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Biomedical subjects

T Okuyama

Publications and source records attributed to T Okuyama.

At least 91 records · Page 5Linked to original sources
PubMed2000

[Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT].

Cerebral blood flow(CBF) in 34 patients with bilateral chronic subdural hematoma was measured by 99mTc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 13 cases with headache(headache group), 10 cases with hemiparesis(hemiparesis group), 5 cases with tetraparesis(tetraparesis group) and 6 cases with consciousness disturbance or dementia(consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma was bilaterally found in the hemiparesis and tetraparesis groups, and which was finally observed in whole brain in the consciousness disturbance group.

Adult↗
PubMed2000

[Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image].

The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image(MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI.

Acute Disease↗
PubMed2000

Persistence of the benefits of a structured psychiatric intervention for breast cancer patients with lymph node metastases.

The aim of this study was to investigate the persistence of clinical effectiveness of a 5 week structured group intervention program for Japanese breast cancer patients. A total of 47 patients with breast cancer completed the full program. The results of the Profile of Mood States (POMS) scores were compared before, immediately after, and 6 months after the intervention program. As analysed by POMS scores, the clinical effectiveness of a structured group intervention program persisted for 6 months for patients without nodal metastases. In contrast, the intervention program did not show a lasting effect for patients with nodal metastases. This study demonstrated the short-term effectiveness of structured interventions among Japanese cancer patients, but persistence of the effects of intervention was found only among patients without nodal metastases. For patients with nodal metastases, additional intervention would be needed.

Adult↗
PubMed2000

Effects of a structured psychiatric intervention on immune function of cancer patients.

The aim of the present study was to examine the influence of mood state and coping styles on the immune function in Japanese breast cancer patients who participated in a structured group intervention program. The program consisted of five-weekly 90-minute sessions, including psycho-education, psychological support, problem-solving technique and relaxation/imagery. Out of 77 breast cancer patients who participated in this program, 34 were eligible for measurement of immune functions because they received adjuvant chemotherapy. Comparison of the pre- and post-intervention scores of the Profile of Mood States (POMS) revealed significant decreases in Depression (p < 0.05), Lack-of-Vigor (p < 0.01), Tension-Anxiety (p < 0.01), Confusion (p < 0.05) and Total Mood Disturbances (p < 0.01), as expected. Concerning coping styles, there were tendencies to decrease the score of active-cognitive coping (p = 0.09), although the differences were not statistically significant. In contrast, the pre- and post-intervention values of immune parameters such as CD3, CD4, CD8, CD4/8 and natural-killer cell activity showed no significant differences. In this report, we discuss several possibilities underlying these findings. Further studies with a larger number of subjects and controls are needed to reach conculusions.

Adaptation, Psychological↗
PubMed1999

Neonatal intramuscular injection with recombinant adeno-associated virus results in prolonged beta-glucuronidase expression in situ and correction of liver pathology in mucopolysaccharidosis type VII mice.

For many metabolic diseases, early correction of the inherited deficiency is required to prevent long-term sequelae. We examined the ability of adeno-associated virus (AAV) to mediate efficient gene transfer during the neonatal period in mice with the lysosomal storage disease mucopolysaccharidosis type VII (MPS VII). Quadriceps of newborn MPS VII mice were injected with an AAV vector containing human beta-glucuronidase (GUSB) cDNA. High-level intramuscular GUSB expression was seen as early as 2 weeks of age, and persisted for at least 16 weeks with no reduction in activity. In addition, GUSB activity was detected in both liver and spleen at later time points. The level of GUSB activity resulted in a significant reduction in lysosomal storage in the liver and a minimal reduction in the spleen at 16 weeks. However, the temporal and spatial pattern of hepatic GUSB activity, coupled with the presence of GUSB cDNA in liver sections, suggests that hematogenous dissemination of virus at the time of injection led to gene transfer to hepatic cells. These results demonstrate that AAV vectors can successfully infect neonatal muscle and persist through the rapid growth phase following birth. However, GUSB secretion from an intramuscular source is inefficient, limiting the therapeutic efficacy of this approach.

Age Factors↗
PubMed1999

Quality of life following surgery for vertebral metastases from breast cancer.

BACKGROUND AND OBJECTIVES: The quality of life of patients with vertebral metastases from breast cancer treated with surgery was evaluated. METHODS: Seven such patients underwent surgery for vertebral metastases following chemoendocrine treatment. They presented with pain and some with neurological compromise. RESULTS: Following posterior stabilization with a segmental instrument, pain was alleviated in all seven women, two showed improvements in neurological compromise, and performance status was improved in five. In no patient was there neurological deterioration secondary to surgical intervention. They were out of bed on the 4th postoperative day and discharged on the 14th day on average. CONCLUSIONS: The quality of life was improved for these surgically treated patients. We recommend surgical stabilization for selected patients with a vertebral metastasis from breast cancer.

Adult↗
PubMed1999

Effect of physical training and its cessation on percent fat and bone density of children with obesity.

OBJECTIVE: We determined the effect of 4-month periods of physical training (PT) and detraining on percent fat (percent fat) and bone density of children with obesity. RESEARCH METHODS AND PROCEDURES: Subjects were 79 7- to 11-year-old children with obesity; 34 were white, 44 were black, and 1 was Asian, 26 were male and 53 were female. They were randomly assigned to two groups: group 1 engaged in PT for the first 4 months, while group 2 engaged in PT during the second 4 months. Body composition was measured with dual energy absorptiometry, and diet was measured with 4 days of recall for each 4-month period. PT was offered 5 days/week for 40 minutes/session, heart rate monitors were worn, and no dietary information was given; mean attendance was 80%, and mean heart rate per session was 157 bpm. RESULTS: Group by time interactions across the three time-points (from analysis of variance) were significant for percent fat (p = <0.001) and bone density (p = 0.045). Both groups declined in percent fat during the periods of PT, by an average of 1.6% fat units; in the 4 months after cessation of PT, group 1 increased by 1.3% fat. In both groups, bone density increased more during periods of PT (0.025 g/cm2) than during periods of no PT (0.010 g/cm2). No significant PT vs. no-PT differences were found for dietary intake of energy, macronutrients, or calcium. DISCUSSION: This study suggests that regular exercise, without dietary intervention, can enhance the body composition of children with obesity.

Adipose Tissue↗
PubMed1999

The effectiveness of chemotherapy with cisplatin and 5-fluorouracil for recurrent small cell neuroendocrine carcinoma of the rectum: report of a case.

We report herein the case of a 46-year-old-man with small cell neuroendocrine carcinoma (NEC) concomitant with large villous adenoma of the rectum, who underwent abdominoperineal resection with regional lymphnode dissection. The resected specimen was histologically found to contain a small lesion of NEC confined to the submucosa in the large adenoma. A computed tomography scan done 4 months postoperatively revealed recurrences in the liver, lymph nodes, and bone. Therefore, two cycles of sequential intravenous combined chemotherapy with standard doses of cisplatin and 5-fluorouracil (5-FU) were administered, after which the size of each tumor decreased remarkably. Nevertheless, the patient died 8 months after the operation. As there was a fair response of this tumor to the combined chemotherapy of cisplatin and 5-FU, this regimen against NEC of the colon and rectum should be given consideration.

Adenoma, Villous↗
PubMed1999

Overexpression of Bcl-2 protects human hepatoma cells from Fas-antibody-mediated apoptosis.

BACKGROUND/AIMS: Fas is a cell surface antigen, that triggers apoptosis upon specific ligand or antibody binding. The proto-oncogene bcl-2 prevents apoptosis induced by various treatments. The aim of our study was to evaluate whether Bcl-2 protects hepatoma cells from Fas-mediated apoptosis. METHODS: Two human cell lines, HCC-T and HepG2 were used. Expression of Fas antigen and Bcl-2 was detected by flow cytometry and Western blotting. Cell viability and apoptotic change were examined after anti-Fas- and antisense oligodeoxynucleotide treatments. Apoptotic cells were detected by nick-end labelling and the TUNEL method. To test if Bcl-2 expression can protect HepG2 cells from Fas-mediated apoptosis, the cells were transduced using retroviral vector, LZBC, designed to coexpress E. coli beta-galactosidase and human Bcl-2. To further confirm the protective effect of Bcl-2 expression against Fas-mediated apoptosis in HepG2, Bcl-2 expressing plasmid vector was produced and a cell line stably expressing Bcl-2 was cloned. RESULTS: Western blot analysis showed constitutive Bcl-2 expression in HCC-T cells, but not in HepG2 cells. HCC-T was resistant to apoptosis after treatment with an agonist anti-Fas antibody (1 microg/ml for 3 days), whereas 33% of the HepG2 cells were killed by this treatment. Inhibition of Bcl-2 expression by transfection of antisense oligodeoxynucleotides caused spontaneous apoptosis in HCC-T, but not in HepG2 cells, suggesting that Bcl-2 is essential for survival of HCC-T cells, whereas other proteins may substitute for it in HepG2 cells. Following LZBC infection, 10% HepG2 cells were beta-galactosidase-positive by X-gal staining and Bcl-2-positive. In cells surviving after anti-Fas treatment, the proportion of beta-galactosidase-positive cells increased to 50% and the beta-galactosidase activity increased 6-fold, indicating that Bcl-2 expression protected the cells from Fas-mediated apoptosis. In the cloned HepG2 cells stably expressing Bcl-2, the extent of Fas-mediated apoptosis was inversely related to the level of Bcl-2 expression. CONCLUSION: Bcl-2 confers protection to human hepatoma cells against Fas-mediated apoptosis, and is essential for survival of some, but not all, hepatoma cells.

Apoptosis↗
PubMed1999

Changes in mRNAs of inducible nitric oxide synthase and interleukin-1 beta in the liver, kidney and lung tissues of rats acutely exposed to paraquat.

Nitric oxide (NO) reacts with superoxide to form the potent oxidant peroxynitrite, which causes serious cell damage. Interleukin-1 beta (IL-1 beta) is known to be a strong activator of NO production via induction of inducible nitric oxide synthase (iNOS). Since paraquat (PQ) undergoes redox cycling in vivo, resulting in a constant generation of superoxide, peroxynitrite may be a pathogenetic factor in the oxidative cell damage. In this study, we have investigated whether mRNAs of iNOS and IL-1 beta are affected in rat liver, kidney and lung tissues by exposure to non-lethal and lethal doses of PQ. Suppression and then marked stimulation of the iNOS mRNA were observed in the liver tissues of rats exposed to a lethal dose of PQ, while the kidney and lung tissues showed little changes. We also detected nitrotyrosine in liver tissues of rats exposed to a lethal dose by immunohistochemistry, suggesting the simultaneous generation of NO and superoxide in liver injury during acute lethal PQ poisoning. On the other hand, the IL-1 beta mRNA in the liver tissues decreased throughout the experiments, suggesting that this cytokine is not responsible for stimulation of the iNOS gene. IL-1 beta mRNA in lung tissues in the non-lethal group showed an increase, with maximum levels at 16-24 h, while little changes were observed in iNOS mRNA in this organ. These data suggest that acute lethal poisoning and non-lethal poisoning by PQ undergo different mechanisms of action of NO and IL-1 beta systems; the former is due, at least in part, to an increase in NO production, while the latter is due to stimulation of IL-1 beta and/or other cytokines.

Journal Article↗
PubMed1999

Effects of exercise training and its cessation on components of the insulin resistance syndrome in obese children.

OBJECTIVE: To determine the effect of exercise training (ET) on components of the insulin resistance syndrome (IRS) in obese children. DESIGN: Randomized, modified cross-over study, with subjects assigned to one of two conditions: (1) 4 months of ET followed by 4 months of no-ET; or (2) 4 months of no-ET followed by 4 months of ET. Measurements were made at three time points: 0, 4 and 8 months. SUBJECTS: 79 obese, but otherwise healthy children (age: 7-11 y, percent fat (%fat) 27-61%). MEASUREMENTS: Plasma lipid and lipoprotein concentrations, plasma insulin and glucose concentrations; %fat; submaximal heart rate (HR) as an index of fitness. EXERCISE TRAINING: ET was offered 5 d/week 40 min/d. For the 73 children who completed 4 months of ET, the mean attendance was 80% (that is, 4 d/week) and the average HR during ET was 157 bpm. RESULTS: Significant (P < 0.05) group x time interactions were found for plasma triglyceride (TG) and insulin concentrations and %fat. The average change for both groups, from just before ET to just after the 4 month ET was -0.24 mmol.l-1 for TG, -25.4 pmol.l-1 for insulin and -1.6 units for %fat. When Group 1 ceased ET, over the following 4 month period the average change for insulin was +26.6 pmol.l-1 and for %fat +1.3 units. CONCLUSION: Some components (plasma TG, insulin, %fat) of the IRS are improved as a result of 4 months of ET in obese children. However, the benefits of ET are lost when obese children become less active.

Analysis of Variance↗
PubMed1999

Comorbidity of depression among physically ill patients and its effect on the length of hospital stay.

This study was carried out to demonstrate the prevalence of depression among physically ill patients and to investigate its effects on the length of hospital stay. Out of 65 inpatients (44 male, 21 female; 51 with benign and 14 with malignant diseases), 14 (21.5%) met the criteria for major depression in the DSM-IV. The average length of hospital stay was compared according to the comorbidity with major depression. Among the patients with benign diseases, those with major depression stayed longer (P<0.05) at the hospital than those without it (82.2 vs. 36.0 days). Likewise, among the cancer patients, those with major depression stayed longer than those without it (83.8 vs. 51.4 days), although this was not significantly different. The duration of hospitalization needs to be shortened because of the reduction in national medical costs, the economics of hospital administration and the quality of life of patients and their families. Further research is needed to demonstrate the role of consultation-liaison psychiatry in the shortening of hospitalization.

Adult↗