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Biomedical subjects

T Inoue

Publications and source records attributed to T Inoue.

At least 343 records · Page 19Linked to original sources

[Clinical experience of new stereotactic radiotherapy system named CyberKnife].

The CyberKnife is a small linear accelerator mounted on a robot. The CyberKinfe has the IPS(Image Processing System) that evaluates the patient position during the treatment. If there is any movement of the patient, the robot chases the tumor. Invasive flame to fix the patient skull is not needed. From April 1998 through July 2000, we applied the CyberKnife treatment for 136 sites in 94 patients. Sixty-seven of 136 sites were metastatic brain tumors. Progression-free rate of tumors treated with 24-27 Gy at 3 months after treatment was 89%. There was no severe adverse effects except epilation. The CyberKnife treatment was applied for tumors in the body in USA. It will be available in Japan in near future.

Brain Neoplasms↗

Post-load glucose measurements in oral glucose tolerance tests correlate well with 1,5-anhydroglucitol, an indicator of overall glycaemic state, in subjects with impaired glucose tolerance.

Using both cross-sectional and longitudinal methods, we investigated the relationship between post-load serum glucose concentration in a 75 g oral glucose tolerance test (OGTT) and overall glycaemic state in subjects with impaired glucose tolerance (IGT). Glycaemic state was assessed by measuring glycated haemoglobin (HbA1c) and the serum concentration of 1,5-anhydroglucitol (1,5-AG). In the cross-sectional study, the concentration of 1,5-AG, while remaining within a normal range, was reduced to a degree proportional to the post-load glycaemic level. Although the correlation between HbA1c and post-load plasma glucose was relatively weak (r=0.281, P<0.001), a significant inverse correlation (r=-0.824, P<0.0001) was found between 1,5-AG and mean post-load plasma glucose concentration in 211 subjects with IGT. Fasting plasma glucose (r=-0.539, P<0.0001) and 2 h plasma glucose (r=-0.621, P<0.0001) were correlated with 1,5-AG less strongly than was post-load glycaemia. Both 1,5-AG and HbA1c were correlated weakly but significantly with the fasting insulin concentration. In the longitudinal study we measured 1,5-AG and mean post-load plasma glucose with an OGTT once yearly for 10 years in 15 subjects with IGT. Strong inverse correlations were seen between 1,5-AG and mean post-load plasma glucose in each subject (range of r values among subjects of -0.584 to -0.978). These findings suggest a close relationship between post-load plasma glucose concentration measured by OGTT and overall glycaemic state in subjects with IGT.

Adult↗

Arrhythmogenic right ventricular dysplasia presenting as regression of left ventricular dysfunction: a case report.

Arrhythmogenic right ventricular dysplasia is considered to be a slowly progressive disease in which left ventricular dysfunction and congestive heart failure usually appear at the end stage. The initial clinical presentation of this 56-year-old Japanese woman was left-sided heart failure, and the diagnosis was dilated cardiomyopathy, but her left ventricular size and ejection fraction regressed during 10 years of treatment, whereas her right ventricular parameters showed no change.

Arrhythmogenic Right Ventricular Dysplasia↗

[Anesthesia for electroconvulsive therapy during pregnancy--a case report].

We experienced anesthetic management for ECT in a patient with psychiatric disease during the third trimester of pregnancy. The 24 year-old patient had been on oral antipsychotics prescribed to treat schizophrenia for ten years. Her signs and symptoms deteiorated during pregnancy in spite of increased doses of antipsychotics. With tocolytic agent administered intravenously, anesthesia was induced by intravenous thiamylal immediately followed by intravenous suxamethonium for muscle relaxation. Alternative current was applied on both side of the head after the sufficient anesthesia had been obtained. The patient received intermittent mandatory ventilation by breathing mask with 100% oxygen during the procedure. Along with monitoring of maternal hemodynamic variables and arterial oxygen saturation (Spo2), fetal heart rate and uterine contraction were recorded by cardiotocogram throughout the procedure. At the first two treatments, the patient showed neither significant uterine contraction nor fetal heart rate changes. At the third treatment, continuous uterine contraction refractory to tocolysis was recorded for six minutes, resulting in fetal bradycardia. At the sixth treatment, general anesthesia was induced and maintained by sevoflurane in oxygen followed by suxamethonium for muscle relaxation. The uterine contraction was remarkably diminished and fetal heart rate remained unchanged during the procedure. In conclusion, inhalation anesthesia is beneficial for ECT in the last stage of pregnancy to reduce uterine contraction by potential uterine relaxation effect of anesthetics.

Adult↗

[Experimental study of pharmacological hypothermia: enhanced neuroprotective effect of a novel 5-HT 1 A agonist SUN N4057 by the pharmacological hypothermia].

PURPOSE: 5-hydroxytryptamine(5-HT) 1 A receptor agonists have a potentially marked neuroprotective reaction by both neuroprotective and hypothermic effects. We previously reported (1) the neuroprotective effect against the cerebral ischemia under normothermic condition, and (2) the hypothermic effect of the novel compound of 5-HT 1 A agonist, SUN N4057. The present investigation was designed to examine the enhancement of the neuroprotective effect by its pharmacological hypothermia. METHODS: In 24 anesthetized cats(body weight 1.9-4.6 kg), the left middle cerebral artery(MCA) occlusion was performed via the transorbital approach. Just after MCA occlusion, SUN N4057(6 micrograms/kg/min) was infused. Physiological parameters were measured continuously, and arterial blood gas was analyzed hourly for 6 hours and maintained within the normal ranges. Animals were randomly allocated to the following three groups: (1) ischemic controls infused with sterile saline(Group A, n = 8), (2) SUN N4057 under normothermic condition(Group B, n = 8), (3) SUN N4057 (Group C, n = 8). Then, brain coronal sections of 3 mm in thickness were stained with 1% triphenyltetrazolium chloride(TTC) solution, and hemispheric infarct volumes were calculated by using a computerized image analysis system. RESULTS: There were no significant differences in any physiological parameters among 3 groups. In Group C, brain temperature decreased significantly starting 1 hour after MCA occlusion and dropped by 2.1 +/- 0.7 degrees C 5 hours. Infarct volumes were 35.6 +/- 6.9% (Group A), 23.3 +/- 5.8% (Group B) and 12.3 +/- 11.3% (Group C), respectively. There were significant differences among three groups(p < 0.05). CONCLUSION: On the basis of these data, we conclude that SUN N4057 provides more effective neuroprotection by the combination of hypothermic and neuroprotective effects. Chemical hypothermia may lead to a new therapeutic approaches for treatment of brain ischemia.

Animals↗

[Immunohistochemical study of KL-6 in pulmonary tuberculosis].

KL-6 is a glycoprotein antigen derived from the cell line of human lung adenocarcinoma. Although KL-6 is known to be a serum marker of interstitial pneumonia, elevated KL-6 serum levels have also been reported in some cases of pulmonary tuberculosis. To elucidate the mechanism of KL-6 elevation in pulmonary tuberculosis, we stained pulmonary tissue samples from five clinical cases for immunohistochemical analyses. In the two cases showing productive changes, KL-6 immunoreactivity was localized in the area of type II pneumocytes showing strong interstitial changes surrounding caseous necrosis. In the two cases showing exudative changes, KL-6 immunoreaction was observed not only to surround caseous necrosis but also to appear within it, particularly in the remaining alveolar lumen septa. On the other hand, the one patient with old pulmonary tuberculosis that showed slight interstitial changes presented with weak KL-6 immunoreactivity on the surface of the alveolar lumen surrounding the tuberculotic region. These results suggest that serum elevation of KL-6 in pulmonary tuberculosis originates from the proliferation of type II pneumocytes along with interstitial changes that surround the tuberculous region.

Antigens↗

Real time reverse transcriptase polymerase chain reaction of urinary cytokeratin 20 detects transitional cell carcinoma cells.

PURPOSE: We evaluate the diagnostic use of cytokeratin 20 messenger (m) RNA quantitation in urine as a marker of urothelial transitional cell carcinoma using the real time reverse transcriptase polymerase chain reaction (RT-PCR). MATERIALS AND METHODS: Spontaneously voided urine was obtained from 47 patients with urothelial transitional cell carcinoma (carcinoma group), 19 other urological diseases (noncarcinoma group) and 27 healthy volunteers (control group). Quantification of cytokeratin 20 was performed with mRNA extracted from urine samples with primers and hybridization probes specific for cytokeratin 20 on a LightCycler instrument (Roche Diagnostics Corp., Indianapolis, Indiana). RESULTS: This method allowed reproducible quantitation of 10 to 106 cytokeratin 20 expressing colon carcinoma cells per 107 peripheral blood leukocytes, comparable to the sensitivity of conventional RT-PCR with a wide linear measuring range. Cytokeratin 20 mRNA values in the carcinoma group (mean 35,850) were significantly higher than noncarcinoma (171) and control groups (4.55, p <0.0001 and <0.0001, respectively). Urinary cytokeratin 20 mRNA values significantly correlated with tumor grade, urinary cytological class, immunostaining pattern and depth of tumor invasion. Sensitivity and specificity of real time RT-PCR with a cutoff value of 15 were 81% and 83%, whereas those of conventional cytology were 28% and 100%, respectively. CONCLUSIONS: These results indicate that real time cytokeratin 20 RT-PCR is a sensitive, quantitative, rapid and specific method to detect free cancer cells in the urine, with good potential for monitoring recurrence of urothelial transitional cell carcinoma.

Adult↗

Should the supplemental vein graft be anastomosed upstream or downstream of the internal thoracic artery (ITA) for ITA hypoperfusion?

BACKGROUND: This study was designed to compare internal thoracic artery (ITA) flow in different settings of supplemental vein grafting for ITA hypoperfusion. METHODS: Fourteen dogs each received two coronary bypass grafts to the circumflex artery (CFX), using left ITA and vein grafts, and then the proximal CFX was ligated. The animals were divided into two groups. G-I dogs receiving the vein graft proximally to the ITA graft and G-II receiving the vein distally. ITA flow was evaluated regarding 1) effects of competition from the vein graft, and 2) pharmacological or physiological effects on the ITA's contribution to distal perfusion. Flow is expressed as a mean (ml/min). RESULTS: ITA flow was 44.2+/-5.9 in G-I, and 45.7+/-6.5 in G-II (p=ns), when the vein graft was occluded. With a vein graft open, ITA flow decreased to 7.5+/-1.6 in G-I, and 6.8+/-1.8 in G-II (p=ns), and ITA's contribution to total perfusion requirements was 18% in G-I and 16% in G-II. Adenosine (0.2 mg/min/kg) increased the ITA flow in both groups, 18.4+/-3.2, and 16.3+/-3.8, respectively (p=ns), and ITA's contribution to distal perfusion was increased to 32% in G-I and 27% in G-II. In contrast, phenylephrine (0.003 mg/min/kg) decreased ITA flow and ITA's contribution to distal flow in both groups (6.1+/-1.1, 11% vs 6.2+/-1.4, 11%, p=ns), but increased vein flow significantly. Cardiac pacing (150 bpm) increased the ITA flow and ITA's contribution to distal perfusion equally in both groups (8.4+/-1.5, 16% vs 7.6+/-2.6, 15%, p=ns). CONCLUSIONS: Supplemental vein grafting, whether it is placed distally or proximally, limits ITA flow and ITA's contribution to distal perfusion both in the resting heart and during the increased myocardial oxygen demand.

Anastomosis, Surgical↗

Falcotentorial meningioma accompanied by temporal lobe hematoma.

We report a case of a falcotentorial meningioma accompanied by hematoma in the temporal lobe. A healthy 51 year-old-female with no history of hypertension presented with sudden onset of consciousness disturbance and right hemiparesis. Computed tomography revealed a hematoma 5.5 cm in diameter surrounded by thick edematous brain in the left temporal lobe and a tumor 3.5 cm in diameter in the pineal region. Bilateral carotid angiography detected occlusion of the Galenic vein and straight sinus. No causative abnormality of hemorrhage was apparent. However, the left basal vein of Rosenthal had disappeared, and anastomotic venous channels could be observed in the medial left temporal lobe, contiguous to the hematoma. Emergency craniotomy failed to detect any abnormality which could cause hemorrhage in the brain parenchyma surrounding the hematoma. Subtotal removal of the tumor, histologically diagnosed as fibrous meningioma, was achieved three months later employing an occipital transtentorial approach. Venous congestion caused by compression due to the tumor was considered to be one of possible causes of the hemorrhage.

Brain↗

Runoff characteristics of major ionic species during rain events in forested watershed.

The runoff characteristics of major ionic species from a stream in a forested watershed were investigated during two rain events. The values of EC and the concentrations of alkalinity, anions and cations, except for NO3-, decreased according to the increase of discharge, and showed a sharp lower peak. On the other hand, the concentrations of NO3- and K+ indicated an opposite change. The amount of output of anions and cations was also larger than those of the input, especially in a storm event. During a storm event, the NO3- concentrations in soil water 20 cm deep taken by a tension lysimeter were not detected, even though the surface soil of 0-5 cm deep included 20 to 50 mg/kg of NO3-. The direct contribution for NO concentrations by suspended solids in water was estimated through three percentages of the stream water output. Surface runoff was also not observed. These results suggest that the prompt subsurface runoff of the direct runoff from surface layer of soil may be predominant during rainfall in the forested area, and the increase of NO3- concentrations in the stream may be caused through the process.

Environmental Monitoring↗

Runoff characteristics of nutrients in the forest streams in Hyogo Prefecture, Japan.

Nutrients and other pollutant runoffs from streams in artificial forest areas in central Hyogo Prefecture in southwest Japan have been investigated to estimate pollutant loads since 1995. The orthophosphate and ammonium nitrogen contents were usually low and constant during the investigation. When the flowrates of the streams were normal, the concentrations of suspended solids, COD(Mn), TOC and total phosphorus were very low, and did not change much. However, when stream flows were increased by rainstorms or other precipitation, higher concentrations of these parameters occurred. Otherwise, the average concentrations of nitrate nitrogen and total nitrogen were 0.26 mg/l and 0.31 mg/l, respectively, and they were often increased by precipitation events. They changed at the same time because the ratio of nitrate nitrogen per total nitrogen was high, about 80%. The fluctuation of concentrations of total phosphorus was similar to SS concentrations, which suggested that phosphorus was discharged in the types of suspended solids from forest areas. The specific loads of the nutrients and some other pollutants did not differ among the three watersheds investigated. However, the difference among them between fine days and rainy days was fairly large. It was presumed that pollutant runoff from forest areas is strongly dependent on precipitation events.

Agriculture↗

Runoff of acidic substances that originated from atmospheric deposition on Yakushima Island, a world natural heritage site.

In this paper we present monitoring data of stream waters that may reflect acidic impacts on the island as well as the rainwater qualities. The pH ranges of the river water in the Kawara streams in the western part of the island and the Yodogo stream in the central part of the island were 5.71-6.35 and 5.85-6.12 during 1992-1999, respectively. The concentrations of SO4(2-) and NO3- in the river water were lower than those in the rainwater. Many differences were observed among the sampling sites. Higher concentrations of acid substances are found in the stream waters of the western area compared to the other areas. On the other hand, sulfuric acid is the major acid in the rainwater, snow and rime ice. No differences were observed in the ion constituents of the rainwater collected in the areas. These results suggested that the densely growing canopy may play a role in holding air pollutants, and acidic substances deposited on the canopy would be discharged as a through-fall and a stem flow. Furthermore, the water mass containing high ionic substances in the western area has been held in the groundwater layer, continuously supplying the stream waters during dry weather days. On the other hand, part of the basic runoff will be diluted with a surface runoff during the rainy days. As a result, the concentrations of the ionic substances in the stream waters during rainy days decreased.

Acid Rain↗

[Occurrence of BOOP outside radiation field after radiation therapy for small cell lung cancer].

We report a case of bronchiolitis obliterans organizing pneumonia (BOOP) that occurred outside the radiation field after radiation therapy for small cell lung cancer. A 74-year-old woman received chemotherapy and a total of 60 Gy of radiation therapy to the right hilum and mediastinum for small cell carcinoma of the suprahilar area of the right lung. Radiation pneumonitis developed within the radiation port 3 months after the completion of radiation therapy. She complained of cough and was admitted 7 months after completion of the radiation therapy. Chest radiography and computed tomography demonstrated peripheral alveolar opacities outside the radiation field on the side contralateral to that receiving the radiation therapy. Bronchoalveolar lavage showed that the total cell count was increased, with a markedly increased percentage of lymphocytes. Transbronchial lung biopsy revealed a histologic pattern consistent with BOOP. Treatment with corticosteroids resulted in rapid improvement of the symptoms and complete resolution of the radiographic abnormalities of the left lung. Although some cases of BOOP following radiation therapy for breast cancer have been reported, none of BOOP after radiation therapy for lung cancer have appeared in the literature.

Aged↗

[Two cases of bronchus-associated lymphoid tissue lymphoma].

We report 2 cases of bronchus-associated lymphoid tissue lymphoma (BALT lymphoma), which is a rare disease. Patient 1 was a 76-year-old woman with a chief complaint of cough. Since plain chest radiography revealed an abnormal shadow in the hilum of the lung, she visited our hospital. Patient 2 was a 56-year-old man, who had been diagnosed as having pseudolymphoma at a medical check-up in a local hospital. During follow-up, however, he was referred to our hospital because of enlarged tumors and chest pain. In both patients, bronchofiberscopy demonstrated submucosal tumors and biopsy samples showed formation of lymphoepithelial lesions by centrocyte-like cells with a B-cell staining pattern. The patients were therefore diagnosed as having BALT lymphoma. Both received CEOP-E treatment, which improved the clinical symptoms but did not result in complete remission. The patients have been followed up after discontinuation of the medication. The progress of the disease has been slow, and both patients are alive as of September 2001.

Aged↗

New animal models for encapsulating peritoneal sclerosis--role of acidic solution.

OBJECTIVE: Encapsulating peritoneal sclerosis (EPS), in which all or part of the intestine is enveloped in a fibrous ball resembling a cocoon, is a serious complication of peritoneal dialysis (PD). The aim of the present study was to investigate whether pH-neutral or acidic dialysis solutions induce peritoneal fibrosis. DESIGN: We divided 18 male Wistar-Kyoto (WKY) rats into three groups and dialyzed them with various solutions as follows: group I, 10 mL acidic dialysis solution (pH 3.8, containing 1.35% glucose), n = 6; group II, 10 mL pH 5.0 dialysis solution, n = 6; and group III, 10 mL neutral dialysis solution (pH 7.0), n = 6. Peritoneal catheters were inserted, and dialysis solution was injected every day for 40 days. At the end of the experiment, a peritoneal equilibration test (PET) was performed. Expression of mRNA of aquaporins 1 and 4 (AQP-1 and AQP-4) in the peritoneum were studied by semiquantitative reverse-transcriptase polymerase chain reaction (RT-PCR). RESULTS: In rats treated with pH 3.8 dialysis solution, necropsy findings revealed features identical to those of EPS. The typical appearance was of granulation tissue or fibrotic tissue (or both) covering multiple surfaces. Multiple adhesions were present. In microscopic examinations, peritoneal fibrosis and loss of mesothelium were found. In rats treated with pH 7.0 dialysis solution, no signs of EPS were seen. In rats treated with pH 5.0 dialysis solution, milder changes (subserosal thickening and partial adhesion of the peritonea) were observed. The mRNA of AQP-1 and AQP-4 were expressed in the peritonea of the rats. The expression of the AQPs was significantly suppressed in rats treated with pH 3.8 dialysis solution. CONCLUSIONS: In rats, long-term intraperitoneal injection of acidic dialysis solution produced features typical of EPS in humans. Newly developed neutral dialysis solutions protected the against the development of EPS during peritoneal dialysis in rats.

Animals↗

Nursing in Japan.

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Accreditation↗

New rat model for attention deficit hyperactive disorder (ADHD).

PURPOSE: In a strain of the Long-Evans Cinnamon (LEC) rats, we found spontaneously hyperactive animals designated as "wiggling," and established a congenic wiggling (Wig) rat by transferring the gene from the LEC to the Wistar King-Aptekman/Hokkaido (WKAH) strain. We evaluated the feasibility of the Wig rat for an animal model of human attention deficit hyperactive disorder (ADHD). METHODS: Mode of inheritance was examined by use of linkage analyses. Motor activity, behavior, and working memory were assessed by use of electric digital counters, open field test, and Y-maze and water-maze tests. RESULTS: The abnormal behavior, including hyperactivity, was transmitted in autosomal recessive mode. Diurnal and nocturnal motor activity of 12- to 14-week-old Wig rats was markedly higher than that of controls, and this hyperactivity was more prominent during nighttime than daytime. Ambulation in the open-field test was significantly increased in Wig rats, but rearing was decreased in Wig rats, compared with controls. Results of the Y-maze tests indicated that spontaneous alternation behavior was significantly impaired in Wig rats, although there was no difference in the total arm entries. The water-maze test could not be performed because, when exposed to water, Wig rats panicked and almost drowned. CONCLUSIONS: Wig rats are hyperactive and have impaired working memory and impulsive behavior, as assessed by the motor activity and open-field tests and the Y-maze test, and these abnormalities are transmitted by a single gene with Mendelian pattern. Wig rats represent an excellent animal model of human ADHD.

Animals↗