Search PubMed⌕ Search

Biomedical subjects

S Isogai

Publications and source records attributed to S Isogai.

At least 55 records · Page 3Linked to original sources

A case of the human sternocleidomastoid muscle additionally innervated by the hypoglossal nerve.

An anomalous nerve supply from the hypoglossal nerve (XII) to the sternocleidomastoid muscle (SM) was observed in the right neck of an 82-year-old Japanese female. This nerve branch arose from the hypoglossal nerve at the origin of the superior root of the ansa cervicalis. The nerve fiber analysis revealed that this branch consisted of fibers from the hypoglossal nerve, the first and the second cervical nerves and had the same component as the superior root of the ansa cervicalis. SM appeared quite normal and the most part was innervated by the accessory nerve and a branch from the cervical plexus. The anomalous branch from XII supplied the small deep area near the anterior margin of the middle of the sternomastoid portion of SM. It is reasonable to think that the small deep area of SM, which was innervated by the anomalous branch from XII, occurs as the result of fusion of the muscular component from infrahyoid muscles. If the muscular component does not fuse with SM, it is thought to appear as an aberrant muscle such as the superior sternoclavicular muscle (Hyrtl) which is also supplied from a branch of the superior root of the ansa cervicalis.

Aged↗

Resistance to ketosis in moderately obese patients: influence of fatty liver.

To elucidate whether the presence of fatty liver influences ketogenesis in obesity, the metabolic and hormonal changes in basal and low-dose epinephrine (EPI)-stimulated states were studied in 12 obese patients (OB) with normal glucose tolerance, consisting of 6 without fatty liver (OBN) and 6 with fatty liver (OBF). In the basal state, the total ketone body (TKB) concentration and the TKB to free fatty acid (FFA) ratio were significantly (p < 0.01) lower in the OBF than in the OBN group, despite elevated, but comparable, FFA levels in both groups. The basal FFA level and the TKB/FFA ratio correlated with the degree of fatty liver (p < 0.05-0.01). EPI infusion resulted in accelerated lipolysis and diminished FFA-induced ketogenesis, similar to the findings of the basal data. These results suggest that fatty liver per se is related to diminished FFA-induced ketogenesis, leading to resistance to ketosis in obesity.

3-Hydroxybutyric Acid↗

[An aberrant muscular nerve to the latissimus dorsi muscle from the posterior cutaneous nerve of the arm].

In the 1987 student course on gross anatomy dissection of cadavers at Iwate Medical University School of Medicine, an aberrant muscular nerve to the latissimus dorsi muscle arising from the posterior cutaneous nerve of the arm was found bilaterally in a 65-year-old female who had died of acute pneumonia. The case was investigated anatomically. The posterior cutaneous nerve of the arm arose from the radial nerve approximately at the lateral axial border as the first branch independently on the right, and by forming a trunk with the nerve to the long head of the triceps brachii muscle on the left. The aberrant muscular nerve originated from the posterior cutaneous nerve of the arm about 3 cm distally to the point of the branching of the cutaneous nerve from the radial nerve. This aberrant nerve entered the latissimus dorsi muscle near the transitional area from the muscular part to the tendinous part while dividing into three on the right, and without dividing on the left. The side into which the aberrant nerve entered was just the reverse of the side into which the thoracodorsal nerve and artery supplied. The muscular part innervated by the aberrant nerve was bounded by a tendinous intersection for the most part of the latissimus dorsi muscle innervated by the thoracodorsal nerve. The intramuscular nerve distribution of the aberrant nerve was investigated under a binocular dissecting microscope. It was revealed that there was no communication between the ramification of the aberrant nerve and that of the thoracodorsal nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Bilateral absence of the quadrangular space of the axilla].

In the 1988 student course on gross anatomy dissection of cadavers at Iwate Medical University School of Medicine, two cases of the absence of the quadrangular space of the axilla were found bilaterally in a 92-year-old female who had died of heart failure. The cases were investigated anatomically. The tendons of insertion of the latissimus dorsi and the teres major muscles and the tendon of origin of the long head of the triceps brachii muscle were united, forming a conjoint tendon that attached to the infraglenoid tubercle of the scapula and the lower part of the anatomical neck of the humerus adhering to the articular capsule of the shoulder joint. The subscapularis muscle was normal except that a muscular bundle arose from the conjoint tendon and inserted to the lesser tubercle of the humerus and the crest continuing down from the tubercle. A part of the conjoint tendon was covered by the insertion of the subscapularis muscle, and there was no space between the conjoint tendon and the insertion of the subscapularis muscle. The teres major muscle was poorly developed, but the area of origin was rather wide and arose from both the dorsal and costal surfaces of the scapula. The anatomical features of the latissimus dorsi and the long head of the triceps brachii muscles were normal except for the insertion of the former and the origin of the latter. The triangular space of the axilla was found to be surrounded by the conjoint tendon, teres major muscle, and the lateral border of the scapula covered by the subscapularis and the teres minor muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Increased intraglomerular thrombin formation in diabetic microangiopathy.

Estimations of soluble fibrin monomer complexes (SFMC) in plasma are a convenient index of thrombin activation. Renal venous-arterial differences in plasma SFMC concentrations were determined in 16 randomly chosen diabetic patients by sampling directly and simultaneously from the renal artery and vein according to the method of Seldinger. In all subjects, SFMC concentrations were higher in the renal vein than in the renal artery, indicating that the kidney is an important source of SFMC. Venous-arterial differences were markedly elevated in patients with severe renal and retinal microangiopathy coupled with hypertension. The hypothesis is advanced that elevated plasma SFMC levels lead to abnormal fibrin deposits in lesioned glomeruli and retinal vessels. It is postulated that plasma SFMC may be a useful parameter for the assessment of diabetic vascular complications.

Adult↗

Plasma fibrinopeptide A levels during insulin-induced plasma glucose falls in diabetics.

Plasma fibrinopeptide A (FPA) concentration, as a measure of thrombin activity, was determined during an insulin tolerance test in 17 non-obese diabetics. FPA was measured by a modification of the Nossel method. Administration of insulin significantly lowered plasma glucose, accompanied by a significant increase in FPA from 0.9 +/- 0.1 ng/ml to 4.3 +/- 1.6 ng/ml (P less than 0.05) as well as a significant increase in circulating levels of epinephrine and growth hormone. The magnitude of the peak in epinephrine levels correlated well with both the rate of decline of plasma glucose and the magnitude of the peak of FPA. In addition, the FPA increment was suppressed by treatment with heparin. These results indicate that insulin-induced hypoglycemia or a rapid fall in plasma glucose is associated with enhanced thrombin generation and fibrin formation, which may be considered as a contributory factor to the development of diabetic microangiopathy through a hypercoagulable state.

Adult↗

The effect of glycemic control on plasma soluble fibrin monomer complexes and fibronectin in diabetic patients.

We have shown previously that increased concentrations of plasma soluble fibrin monomer complexes (SFMC) and elevated fibronectin (Fn) levels are closely related to the development of diabetic microangiopathy. The purpose of the present study was to explore whether or not changes in plasma glucose levels could have an effect on these protein constituents. Plasma glucose levels of 25 uncontrolled diabetic patients were brought under control with insulin and serial measurements of SFMC and Fn were made over a period of 4 weeks. Glucose values fell from an average of 312 mg/100 ml to 160 mg/100 ml. Ten patients with macroproteinuria (i.e. greater than or equal to 0.5 g/24 hr) showed initially elevated plasma SFMC and Fn concentrations. These levels fell significantly over the 4 week observation period: from 13.6 mg/100 ml to 9.4 mg/100 ml for SFMC and from 38.4 mg/100 ml to 34.5 mg/100 ml for Fn. The remaining 15 patients had nearly normal levels of both SFMC (7.9 mg/100 ml) and Fn (31.1 mg/100 ml) and glycemic control brought no further reduction. The data indicated that a) elevated SFMC and Fn levels are indeed associated with diabetic microangiopathy, especially in the presence of macroproteinuria; and b) adequate glycemic control is capable of normalizing the plasma concentration of these constituents.

Adult↗

Plasma soluble fibrin monomer complexes in nephrotic syndrome--with reference to hypoalbuminemia.

Plasma soluble fibrin monomer complexes (SFMC) in 10 patients with nephrotic syndrome were measured to demonstrate the contribution of hypoalbuminemia to the SFMC formation. The levels of SFMC as well as plasma fibrinogen (Fbg) levels were significantly higher than those in control subjects. There was a negative correlation between the levels of SFMC and serum albumin, and also between Fbg and serum albumin. The increase in SFMC levels which indicates the intravascular generation of thrombin might be correlated to hypoalbuminemia in nephrotic syndrome with hypercoagulability.

Adult↗

Epidemiological and clinical studies on blindness due to diabetic retinopathy.

To clarify the epidemiological and clinical features of blindness due to diabetic retinopathy, 21 patients were studied. Blind diabetics seen at our clinic numbered 2, 3, 4 and 12 in 1965-1969, 1970-1974, 1975-1979 and 1980-1981 respectively. The ratio of males to females was about 4:3. Patients whose onset was in the 10-19, 20-29, 30-39, 40-49 and 50-59 year age group numbered 4, 5, 6, 3 and 3 respectively. No difference was seen in the duration of the disease between patients whose onset was below and patients whose onset was above 40 years of age. Most of the blind diabetics (81.8%) were treated with insulin and hypoglycemic symptoms had occurred on several occasions in 14 cases. Hypertension was a complication in 10 (45%) and orthostatic hypotension in 7 cases (31.8%). Patellar tendon reflex disappeared in 15 cases (68.2%). Proteinuria was strongly positive in 11 cases (52.4%). It was therefore concluded that the number of blind diabetics has been increasing in our clinic since 1975. Insulin therapy and the association of hypoglycemia were thought to be important precipitating factors of blindness in diabetics. The levels of plasma fibrinogen and soluble fibrin monomer complexes in blind diabetics were higher than those in diabetics without retinopathy.

Adolescent↗

Epidemiological studies on renal papillary necrosis with diabetes mellitus in Japan.

Eighty-six cases of renal papillary necrosis (RPN) published in Japan over the years 1949-1980 were studied. While several hundreds cases of RPN were reported in certain European countries and the USA, only 5 cases were published in Japan up until 1960. However, the number of case reports has increased to 28 over the 5 year period of 1976-1980. The ratio of diabetics (62 cases) to nondiabetics (24 cases) is about 2.6:1 and is the same as that reported by Lauer in the USA. In diabetics, RPN was more frequently seen in females (3.4:1) and at more advanced age. Frequency of bilateral occurrence was high (47.5%). The prevalence of the association of glomerulosclerosis (75.0%) was higher than that reported by Silverman et al. in the USA (47.1%). The Incidence of the association of disturbances of consciousness (29.5%) was similar to that reported by Edmondson et al.. It was concluded that the number of cases of RPN with diabetes mellitus in Japan started to increase about 20 years later than in the USA, and that the frequency of the association between RPN and diabetic glomerulosclerosis in Japan seems to be higher than in the USA. Furthermore, it was noted that RPN was frequently associated with hyperosmolar nonketotic diabetic coma.

Diabetic Coma↗

Plasma soluble fibrin monomer complexes in the development of diabetic retinopathy.

To elucidate the relationship between plasma soluble fibrin monomer complexes (SFMC) and retinal or vitreous hemorrhages, 11 diabetics were studied for 15 months. The levels of SFMC in 3 out of the 11 cases were elevated prior to hemorrhages and in the other 8 cases SFMC levels were elevated after hemorrhages. With regard to fibrinogen (Fbg) concentrations, there was no significant difference between the values before and after hemorrhages. The plasma glucose levels did not change significantly during the observation. It was concluded that the SFMC level was not only an indicator of the intracapillary generation of thrombin but an important factor affecting the development of diabetic retinopathy.

Aged↗

Plasma soluble fibrin monomer complexes in diabetic microangiopathy.

We studied the relationship between plasma soluble fibrin monomer complexes (SFMC) and diabetic microangiopathy. SFMC concentrations were investigated in 7 patients with advanced retinopathy (group II) and in 10 patients with both retinopathy and proteinuria (group III), and also in 12 control patients (group I). The age of the patients in each group was similar and overnight fasting blood sugar levels were below 220 mg/dl. Group II had higher levels of SFMC (21.8-3.8 mg/dl) than group I (7.3-4.8 m/dl). Group III showed the higher value of blood urea nitrogen (BUN) than other groups and showed higher levels of SFMC (31.5-12.3 mg/dl) than group II. There was no significant correlation between the levels of SFMC and blood sugar, but positive correlation between BUN concentrations and SFMC was recognized in group III. Increasing of SFMC levels were correlated to fibrinogen (Fbg) levels in all subjects. There was no correlation between the levels of SFMC and antithrombin (AT-III) except in group II. The 24-h urinary protein was significantly correlative to SFMC, and Fbg was also considered to be closely associated with microangiopathy and act to promote it.

Adult↗