BACKGROUND: Computed tomography (CT) has been widely used for preoperative mediastinal lymph node evaluation in lung cancer. But its accuracy has remained controversial. We studied the predictability of N-staging by CT scan. METHODS: From 1981 to 1996, 546 patients had preoperative CT scan and underwent a surgical resection with mediastinal lymph node dissection for primary pulmonary adenocarcinoma and squamous cell carcinoma. Nodes larger than 1.0 cm at short axis were considered abnormal. The discrepancy between clinical and pathologic findings in N factor was analyzed. RESULTS: Sensitivity (ST), specificity (SP) and accuracy (AC) were 33.0%, 90.4% and 78.9%, respectively. No statistically significant difference in the results is detected for individual years or types of scanning device. There were statistically significant differences as follows: ST and SP by histologic type, SP by gender, SP and AC by tumor size, SP by Brinkman index, ST by tumor location, and AC by serum CEA value. CONCLUSIONS: We should pay attention to false positive nodes in heavy smokers (or males), and positive nodes in adenocarcinoma, tumor larger than 3 cm or rising of serum CEA value, regardless of negative lymph node on CT scan.

Adenocarcinoma↗
PubMed2001

The characteristics of screened patients with abdominal aortic aneurysm.

BACKGROUND: Screening for abdominal aortic aneurysm (AAA) has not yet been established in Japan. We therefore report the characteristics of a screened population and discuss the implications of screening using ultrasound in Japan. METHODS: The subjects in our screening group were composed of 4428 participants who were 60 years of age or older. Aneurysm was detected in 16 cases, 15 males and 1 female, the detection rate being 0.4% in total and 0.9% in the males. We compare the characteristics of screened patients (n = 16) with non-screened patients operated on for abdominal aortic aneurysm (n = 166). RESULTS: There were no significant differences in the mean age or in the female ratio between the screened and non-screened groups (71 vs 70 y/o, 6% vs 13%, respectively). Solitary iliac aneurysms were significantly (p < 0.05) more frequent in the screened than in the non-screened group (19% vs 3%). The size of aneurysm in the screened group was significantly (p < 0.05) smaller compared with the non-screened group. Sixty-three per cent of the screened group and only 8% of the non-screened group had an aneurysm less than 40 mm in size. Aneurysm was palpable in only 31% of those of the screened group. There were no significant differences between the groups in the frequency of arteriosclerotic risk factors such as hypertension, ischaemic heart disease, diabetes mellitus, peripheral vascular disease and smoking habits. Surgical treatment was selected in 7 out of 16 screened patients. The remaining 9 patients with small-sized abdominal aortic aneurysms have been carefully followed up. CONCLUSIONS: Screening for abdominal aortic aneurysm using ultrasound is advisable especially for male participants and for the detection of iliac aneurysms. This screening procedure is useful for early detection because the screened aneurysm is generally small-sized and impalpable.

Aged↗
PubMed2001

[A surgical treatment for ischemic heart disease associated with systemic lupus erythematodes: report of a case].

We reported a case of coronary artery bypass grafting (CABG) associated with systemic lupus erythematodes (SLE). A 45-year-old male who had been treated for SLE with prednisolone for 9 years was transferred to our department for a surgical treatment due to ischemic heart disease (IHD). We successfully performed CABG resolving various perioperative complications. The intensive care is indispensable in the case of IHD with SLE.

Anti-Inflammatory Agents↗
PubMed2001

[Mediastinal lymph node carcinoma without apparent primary lesion: report of case].

A 62-year-old man with dyspnea had an enlarged lymph node, 6.5 cm in size in the left hilum, but no primary carcinoma could be found. The patient underwent lymph node dissection under video-assisted thoracoscopic surgery, and the histological diagnosis was undifferentiated carcinoma. No primary lesion has been identified even in postoperative survey. The postoperative course was uneventful with no evidence of recurrence eight months after the operation.

Carcinoma↗
PubMed2001

[Complete transection of the left main bronchus due to a blunt chest trauma: report of a case].

A 62-year-old man was injured in a traffic accident. A chest roentgenogram showed pneumothorax, hemothorax, subcutaneous and mediastinal emphysema, multiple rib fractures, and a shift of the trachea to the right. Bilateral thorax drainage was performed, and air leakage from a left chest tube was observed. A chest computed tomogram demonstrated stenosis and deformation of the left main bronchus. Bronchofiberscopy revealed complete obstruction of the left main bronchus by the left main pulmonary artery. An emergency thoracotomy revealed complete transection of the left main bronchus and laceration. End-to-end anastomosis of the left main bronchus was performed with interrupted 4-0 PDS II suture. The patient was discharged at the 33rd hospital day.

Accidents, Traffic↗