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Biomedical subjects

T Abe

Publications and source records attributed to T Abe.

At least 469 records · Page 26Linked to original sources
PubMed2000

[Successful treatment using detachable coils for traumatic carotid cavernous fistula as a complication of transsphenoidal surgery for a pituitary adenoma: a case report].

We report a case of a patient with traumatic carotid cavernous fistula (CCF) caused by transnasal-transsphenoidal surgery, who was successfully treated using detachable coils. A 47-year-old man was admitted to our hospital because of severe headache. He was confirmed to have a nonfunctioning pituitary adenoma with presellar-type sphenoid sinus. Cerebral angiography initially disclosed no vascular lesions. A transnasal-transsphenoidal adenomectomy was performed. When the anterior wall of the sphenoid sinus was dissected with a chisel, the chisel deeply stuck into the posterolateral part of the sinus. Profuse arterial bleeding was observed through the sphenoid sinus. The bleeding was stopped easily by compression and packing with bone wax. The operation was continued, the sellar floor was opened widely and the tumor was removed subtotally. The medial wall of the cavernous sinus was intact. Histological examination revealed a pituitary adenoma. Immediately after surgery, the patient noticed a bruit. He developed chemosis and abducent palsy on the right side. Cerebral angiography displayed a high-flow CCF, which was attributed to the carotid artery injury caused by the transnasal-transsphenoidal surgery. The CCF disappeared after two-staged embolization using detachable coils, 1st transvenous and 2nd transarterial. Ten months later, cerebral angiography showed persistent occlusion of the fistula, and the patient experienced no tumor recurrence. It is suggested that drilling is a safer procedure than using a chisel for dissection of a sphenoid sinus with incomplete pneumatization. Endovascular treatment using detachable coils proved useful to manage the CCF, an unusual complication of transsphenoidal surgery.

Adenoma↗
PubMed2000

[Current topics of acute encephalitis and encephalopathy: introductory remarks].

Encephalitis/encephalopathy is a neurological syndrome characterized by acute onset, symptoms of intracranial hypertension accompanying severe sequels or death. Encephalitis is caused by microbial infection of central nervous system, such as neurotrophic or conventional viruses. Infectious encephalopathy shows similar clinical symptoms to acute encephalitis, without any evidence of inflammation and microbial infection in brain tissues. The national epidemiological surveillance of the diseases is carried out to study the frequency and prognosis of patients with both diseases. The principal treatment is quite different in the both, in the former the eradication of microbial from the brain and in the latter the reduction of pressure of brain edema. Furthermore, the improvement of the brain with severe destruction requires such new step to reduce the activities of enzymes or cytokines to destroy brain tissues, as a mild hypothermia to lower body and brain temperature to 33-34 degrees C.

Acute Disease↗
PubMed2000

[Nocturnal oxygen desaturation during home oxygen therapy in patients with chronic respiratory disease].

We investigated nocturnal oxygen desaturation (NOD) in 36 patients with stable chronic respiratory disease who were receiving home oxygen, therapy (HOT). Study data included medical history, chest roentgenograms, measurement of daytime arterial blood gases while awake, and spirometry. Each subject underwent full overnight oximetry monitoring. Three patients were excluded from further investigation because of periodic desaturation suggestive of sleep apnea. The remaining 33 subjects were divided into two groups: 21 patients with sequelae of pulmonary tuberculosis (TB-sequela) and 12 patients with chronic obstructive pulmonary disease (COPD). The COPD group was divided into two subgroups according to the Burrows classification (Am Rev Resp Dis. 90: 14-27, 1964): 5 patients with type A (Type A) and 7 patients with type B (Type B) COPD. The percentages of total sleep time with SaO2 < or = 85% (DST 85) and SaO2 < or = 90% (DST 90) were calculated for each subject. NOD was defined as DST 85 > or = 1%. Arterial oxygen partial pressure (PaO2) while awake was > or = 60 Torr in all subjects. No difference was observed in mean awake PaO2 values between the TB-sequela and COPD groups. NOD was detected in 8 TB-sequela patients but in none of the COPD patients. Mean DST 85 and DST 90 values were significantly (p < 0.05) higher for the TB-sequela group than for the COPD group. Of 15 TB-sequela patients who were able to complete spirometry tests, 6 had NOD. All 6 of these patients had hypercapnia while awake (PaCO2 > or = 50 Torr) and reduced vital capacity (< or = 50% predicted). No difference was observed in mean DST 90 or DST 85 values between the TypeA and TypeB COPD subgroups. We conclude that NOD is common in patients with chronic stable respiratory disease treated with HOT despite daytime euoxia. TB-sequela patients with hypercapnia and restrictive ventilatory impairment are at high risk for NOD.

Aged↗
PubMed2000

[Postural effects on electromyographic activity of the transversus abdominis muscle].

During breathing at rest in humans, electromyographic activity of the expiratory muscles (EMGem), tidal volume (VT), and minute ventilation (V(I)) are higher when standing than when supine. EMGem is known to correlate with VT and V(I). It is not known whether increased EMGem when standing results directly from the change in posture or indirectly from postural changes in ventilatory pattern. Moving average electromyographic activity of the transversus abdominis (EMGta) was recorded using a pair of fine wire electrodes during carbon dioxide (CO2) rebreathing both while standing and while supine. At matched end-tidal CO2 (ETCO2), VT, or V(I) values, EMGta was significantly higher when standing than when supine. Postural differences in EMGta had no correlation with increasing ETCO2, VT, or V(I) during CO2 rebreathing. These results suggested that both the direct effect of the postural change and an indirect effect through changes in ventilatory pattern contribute to the increased EMGem observed when standing compared to that when supine.

Abdominal Muscles↗
PubMed2000

Autologous iris pigment epithelial cell transplantation in monkey subretinal region.

PURPOSE: To establish autologous iris pigment epithelial (IPE) cell transplantation in monkey eyes. METHODS: Autologous IPE cells from three monkeys were obtained by peripheral iridectomy, and cell culture was performed with autologous serum. The cultured cells were labeled with DiI, and transplantation was performed by transvitreal approach to the submacular region of each monkey. Fundus examination, photography, and fluorescein angiography were performed monthly. Histochemical analysis and electron microscopy were also performed six months after transplantation. RESULTS: Auto IPE cells grew well in auto serum. No fluorescein leakage or retinal thickening was observed after submacular transplantation. We demonstrated the presence of autologous IPE cells in the region 6 months after transplantation by histologic and electron microscopic examination. Electron microscopy also demonstrated that the transplanted cells appeared to be less pigmented and to have less mitochondria than did the host retinal pigment epithelial cells. However, some transplanted cells looked as if they embrace the photoreceptor outer segments. DISCUSSION: Autologous IPE cell culture of the monkey was established using auto serum. Six months after transplantation of the cultured IPE cells, we could still observe the cells in the region. This method may have potential use in human disease that requires autologous cell transplantation to prevent host-graft rejection, and to provide an alternative substance that functions like retinal pigment epithelium.

Animals↗
PubMed2000

[A case report of Binswanger type encephalopathy manifested after coronary artery bypass grafting].

A 68-year-old man showed signs of dementia after undergoing triple CABG with cardiopulmonary bypass. Brain CT revealed widespread atrophy and lucency in white matter without any sign of stroke. No critical stenosis in cervical vessels was found in duplex scanning. He kept politeness well, but had severe memory impairment. These findings were characteristic of Binswanger type encephalopathy which must have been latent preoperatively. This disease is caused by ischemic damage in brain stem and white matter due mainly to atherosclerotic micro cerebrovasculopathy, and highly related to hypertension. We have to be aware of intracranial cerebrovascular disease when assessing the risk of brain damage in candidates for CABG.

Aged↗
PubMed2000

[Expression of the varicella zoster virus thymidine kinase and cytokines in patients with acute retinal necrosis syndrome].

PURPOSE: Acute retinal necrosis (ARN) is caused by varicella zoster virus (VZV) infection. In this study, we investigated the activity of this virus and expressions of some cytokines. PATIENTS AND METHODS: The expression of VZV thymidine kinase and some cytokines were investigated by reverse transcriptase-polymerase chain reaction (RT-PCR) in 9 eyes of 8 patients with ARN. RESULTS: Thymidine kinase expression was observed in all samples except one. Several cytokines, such as interferon (IFN) gamma, tumor necrosis factor (TNF) alpha, interleukin (IL)-1 beta, IL-6, and transforming growth factor (TGF) beta 1 were observed in the samples. Among these cytokines, a statistically significant expression of IFN gamma was observed in the samples of ARN, when compared to those of proliferative vitreoretinopathy (PVR) or other uveitis. The expression of IFN gamma also decreased during successive follow-ups. CONCLUSION: These cytokines may play an important role in the immune response in ARN.

Adolescent↗
PubMed2000

[Esophageal dilation therapy for achalasia of the esophagus].

Esophageal dilation therapy for esophageal achalasia has a 300-year history and remains the first-line therapy because of its low cost, progressively decreasing morbidity and mortality, and possibility of surgery for patients who do not improve. Another advantage is the feasibility of repeated trial even after surgery. The aim of this procedure is to produce a controlled tear in the lower esophageal sphincter muscle. Precise esophagographic, endoscopic, and manometric diagnosis is necessary for successful esophageal dilation therapy. In addition, the exclusion of pseudoachalasia using echogram or CT scan is important. The procedure should be carried out accurately to prevent complications. If perforation occurs, appropriate, timely management is required.

Catheterization↗
PubMed2000

A frequent 1085delC/insGAAG mutation in the RDH5 gene in Japanese patients with fundus albipunctatus.

PURPOSE: To identify the frequency of a mutation of the RDH5 gene in Japanese patients with hereditary retinal degeneration and to characterize clinical findings for the patients associated with a 1085delC/insGAAG mutation in the RDH5 gene. METHODS: Mutation screening by single-strand conformation polymorphism was performed on 6 patients with fundus albipunctatus and 150 patients with autosomal recessive retinitis pigmentosa. The DNA fragment that showed abnormal mobility on SSCP was then sequenced. Clinical features were characterized by visual acuity, slit-lamp biomicroscopy, electroretinography, fluorescein angiography, kinetic visual field testing, and dark adaptometry. RESULTS: A novel 1085delC/insGAAG mutation in the RDH5 gene was identified in all 6 patients, from 4 unrelated families with fundus albipunctatus. The ophthalmic findings of each affected member were very similar, which may provide the natural course of the phenotype produced by the 1085delC/insGAAG mutation. CONCLUSIONS: A homozygous1085delC/insGAAG mutation in the RDH5 gene produces fundus albipunctatus in Japanese patients. These findings suggest that this mutation was a founder effect in Japanese patients with fundus albipunctatus.

Adult↗
PubMed2000

Double simultaneous cysts of the mediastinum.

We describe a rare case of double mediastinal tumors in a 60-year-old male with spinocerebellar degeneration. Magnetic resonance imaging (MRI) accidentally revealed double cystic tumors in the anterior and posterior mediastinum. Surgical management by video-assisted thoracic surgery (VATS) was successfully performed. The histological diagnoses were confirmed as a thymic cyst in the anterior and a thoracic duct cyst in the posterior mediastinum, respectively.

Diagnosis, Differential↗
PubMed2000

Evaluation of insulin response in glucose tolerance test in a patient with Werner's syndrome: a 16-year follow-up study.

To clarify the effect of Werner's syndrome (WS) on beta-islet cell function, the oral glucose tolerance test (OGTT) was repeatedly performed over a period of 16 years in one patient with WS. The data obtained on insulin secretion were assessed in this study. The patient was a 50-yr-old woman of consanguineous parentage. She presented with gray hair, cataracts, a beak-shaped nose and high-pitched voice. She was diagnosed as WS on the basis of her characteristic appearance. OGTT was performed 14 times during 9 admissions to our hospital. After ingestion of glucose, plasma glucose (PG) levels and immuno-reactive insulin (IRI) at 0, 30, 60, 90, 120 and 180 min were determined. PG levels during OGTT gradually increased during dietary therapy and, at the age of 48, insulin treatment was started [PG level at 120 min during OGTT at 46 yr (before treatment) was 1.5 times that at 34 yr]. Insulin secretion had also gradually decreased during the follow-up period (sum of IRI at 34 yr during OGTT post-treatment; 550.8 IU/ml, sum of IRI at 50 yr during OGTT post-treatment; 244.5 IU/ml). However, the insulinogenic indices were maintained at almost the same level value. Our results indicate that insufficient insulin secretion, which could not overcome insulin resistance, might play a crucial role in the pathophysiology and progression of diabetes in WS along with insulin resistance due to a post-receptor defect.

Adolescent↗
PubMed2000

Prevention of postoperative intrapleural adhesion of the thoracotomy incision by a bioresorbable membrane in the rat adhesion model.

For the purpose of reducing the risk of lung injury while separating adhesions in repeated pulmonary resections, the inhibitory effect of hyaluronate based bioresorbable membrane (HA membrane) on postoperative adhesions was investigated in a new pleural adhesion model in rats. First of all, a novel post-thoracotomy adhesion model in rats was successfully established by using a combination of mechanical, chemical and ischemic injuries of the pleura during operation. After undergoing the same adhesion-inducing procedures, one of two groups was treated with HA membrane inserted between the lung and the parietal pleura, and the other group underwent infusion of saline only. The severity of the adhesion formation was macroscopically lower in the HA membrane-treated rats, and they had favorable mesothelial regeneration microscopically. Additionally, the activity of type 1 plasminogen activator inhibitor (PAI-1) in the intrapleural lavage fluid (ILF) was measured at 24 hours postoperatively because this is the main influence on adhesion formation after surgery. PAI-1 activity was 23.37+/-2.57 U/ml in the saline-treated group and 17.85+/-3.06 U/ml in the HA membrane-treated group. The result suggests that the HA membrane inhibits postoperative adhesion formation through a significant repression of PAI-1 activity.

Absorbable Implants↗
PubMed2000

Early and late results of mitral valve repair for mitral valve regurgitation. Significant risk factors of reoperation.

BACKGROUND: Mitral valve repair for mitral valve regurgitation has many advantages over mitral valve replacement. However, durability and reoperation after mitral valve repair still remain major problems. We examined the outcome of mitral valve repair for mitral valve regurgitation and analyzed several pre- and intraoperative potential risk factors to determine the significant risk factors of reoperation. METHODS: From February 1981 to November 1996, 86 patients underwent mitral valve repair for mitral regurgitation or combined mitral regurgitation and stenosis. The mean age was 53 years, and 88.4% were New York Heart Association class III or IV. The causes of mitral valve disease were degenerative disease in 53 patients, rheumatic disease in 15, infective endocarditis in 11, and ischemic disease in 7. There were 2 early and 8 late deaths. RESULTS: Actuarial overall survival including early death at 10 years was 83.2+/-6.1%, freedom from reoperation was 86.8+/-5.3%, freedom from thromboembolism was 90.9+/-6.2%, and freedom from infective endocarditis was 98.5+/-1.5%. There was no bleeding event. At the last follow-up, most patients were in New York Heart Association class I or II. Prolapse of anterior leaflet and rheumatic mitral regurgitation were identified as independent predictors for reoperation. CONCLUSIONS: The repair techniques for anterior leaflet prolapse and patient selection in rheumatic mitral disease are important for improving long-term results of mitral valve repair for mitral regurgitation.

Adolescent↗
PubMed2000

[A case treated surgically through anterior axillary thoracotomy for recurrent right spontaneous pneumothorax after repeated video-assisted thoracoscopic surgery].

A 21-year-old male who had thoracoscopic surgery for right spontaneous pneumothorax was admitted to our hospital complaining of dyspnea due to the recurrence. There was no bulla in right apex but empysematous change in visceral pleura at re-thoracoscopic surgery. Two bulla in right S6 were removal using endo-stapler. Three years after the second thoracoscopic surgery, the recurrence of right pneumothorax was recognized. Chest CT revealed a new bulla in right apex. Therefore the third operation was carried out through anterior axillary thoracotomy. A new bulla was resected with endo-stapler and pleurodesis using argon laser was also applied to prevent of recurrence of pneumothorax. The patient is now doing well without recurrence 6 months after the third operation.

Adult↗
PubMed2000

Left internal thoracic artery harvesting in pleural symphyses under minimally invasive direct vision.

In minimally invasive direct coronary artery bypass grafting (MIDCAB), the internal thoracic artery (ITA) is harvested under a direct-vision or videothoracoscopic techniques. However, whatever the technique used, dense pleural adhesions hamper ITA harvesting. We describe the case of a patient who underwent MIDCAB 40 years after a pulmonary resection for tuberculosis. The parietal pleura adhered to the left lung so firmly that we could not enter the intrapleural cavity. Therefore, the ITA was harvested creating an extrapleural tunnel Although this approach resulted in more operating time and bleeding, an anastomosis between the ITA and left anterior descending coronary artery was performed successfully. We believe that MIDCAB can be carried out even in patients with dense pleural adhesions.

Aged↗