Biomedical subjects

T Inagaki

Publications and source records attributed to T Inagaki.

At least 73 records · Page 4Linked to original sources

PubMed2000

[Diffusion-weighted MRI in patients with occlusive cerebrovascular disease: the initial DWI findings within 6 hours after onset].

We performed this study to evaluate the accuracy of diffusion-weighted imaging (DWI) in detecting focal ischemia, and to predict the role of DWI in the management of patients with ischemia in the superacute phase. 99 patients with clinically diagnosed acute occlusive cerebrovascular disease were studied with DWI within 6 hours after onset of symptoms. In 88 of 99 patients, early ischemic lesions were identified on initial DWI as hyperintensity areas. The initial DWI findings were classified into 4 types according to the location and extent of the hyperintensity area. The patients with type 1 (no hyperintensity area) were clinically diagnosed as TIA or complete stroke within 2 hours after the onset. 28 patients out of the patients with type 2 (hyperintensity area in the perforator's territory) were diagnosed with lacunar infarction, and the remaining 13 patients were diagnosed as victims of stroke caused by main trunk occlusion. Except for 2 patients with TIA, the patients with type 3 (scattered hyperintensity areas in the cortex) had main trunk occlusion and showed a more extended ischemic area on SPECT than hyperintensity area on DWI. All the patients with type 4 (extended hyperintensity area) had main trunk occlusion and showed severe hypoperfusion in the affected area on SPECT, and the area of hypoperfusion was well matched with the hyperintensity area on DWI. Comparing DWI findings with rCBF on SPECT, a significant difference was noted in rCBF between hyperintensity and non-hyperintensity area. We considered that emergence of hyperintensity on DWI was related to both the time of duration and the degree of hypoperfusion, and the reduced perfusion area where DWI showed no hyperintensity was thought to be the "ischemic penumbra". Our study indicated DWI had high diagnostic accuracy in superacute occlusive cerebrovascular disease and could furnish useful information to reveal the pathologic condition. In addition, DWI is expected to be available for selection as a therapeutic strategy.

Acute Disease↗

PubMed2000

[A case of Marchiafava-Bignami disease demonstrated by MR diffusion-weighted image].

A Case of Marchiafava-Bignami disease demonstrated by MR diffusion-weighted image (DWI) was reported. A 55-year-old male with chronic alcoholism demonstrated dysarthria, disorientation and apraxia of left-hand. Sagittal view on MRI showed a swelling of the corpus callosum. The body and splenium of the corpus callosum showed symmetrically iso-intensity in T1 WI and hyperintensity in T2 WI, and remarkable hyperintensity in fluid attenuated inversion recovery images. DWI showed a definite hyperintensity area on the corpus callosum and the apparent diffusion coefficient (ADC) map presented the decreased water self-diffusion. These findings differed from the other demyelinating diseases, such as multiple sclerosis. We considered these DWI findings were the initial changes on MBD which preceded the demyelination. To our knowledge, this is the first report of DWI that was used in a case of Marchiafava-Bignami disease.

Alcohol-Induced Disorders↗

PubMed2000

[Vertebral arterial dissection with subarachnoid hemorrhage after ischemic onset].

A case is reported of the vertebral arterial dissection presenting initially with cerebellar infarction, and which subsequently occurred with subarachnoid hemorrhage 14 days later. A 75-year old male was admitted because of vertigo and ataxia. MR T2-weighted imaging showed a hyperintensity areas on the left cerebellar hemisphere and MR angiography showed multiple stenotic lesions in the left vertebral artery. We diagnosed his illness as dissection of the left vertebral artery and antiplatelet therapy and the blood pressure control were carried out. Fourteen days after the onset, the patient complained of sudden onset of headache and subarachnoid hemorrhage was confirmed on CT scan. Proximal clip occlusion of the left vertebral artery and OA-PICA anastomosis was carried out immediately. The patient was discharged with slight truncal ataxia. We evaluated the features of this vertebral arterial dissection presenting with subarachnoid hemorrhage after ischemic stroke with reference to another reported cases.

Aged↗

PubMed1999

Impaired pancreatic exocrine function in rats with carbon tetrachloride-induced liver cirrhosis.

BACKGROUND: Substantial numbers of studies have revealed the close correlation between chronic pancreatitis and cirrhosis in human. However, the situation with regard to pancreatic enzyme secretion is less clear. AIM: The aim of the study was to investigate pancreatic exocrine function in rats with carbon tetrachloride-induced liver cirrhosis in rats. METHODS: Pancreatic exocrine function and morphology in Sprague-Dawley rats with carbon tetrachloride-induced liver cirrhosis were investigated. Pancreatic exocrine functions stimulated by cholecystokinin-8 and other secretagogs were assessed in isolated pancreatic acini, and in vivo and morphological changes were studied by routine histological examination and electron microscopy. RESULTS: The basal and cholecystokinin-8-stimulated amylase releases from acini and acinar amylase content were significantly lower in the cirrhotic rats than the control. None of the secretagogs induced the some amount of amylase release in cirrhotic as in control rats. Volume of the pancreatic juice and outputs of amylase and protein were significantly decreased under basal and cholecystokinin-8-stimulated conditions in vivo. Electron microscopy revealed most of the rough-surfaced endoplasmic reticulum accompanying less numbers of ribosomes to be dilated and some mitochondria to be swollen in cirrhotic rats. CONCLUSION: Pancreatic exocrine functions are decreased in cirrhotic rats owing to alterations at the electron microscopic levels, reflecting an impaired acinar intracellular messenger system.

Amylases↗

PubMed1999

A case of seizures 1 week after the cessation of interferon-alpha therapy.

We report on a 60-year-old woman with a history of bipolar mood disorder who had seizures and developed a delirious state 1 week after the cessation of interferon-alpha (IFN-alpha) for chronic hepatitis C. The IFN-alpha was administered to the patient for 7 weeks (266 million IU). One week after the cessation of IFN-alpha therapy, the patient had four generalized tonic-clonic seizures over a 2-day period and developed a delirious state for 2 months. We consider these seizures and delirious state to be related to IFN-alpha.

Delirium↗

PubMed1999

Pathological changes of the spinal cord in centenarians.

In order to study the changes that occur in the spinal cords of the aged, 19 centenarian spinal cords from two men and 17 women (age range, 100-116 years at death; mean, 103 years) were pathologically examined. Cross-sections at each segmental level of the 19 autopsied spinal cords were examined for histopathological changes. The cross-sectional area and flattening ratio at the level of the C7 segment were measured. The size of the cords had some negative correlation with age, but the individual variation was considerably large. Among the 19 centenarians, macroscopic anteroposterior flattening appeared in the lower cervical cords in six individuals. In these cases, various degrees of neuron loss were observed in the anterior horn. White matter degeneration appeared frequently, especially in the posterior column. In 12 cases, myelin loss in the fasciculus of Goll at the cervical level was observed. The degeneration of the fasciculus of Goll was considered to be upward wallerian degeneration secondary to posterior root damage at the lumbosacral level. These changes seemed to be produced by disorders in the spinal canal or surrounding tissue, such as cervical spondylosis, degeneration of the intervertebral disk and spinal canal stenosis. Argyrophilic structures such as neurofibrillary tangles and neuropil threads were observed in 16 cases; however, this incidence was less than in the brain. Medial thickening of the anterior spinal artery was found in four cords. Amyloidangiopathy was noted in only one cord. Necrosis and hemorrhage due to vascular disturbance were not found.

Aged↗

PubMed1999

A case of prostatic cancer metastasizing to the orbit.

PURPOSE: We report on a case of prostatic cancer with multiple bone metastases, including right orbital involvement. METHODS/RESULTS: Hormonal treatment and local irradiation to the right orbit were performed. Subjective symptoms with exophthalmos and pain disappeared. CONCLUSIONS: We report on a case of prostatic cancer metastasizing to the right orbital bone.

Adenocarcinoma↗

PubMed1999

A neuropathological study of dementia in nursing homes in Shimane prefecture, Japan: evaluation of the age and gender effect.

BACKGROUND: Vascular dementia (VD) has been held responsible for the majority of all dementia cases in both epidemiological and neuropathological studies in Japan. The aim of this study was to clarify relative frequencies of dementia neuropathologically in Japanese nursing home residents over a 17-year period and to clarify the gender and age effect on the relative frequencies. METHODS: Three hundred ten aged nursing home residents (146 men and 164 women), including dementia cases in Shimane prefecture, Japan, were evaluated clinically and neuropathologically over a period of 17 years. RESULTS: One hundred twenty-two (48 men and 74 women) of the 310 autopsied (39%) had shown signs of dementia during their lives. In classifying dementia type, Alzheimer's disease (AD) accounted for 34% (41); VD 35% (42); mixed dementia 11% (14); and "other" dementia 20% (25) of all samples. As to the gender and age effect, the most characteristic findings were as follows: (a) There were only VD cases in the 57-69-year-old group; (b) the 70-79 male age group lacked any cases with only AD; (c) more AD than VD was found in elderly men; and (d) in women, AD was the major cause of dementia in total. CONCLUSIONS: VD is responsible for the major cause of dementia in the younger women and the men under 90 years of age; AD is the leading cause of dementia in the elderly men and the women over 79 years of age in nursing homes, Shimane prefecture, Japan.

Age Factors↗

PubMed1999

Decreased pancreatic exocrine function in the mutant Eisai hyperbilirubinemic rat (EHBR).

The Eisai hyperbilirubinemic rat (EHBR) is a Sprague-Dawley rat (SDR) mutant with conjugated hyperbilirubinemia as an autosomal recessive trait. EHBRs manifest jaundice from birth, which is permanent except for a transient decrease at 6-8 weeks of age. To investigate whether the hyperbilirubinemia affects pancreatic exocrine function and acinar cell growth, EHBRs at 6 (without jaundice) and 12 weeks (with jaundice) of age were compared, along with SDRs as controls. Pancreatic wet weights did not significantly differ, but amylase content of acini was lower in EHBRs than SDRs. No correlation was found between pancreatic wet weight and serum bilirubin levels in EHBRs. In vitro amylase release in response to 1-100 pM cholecystokinin octapeptide (CCK-8), 1 microM 12-O-tetradecanoylphorbol 13-acetate, and 2.5 microM calcium ionophore A23187, and in vivo pancreatic secretion stimulated by CCK-8 (0.08 microg/kg body weight/h) were significantly lower in the EHBR cases than in the SDRs. At the electron microscopic level, many acinar cell nuclei were pyknotic, most elements of their Golgi complexes were atrophied, some mitochondria demonstrated fusion, and the rough-surfaced endoplasmic reticulum (RER) was dilated in EHBRs. These findings are indicative of a hypofunctional state. However, no differences between EHBRs at 6 and 12 weeks of age were evident, suggesting that the hyperbilirubinemia does not exert any pronounced influence on acinar cell growth or pancreatic exocrine function.

Age Factors↗

PubMed1999

Impairment of the correlation between urinary contents of alpha-1-microglobulin and ulinastatin is induced by intracerebroventricularly administered interleukin-6 in mice.

We have found previously that the correlation between urinary contents of alpha-1-microglobulin (alpha1M) and ulinastatin (UT) depends on the type of neuropsychiatric disease. Since interleukin (IL)-1beta and IL-6 are closely involved in pathophysiological aspects of various neuropsychiatric diseases, effects of intracerebroventricularly (i.c.v.) administered IL-1beta and IL-6 on the correlation between urinary contents of these two glycoproteins were examined in mice, a species in which alpha1M and UT and also the correlation between the urinary contents thereof are expressed similarly to humans. Indices (volume, contents of creatinine, alpha1M and UT, and alpha1M/UT ratio) in urine collected after i.c.v. administrations of 2 and 20 ng of either IL-1beta or IL-6 were not statistically different from those of the vehicle-treated (control) groups. Neither IL-1beta (2 and 20 ng) nor the lower dose of IL-6 (2 ng) affected the positive correlation between urinary contents of alpha1M and UT. However, a higher dose of IL-6 (20 ng) nullified the positive correlation for 2 days after administration. Recovery to a positive correlation was thereafter displayed. These findings suggest that central IL-6 plays an important role in correlating urinary contents of alpha1M and UT without affecting the renal functions.

Alpha-Globulins↗

PubMed1999

Effect of fleroxacin on mouse bladder carcinogenesis with N-butyl-N- (4-hydroxybutyl) nitrosamine.

We recently reported fleroxacin significantly affected cell proliferation in a dose-dependent manner in transitional cell carcinoma cell lines. In this study, we investigated the effect of fleroxacin on mouse bladder carcinogenesis with N-butyl-N-(4-hydroxybutyl) nitrosamine (BHBN). Five-week-old C57BL/6 female mice were divided into three groups. The forced oral administrations of fleroxacin (10 or 50 mg/kg/day) were done for 1 week, then the 0.05% BHBN was given for 8 or 12 weeks. Fleroxacin treatments were continued until sacrifice. The mice were sacrificed at 4 weeks or 8 weeks latent period after BHBN administration, and the histological changes in the bladder were examined. Our study suggested that fleroxacin tended to suppress the development of bladder carcinoma or the malignant changes induced by a shorter period of BHBN administration (8 weeks) in mice. However, in the group of the BHBN administration for 12 weeks, there were no significant effects on the prevention of bladder carcinoma in both of the treatment groups with fleroxacin (10 or 50 mg/kg/day). This study did not make it clear that oral administration of fleroxacin suppressed the development of bladder carcinoma induced by BHBN in mice. However, it is very preliminary data and further experiments need to be done with a much higher dose of the fleroxacin or with other kinds of fluoroquinolone antibiotics.

Animals↗

PubMed1999

[Cilostazol increased heart rate with improvement of activity of daily living in an elderly patient with sick sinus syndrome].

An 86-year-old man had a history of hypertension and had been treated with calcium antagonist but no medications that could reduce heart rate. As a 12-lead electrocardiogram showed sinus bradycardia, complete right bundle branch block and left anterior fascicular hemiblock on his first visit to our hospital on January 1998, he was admitted to our hospital for further examination and treatment. A 24-hour Holter electrocardiogram demonstrated a total number of 74,182 heartbeats per day with pauses (> 2.0 sec) of 187/day. Overdrive atrial pacing study and His bundle electrogram revealed a prolonged corrected sinus node recovery time (5.820msec at a stimulation rate of 130/min) and H-V conduction time (80msec) with normal A-H conduction time, respectively. We diagnosed these abnormalities as sick sinus syndrome (Rubenstein II). His activity of daily living score was 30 points by the Barthel index on the day of admission. Oral administration of orciprenaline sulfate (30 mg/day), a beta-adrenoceptor agonist, was initially chosen rather than implantation of a cardiac pacemaker to increase his heart rate since he did not have any symptoms due to bradycardia and he did not give us an informed consent for the implantation. Orciprenaline sulfate, however, failed to increase total heartbeats (73,079/day). Then, oral cilostazol (100 mg/day), a phosphodiesterase III inhibitor, was administered. After two weeks of the regimen total heart beats were increased (85,642/day) with no pauses. The increase in heart rate resulted in the improvement of his activity of daily living (Barthel index: 55 points). Cilostazol could be the first line medication for elderly patients with bradyarrhythmia in whom implantation of cardiac pacemaker is not absolutely indicated.

Activities of Daily Living↗

PubMed1999

[Glioblastoma fed by meningeal branches of the external carotid artery: a case report].

A rare case of glioblastoma fed by meningeal branches of the external carotid artery was reported. A 63-year-old female was transferred to our hospital suffering from gait disturbance and dysarthria. CT and MRI revealed brain tumor and paratumoral hemorrhage with a large cyst that was heterogeneously enhanced and existed in the right fronto-temporal region. Right external carotid arteriography demonstrated the tumor stain markedly fed by the right middle meningeal artery and the accessory meningeal artery. Subtotal removal operation was carried out uneventfully using the right fronto-temporal craniotomy. The histological diagnosis was glioblastoma. After the operation the patient was in good condition, and was transferred to another hospital for the purpose of the synchronized chemoradiotherapy. It is well known that any glioma invades the meninges. However, we rarely encountered an intra-axial glioma fed by a meningeal blood supply. A meningeal-invaded glioma may make difficult its differentiation from meningioma. We concluded that there is necessity for close examination of the intra-axial brain tumors invaded and fed by meningeal blood supply.

Brain Neoplasms↗

PubMed1999

Bikunin prevents adhesion of calcium oxalate crystal to renal tubular cells in human urine.

Crystal-renal tubular cell interactions are important factors in crystal retention and development of kidney stones. It has been reported that human urine, especially its macromolecular fraction, distinctively prevented calcium oxalate monohydrate (COM) crystal adhesion to tubular cells. This study was designed to find and isolate a specific substance in human urine with a strong inhibitory effect against crystal adhesion. A protein from the urine was purified by two anion exchange chromatography columns and one gel filtration column. The inhibition activity for COM crystal adhesion to Madin-Darby canine kidney cells was determined quantitatively. Amino acid sequence of the protein was analyzed and then subjected to homology search in the GenBank protein database. A specific human urine protein that inhibited the COM crystal adhesion to the cells was isolated and identified. Molecular mass of the protein was approximately 35 kD. The first 20-amino acid sequence from the N-terminal of the purified protein was structurally homologous with the light chain of inter-alpha-trypsin inhibitor, also called bikunin. The isolated bikunin inhibited crystal adhesion at a minimum concentration of 10 ng/ml, and blocked completely at 200 ng/ml. It is concluded that bikunin may contribute to the regulation of crystal adhesion and retention within tubules during kidney stone formation.

Adhesiveness↗

PubMed1999

[A case of basilar artery occlusion successfully treated with tissue plasminogen activator].

This case concerns a stroke in the basilar artery territory that was successfully treated with a tissue plasminogen activator (t-PA). A 44-year-old man suddenly lost consciousness. It took fifty minutes to arrive to our hospital after the onset. On admission, his consciousness was in a coma state. A head CT revealed normal findings but a cerebral angiography showed complete occlusion in the basilar artery. We gave 240,000 units t-PA intravenously for 60 minutes. The intravenous t-PA dramatically improved his state of consciousness. After treatment, the brain CT scan showed low-density areas in the left occipital area and right pons. The cerebral angiography showed arterial sclerosis in the basilar artery. There was no parenchymal hemorrhage or hemorrhagic infarction in the patient. The hitherto reports showed the intravenous infusion of t-PA may be particular value in patients with thromboembolic occlusion in the middle cerebral artery. In contrast, our results support its efficacy in strokes in the basilar artery territory.

Adult↗

PubMed1999

[Size and location of ruptured cerebral aneurysms diagnosed by three dimensional computed tomographic angiography].

The purpose of this study is to confirm the correct size and the location of ruptured cerebral aneurysms diagnosed and measured using three dimensional computed tomographic angiography. The size and the location were investigated in 136 ruptured cerebral aneurysms encountered in our hospital during 3 years and 10 months. As regards the location of 136 ruptured cerebral aneurysms, 40 were anterior communicating artery aneurysms, 35 were middle cerebral artery aneurysms, 33 were internal carotid artery aneurysms, 12 were distal anterior cerebral artery aneurysms and 16 were posterior circulatory aneurysms. Twenty-seven aneurysms (19.9%) were smaller than 3.0 mm, and 74 aneurysms (54.4%) were less than 5.0 mm in maximum diameter. The maximum diameter of aneurysms located on the anterior communicating artery was 4.8 mm. On the middle cerebral artery it was 6.7 mm, and on the internal carotid artery it was 7.4 mm. We concluded that the rate of small aneurysmal rupture was comparatively more frequent than is reported. The results led to the speculation that the aneurysmal rupture occurred more often in smaller size, and the rate of occurrence may be also related to the aneurysmal location.

Adult↗

PubMed1999

Saving the cost and energy by an interactive multimedia system with ISDN 128 Kbps for telemedicine.

The telemedicine systems offer many potential advantages for health care delivery. In 1997, we implemented Phoenix, the interactive multimedia system of the Nippon Telegraph and Telephone Corporation (NTT) for clinical application involving teleconsultations over a wide area for delivery of special care in emergency medicine at Tokai University linking with eight hospitals via the Integrated Service Digital Network (ISDN) 128 Kbps. This study was designed to determine the potential saving of the cost and energy through the interactive multimedia network. By using the interactive multimedia system with some modifications, we achieved a satisfactory real-time contact regarding clinical matters. We believe that this network has allowed appropriate transfer of information between medical centers. This system has also significantly reduced the estimated cost for clinical meetings.

Humans↗

PubMed1998

Nullification of a positive correlation between urinary contents of alpha1-microglobulin and ulinastatin with intracerebroventricularly administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 1-methyl-4-phenylpyridinium (MPP+) in mice.

Striatal dopamine contents in C57BL/6J mice were reduced at 24 h after intracerebroventricular (ICV) administration of 1-methyl-4-phenyl-1,2, 3,6-tetrahydropyridine (MPTP) or 1-methyl-4-phenylpyridinium (MPP+) in a dose-dependent manner. A dose of 1.8 microg MPP+ significantly (P < 0.05) suppressed the dopamine contents, whereas a similar dose of MPTP did not. A definite positive correlation between urinary contents of alpha1-microglobulin (alpha1M) and ulinastatin (UT) existed in normal mice. However, this correlation was nullified by ICV administration of 18 and 36 microg MPTP or 1.8 and 18 microg MPP+. With 1.8 microg MPTP, a positive correlation between urinary contents of alpha1M and UT was displayed. The urine volume, creatinine content, glomerular filtration rate, alpha1M and UT contents, and alpha1M/UT ratio of urine collected for 24 h post-ICV administration of MPTP or MPP+, were not statistically different from those of control mice. Our findings suggest that the central effects of MPP+, a neurotoxic metabolite of MPTP, nullify the positive correlation between urinary contents of alpha1M and UT without affecting renal functions.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗