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Biomedical subjects

T Kondo

Publications and source records attributed to T Kondo.

At least 991 records · Page 55Linked to original sources

[Early detection of obesity in male adults using a combination of body index and bioelectrical impedance method].

Obesity is an excess of body fat frequently resulting in a significant impairment of health. Body index derived from body weight and height is widely available in Japan. However, body index cannot express the fat deposition in the body. Screening for early obesity was studied using a combination of body index and bioelectrical impedance for detecting fat deposition. Three hundred twenty-nine male subjects with normal body index participated in this study. Blood pressure, uric acid, total cholesterol, high density lipoprotein cholesterol, triglyceride, GOT, GPT, gamma-GTP, choline esterase and glucose tolerance after a 75-gram glucose load were measured. The following results were obtained. 1. Among 321 subjects with normal body index, 95 subjects had body fat exceeding 23% as measured by bioelectrical impedance. 2. By matched-pair comparison in the subjects whose body mass indices were within +/- 10% fasting plasma glucose, triglyceride, GOT, GPT, gamma-GTP and choline esterase were significantly higher and high density lipoprotein cholesterol was significantly lower in subjects with fat deposition over 23% than in the 92 matched controls with body fat less than 23%. In conclusion, bioelectrical impedance appears to be useful for detecting early stages of obesity in subjects with normal body index.

Adult↗

[A 66-year-old man with backache and progressive difficulty of gait].

We report a 66-year-old man with progressive spinal paraplegia. He was well until June of 1991 when he had an onset of backache and right chest pain. On August 25, he lost sensation to void and he became unable to urinate. On the same day, he noted weakness in his legs which became progressively worse, and he was admitted to our hospital. Past medical history included diabetes mellitus which was found 3 years previously. He had upper gastrointestinal series 2 months before, which revealed a normal study. On admission, he was alert and general physical examination was unremarkable. Neurological examination revealed a mentally sound man with normal higher cerebral functions. Cranial nerves were also intact. He was unable to walk. No muscle atrophy was noted, but he had moderate to marked (2/5) weakness in both legs. No ataxia was noted in the upper extremities. Jaw jerk was normal, however, deep reflexes in the upper extremities were decreased, and absent in the lower extremities Babinski sign was present bilaterally. All sensory modalities were diminished below the Th 6 dermatome. No meningeal sign was present. Emergency myelography was performed on the day of admission, which revealed complete block from the Th4 to Th8 segments. CSF taken at that time was xanthochromic, positive Queckenstedt test containing 1,133 mg/dl of protein, 54 mg/dl of sugar and 1/3 microliters of lymphocyte. On August 31, laminectomy was performed from Th5 to Th7. The spinal bones in this area was very fragile and hemorrhagic. A soft yellowish vascular-rich tissue was surrounding the spinal cord in the epidural space. Despite surgery his weakness in legs worsened, and he became paraplegic by September 10th. He became somnolent with disorientation to time. In the subsequent course, he developed metabolic acidosis on September 26. On September 28, he became anuric and hypotensive. He expired later on that day.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

[A fatal case due to intoxication with seven drugs detected by GC-MS and TDx methods].

A twenty-year-old woman was suspected to ingest large amounts of 4 kinds of over-the-counter analgesic and antipyretic drugs, and was found dead. Drugs and poisons were screened by TOXI-LAB drug detection system in the serum and urine, and analyzed by GC-MS and TDx system in the blood, urine, organ tissues and contents of stomach and small intestine. The concentrations (microgram/g) of bromisovalum, apronalide, ibuprofen, ethenzamide, acetaminophen and caffeine in the heart blood were 36.5, 7.58, 43.1, 16.9, 1.22 and 177, respectively. Salicylic acid concentration in the serum was 82.1 micrograms/ml. The concentrations of bromisovalum and caffeine are high enough to be lethal levels. Neither fatal pathological findings nor traumatic wounds were seen. The overdose of both bromisovalum and caffeine and synergistic, additive or combined effects of other 5 drugs above are considered to be her cause of death.

Acetaminophen↗

[Progress of clinical diagnosis of heart failure].

The role of CT and MRI in the diagnosis of heart failure include evaluation of cardiac function and pathological diagnosis. Recently, both CT and MRI have achieved a marked progress in the time dissolution function. As a result, ultrafast CT and gradient field echo (FE) MRI are now available for evaluation of cardiac function. However, the former is yet to become popular because of its extremely high cost. On the other hand, various methods have been devised for blood flow measurement, which is also possible by MRI. CT and MRI provide useful information for detecting the cause of heart failure. With CT, diagnosis of calcification of pericardium, valves, aorta and coronary artery, that of pericardial effusion retention, congenital heart and great vessel disease, intracardiac tumor and thrombosis, as well as, morphological diagnosis of dissecting aneurysm of aorta are possible. Helical CT provides highly continuous three dimensional information. MRI is also available for morphological diagnosis of congenital heart diseases while it is possible to detect valvular regurgitation and shunt flow with FE method. There is a possibility of elucidating the energy metabolism of phosphoric acid by MR spectroscopy. CT and MRI is considered more useful in the pathological diagnosis of heart failure rather than in the evaluation of cardiac function. Further progress in these fields is expected in the future.

Coronary Circulation↗

[Protective effect of FPF 1070 (cerebrolysin) on delayed neuronal death in the gerbil--detection of hydroxyl radicals with salicylic acid].

Cerebrolysin (FPF1070) is an extract from pig brain obtained after enzymic digestion, containing free amino acids (85%) and low-molecular weight amino acid sequences (15%). We studied FPF 1070 to determine its ability to protect against delayed neuronal death in the gerbil when administered before and after ischemia. Transient forebrain ischemia was produced by occluding both common carotid arteries. Morphological changes in the CA1 sector of the hippocampus were evaluated 4 days after 5 min. occlusion. The formation of hydroxyl radicals in the postischemic (15 min. occlusion) reperfused (2 min.) brain was measured with HPLC using salicylate (SA). SA reacts with hydroxyl radicals and yields 2,3- and 2,5-dihydroxybenzoic acid (2,3- and 2,5-DHBA), which can be detected by HPLC-ECD. Gerbils treated with FPF 1070 revealed significant protection of CA1 neurons when it was applied 2 hrs before the occlusion. In contrast, no clear beneficial effects were observed when FPF 1070 was administered immediately after the recirculation. Concentrations of 2,3- and 2,5-DHBA after reperfusion increased significantly compared to the basal levels both in the hippocampus and cerebral cortex. The 2,5-DHBA contents in the postischemic reperfused brain was significantly reduced when FPF 1070 was administered 2 hr. before the occlusion. The administration of dimethylsulfoxide (DMSO), a hydroxyl radical scavenger, prevented ischemia-reperfusion-induced delayed neuronal death, and significantly reduced the 2,5-DHBA content after reperfusion. The results indicated that hydroxyl radicals are produced in the postischemic-reperfused brain and that hydroxyl radical scavenging action of FPF 1070 played an important role in preventing delayed neuronal death.

Amino Acids↗

[An acute axonal form of Guillain-Barré syndrome with autoantibody against ganglioside GD1b--a case report].

We reported a 3-year-old boy of an acute axonal form of Guillain-Barré syndrome (GBS) with autoantibody against GD1b ganglioside. A week after an episode of upper respiratory infection, he was hospitalized with a weakness in the lower extremities. Neurological examination revealed facial weakness, restricted extra-ocular movement, hyporeflexia and tetraparesis without any sensory impairment. CSF protein was elevated with normal cell count after the first week of symptoms. Electrophysiological studies demonstrated normal motor nerve conduction velocity and low M potential amplitude. He had been on a respirator for two months. Although he received plasmapheresis in the acute phase, sixteen month after the onset he continued to have distally dominant limb weakness with wasting. Thin-layer chromatogram with immunostaining revealed that serum IgG from this patient reacted with GD1b, but did not react with GM1. Enzyme-linked immunosorbent assay showed that anti-GD1b titer (IgG) decreased concurrently with the clinical improvement. There have been several reports of an acute axonal form of GBS with antibody to GM1. GD1b, as well as GM1, seems to be a target pathogenic antigen in motor axon disorders.

Autoantibodies↗

[A case of angiosarcoma presenting as ill-defined opacities on chest roentgenogram and hemothorax].

A 74-year old male was referred to the Tokai University Hospital for evaluation of abnormal opacities on a chest roentgenogram. Laboratory tests demonstrated leukocytosis, elevated ESR and CRP, elevated LDH, and hypoxemia. The chest roentgenogram demonstrated several ill-defined nodular infiltrates on the bilateral upper lung fields. In addition, a CT scan revealed bilateral pleural effusion which was found bloody on diagnostic thoracocentesis. Administration of antibiotics failed to improve lung infiltration or laboratory data. The patient died of respiratory failure on the 23rd hospital day. At autopsy, multiple ill-defined nodules, which were associated with alveolar hemorrhage, were scattered in the lungs bilaterally. Both hematoxylin-eosin and silver staining showed atypical cells of a vasoformative nature. Factor VIII related-antigen in the tumor cells was confirmed by the peroxidase-antiperoxidase method. These findings were consistent with angiosarcoma. The tumor foci were demonstrated in the lungs, pleura, kidneys, bone marrow, adrenal glands, and the gastrointestinal tract. The primary site of angiosarcoma, however, was not identified. Angiosarcoma, either primary or metastatic to the lungs, should be included in the differential diagnosis of multiple ill-defined nodular opacities associated with hemothorax.

Aged↗

[Two cases of personal identification based on characteristic findings in hard tissue of human remains].

Two cases of personal identification based on the characteristic findings observed in the bones and teeth of unknown human remains are reported. In Case 1, a skeletonized cadaver could be identified as a 49-year-old male because the autopsy findings of the left clavicle of the cadaver, which was previously operated with metallic screw and wire after fracture, corresponded to the characteristic findings in an antemortem X-ray picture of the presumed person. In Case 2, a cadaver discovered at the seaside, could be identified as a 55-year-old male by comparison between ante- and postmortem dental X-ray findings such as root canal treatment and disease (radicular cyst) including the anatomical characteristics of the root. In forensic practice of personal identification of cadavers with advanced postmortem changes, it seems really important to find out an antemortem medical and/or dental chart and X-ray pictures as well as thorough examination for hard tissue of human remains.

Bone and Bones↗

[Chronic pulmonary mucormycosis diagnosed by bronchoscopy: a case report].

A 56-year-old man with bronchial asthma and diabetes was admitted with massive hemoptysis and thick-walled cavity in the right middle lung field on chest X-ray films. He had been treated with antibiotics for eight months under the diagnosis of lung abscess before his admission. After occlusion of the bronchial arteries with metallic coils, bronchofiberscopy was performed disclosing the obstruction of right B3b. Microscopic examination of bioptic material and bronchial brushing smear taken from right B3b yielded numerous broad, nonseparate hyphae. Right middle and lower lobectomy were performed under a diagnosis of chronic pulmonary mucormycosis. The patient was recovered and discharged on 55 th days after operation.

Biopsy↗

[Stellate ganglion blocks as the suspected route of infection in a case of cervical epidural abscess].

Spinal epidural abscess is a comparatively rare disease. Its prognosis reportedly depends on degree and duration of the neurological symptoms before the treatment. Thus, the importance of early diagnosis and prompt surgical treatment has been emphasized repeatedly. In the case reported here stellate ganglion blocks were considered to be involved in the etiology of a cervical epidural abscess. The 47-year old woman complained of tinnitus and vertigo and repeatedly underwent stellate ganglion blocks over a period of 10 months. In August, 1991, the patient complained of back pain and developed fever. A few days later she noticed motor weakness and sensory disturbances in the legs. Ten days after the onset of these neurological symptoms she complained of rapidly progressive tetraplegia and was referred to this hospital for admission. On admission, she was fully conscious but febrile. Neurologically, she presented tetraplegia, hypesthesia below level of C7 and slight cervical rigidity. Bladder and bowel dysfunction were also observed. MRI examination showed an epidural mass behind vertebral bodies C6-7 compressing the spinal cord. Antibiotic therapy was initiated immediately and emergency surgical decompression was performed through an anterior approach. Intraoperative findings showed a discitis and yellowish liquid pus in the epidural space. Culture of the pus revealed staphylococcus aureus. In this case repeated stellate ganglion blocks before onset of the symptoms were the suspected route of infection. Postoperative MR images confirmed satisfactory decompression of the spinal cord and motor power was gradually recovered after surgery. Approximately 4 months after surgery she could walk independently. Cervical epidural abscess has been rarely reported as a complication of stellate ganglion block.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗

[A 61-year-old man with rapidly progressing dementia and gait disturbance].

We report a 61-year-old male with rapidly progressive dementia and gait disturbance. He was well until spring 1990 as a postmaster, when there was an onset of memory disturbance and mistakes in his job. In May 1990, his wife noted slurring of his speech. In August, there was an onset of gait disturbance. He fell down frequently. In October, he was seen by a neurologist, who found moderate dementia, small step gait, retropulsion, freezing, paratonic rigidity, bradykinesia and a restriction in the vertical gaze on him. His dementia and gait disturbance progressed rapidly and in May 1991, he developed fever and dyspnea and was admitted to Juntendo University Urayasu Hospital. On admission, he was chronically ill and wheezing rale was heard on both lung fields. Neurologically, he was awake but without response to the simplest examiner's command. Cranial nerves appeared intact except for a restriction in the upward gaze. His posture was opisthotonic with a decorticated posture. Marked rigidity was present in all four limbs. He could not sit or stand. Deep reflexes were diminished symmetrically. He was treated by supportive cares, however, he expired 12 days after his admission. In no time myoclonus was observed, nor PSD recorded in his EEG. Cranial CT scans revealed moderate cortical atrophy. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that he had Creutzfeld-Jakob disease despite the absence of myoclonus and PSD. Postmortem examination revealed diffuse spongy state of the cerebral hemisphere as well as striatum.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

[Surgical treatment of stage IVa thymoma].

The relationship between prognosis of the disease and the type of surgery were reviewed in 110 cases of thymoma. Surgical procedures were classified into four types: total resection (TR), subtotal resection (SR), partial resection (PR) and exploratory thoracotomy (ET), and the extent of the disease was expressed as stage I through IV based on Masaoka's classification. Ten-year survival rates for stage III and IVa diseases were 5 6.2% in TR, 37.9% in SR and 30.3% in PR. None of the patients in ET survived more than 28 months. Tumor death after surgery was not observed in TR. Two of three patients with stage IVa disease who underwent TR are alive without recurrence of the tumor at 37 months and 6 months after surgery. The pleuropneumonectomy was performed in the former case. One of four patients who underwent SR and one of three patients who underwent PR both with stage IVa disease are alive at 71 and 150 months after surgical intervention, respectively, in spite of the presence of the tumor relapse. In these patients, repeated chemotherapy and radiotherapy were administered following the resection of the primary lesion. In conclusion, it was indicated that the improvement of the survival rate could be obtained by resection the tumor as completely as possible in stage III and IVa thymoma, as long-term survival has been proved to be possible by macroscopically complete removal of the primary site and pleural disseminations followed by combined adjuvant therapy in patient with stage IVa disease.

Adolescent↗