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Biomedical subjects

T Yoshimoto

Publications and source records attributed to T Yoshimoto.

At least 55 records · Page 3Linked to original sources
PubMed2001

Combination of early and delayed SPET imaging using technetium-99m ethyl cysteinate dimer immediately after local intra-arterial thrombolysis.

The aim of this study was to investigate the prognostic utility of post-treatment technetium-99m ethyl cysteinate dimer (99mTc-ECD) single-photon emission tomography (SPET) for predicting ischemic tissue outcome in cases involving embolic middle cerebral artery occlusion treated with local intra-arterial thrombolysis. We examined twenty-five patients with a moderately ischemic area determined using pretreatment technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) SPET, and with complete recanalization within 6 h. Post-treatment 99mTc-ECD SPET studies, consisting of scanning for 0.5-6.5 min (early scan) and 15-21 min (delayed scan) after tracer injection, were performed immediately after thrombolysis. The extent of the affected area outlined on pretreatment 99mTc-HMPAO SPET was used for the post-treatment early and delayed 99mTc-ECD SPET images, and the AR/CE ratio (ratio of affected regional activity to cerebellar activity) was calculated. The washout index of 99mTc-ECD in the affected area was also calculated by dividing the difference between the AR/CE ratio in the early and delayed images by the AR/CE ratio in the early image. Twelve patients without infarction or with small subcortical/basal ganglial infarction, ten with medium or large cortical infarction, and three with hemorrhage were identified by follow-up computed tomography. Although the AR/CE ratio in post-treatment early 99mTc-ECD SPET images was significantly higher in the hemorrhagic group than in the cortical infarction group, this value did not differentiate the reversible ischemia group from either the cortical infarction or the hemorrhagic group. The AR/CE ratio in post-treatment delayed 99mTc-ECD SPET images statistically differentiated the reversible ischemia group from both the cortical infarction and the hemorrhagic group. However, the difference between the cortical infarction and hemorrhagic groups was not statistically significant. The washout index of 99mTc-ECD statistically differentiated all three groups. This study demonstrated that a combination of early and delayed 99mTc-ECD SPET imaging performed immediately after thrombolysis predicts ischemic tissue outcome.

Adult↗
PubMed2001

Metachronous neurohypophysical immature teratoma occurring 10 years after total resection of pineal mature teratoma.

An 18-year-old boy presented with an immature neurohypophysial teratoma occurring 10 years after total resection of a mature pineal teratoma through an occipital transtentorial approach in 1989. Thorough histological examination had revealed a mature teratoma. He developed panhypopituitarism and diabetes insipidus in 1999. Magnetic resonance imaging revealed a suprasellar tumor occupying the third ventricle. This tumor was totally resected through a frontobasal approach. Histological examination revealed an immature teratoma. This tumor occurred in a different site from the initial tumor and was considered to be de novo and thus a so-called metachronous germ cell tumor. Patients with completely resected mature teratoma require extended follow-up, including periodic magnetic resonance imaging, because of the risk of such a metachronous germ cell tumor.

Adolescent↗
PubMed2001

QT intervals and QT dispersion in patients with subarachnoid hemorrhage.

PURPOSE: To clarify the clinical significance of QT dispersion and the longest QT intervals (L-QTc) in patients with subarachnoid hemorrhage (SAH). METHODS: ECGs, clinical features, and laboratory data were analyzed in 38 patients with SAH (R) and 30 with unruptured cerebral aneurysms (U). Standard 12-lead ECGs obtained on admission were analyzed manually, and the longest QT interval (L-QTc) and the QT dispersion (difference between longest and shortest QTc) were compared between groups. RESULTS: There were no differences between groups R and U in age, sex, or location of aneurysms. The QT dispersion and L-QTc were greater in R than in U (109 +/- 49 vs 64 +/- 21 ms and 503 +/- 63 vs 435 +/- 38 ms, respectively; P < 0.01). The QT dispersion and L-QTc were longer in patients with premature ventricular contractions (PVCs) than in patients without PVCs (185 +/- 30 vs 85 +/- 41 ms and 586 +/- 47 vs 467 +/- 59 ms, respectively; P < 0.01). There were positive correlations between QT dispersion or L-QTc and preoperative Hunt and Hess grade (rs = 0.560 and rs = 0.615, respectively; P < 0.01). QT dispersion and L-QTc tended to correlate negatively with serum K(+) (r = -0.365 and r = -0.376, respectively). CONCLUSION: QT dispersion in patients with SAH is prolonged, especially in high-grade cases.

Journal Article↗
PubMed2001

Intracystic carcinoma of the male breast: report of a case.

We experienced a very rare case of male intracystic breast carcinoma. A 66-year-old man presented at our hospital because of a palpable mass in his right breast. The imaging diagnosis was an intracystic carcinoma with hemorrhagic fluid and two mural nodules. Modified radical mastectomy was performed under general anesthesia. The pathological examination revealed the intracystic papillary carcinoma with foci of microinvasion. The findings of power Doppler ultrasonography and dynamic magnetic resonance imaging were very useful for the differential diagnosis of our case.

Aged↗
PubMed2001

Effect of nitrous oxide on spike activity during epilepsy surgery.

There are controversies over the effect of nitrous oxide on the electrocorticograms in patients with epilepsy. To clarify the effect of nitrous oxide on electrocorticograms, spike activities were compared with and without nitrous oxide under neuroleptoanesthesia in 10 patients with intractable epilepsy during surgery. Spikes decreased with nitrous oxide significantly (P<0.01) and disappeared in 3 cases. We conclude that discontinuation of nitrous oxide should be taken into consideration during electrocorticographic monitoring in epilepsy surgery.

Adolescent↗
PubMed2001

Decrease in intraoperative brain surface temperature in patients with subarachnoid haemorrhage.

BACKGROUND: Recent experimental and clinical evidence of hypothermic protection against neuronal injury creates new interests regarding human brain temperature. However, very little information is available for the brain temperature under certain pathological conditions. In this study, intra-operative brain temperature in patients with subarachnoid haemorrhage (SAH) is particularly addressed. METHODS: Brain surface temperature and oxygen saturation of jugular bulb (SjO2) were monitored during early surgery undergone within 48 hours after the onset in patients with SAH (n = 16). Those were also measured in patients with unruptured aneurysms during elective surgery as control (n = 15). FINDINGS: The brain surface temperature was significantly lower in SAH than control (35.3 +/- 0.8 vs. 36.1 +/- 0.5 degrees C, P < 0.01). The reduction in brain surface temperature was correlated with the severity of the Hunt and Kosnik's aneurysmal grade (r = 0.837, P < 0.01). SjO2 was significantly lower in SAH than control (51.5 +/- 7.3 vs. 68.5 +/- 7.6%, P < 0.01), and was positively correlated with brain surface temperature (r = 0.642, P < 0.01). INTERPRETATION: These results suggest that the brain temperature and/or the temperature gradient within the brain may be altered in an early period after SAH. Since brain temperature is determined by cerebral blood flow (CBF), metabolism, temperature of both circulating blood and surrounding environment, the brain surface temperature reduction may be explained by depressed CBF and metabolism in SAH.

Aneurysm, Ruptured↗
PubMed2001

Analysis of 168 short tandem repeat loci in the Japanese population, using a screening set for human genetic mapping.

We devised a multiplex polymerase chain reaction (PCR) amplification and loading system for the convenient typing of 168 short tandem repeat (STR) polymorphic markers in a commercially available screening primer set for human linkage analysis. We genotyped all these 168 STR loci with 32 healthy unrelated Japanese, calculated allele frequencies at each STR locus, and performed three kinds of tests for Hardy-Weinberg equilibrium (HWE). Significant deviations from HWE in all three tests were observed at only three loci, and the average heterozygosity in the Japanese (0.733) was slightly lower than that in Caucasians (0.773). We also examined 32 Caucasians at some selected loci, to be compared with Japanese. Some markers showed greatly different heterozygosities or allelic distributions in Japanese and Caucasian populations. In two groups of STRs, those with and without irregular alleles (or interalleles), the former had a higher proportion of bimodal allelic distribution and possessed more alleles per locus than the latter. However, no significant differences in the observed and expected heterozygosities, or in the powers of discrimination, were found between the two groups. The present basic study of allele frequency databases of these STRs will contribute to further applications in forensic science and human genetics.

Gene Frequency↗
PubMed2001

Aspergillus parasellar abscess mimicking radiation-induced neuropathy. Case report.

BACKGROUND: Transsphenoidal surgery is a safe procedure for treatment of pituitary adenomas. However, several complications, including post-surgical infection, are known. We describe a case of Aspergillus parasellar abscess that presented with cranial neuropathies following transsphenoidal surgery and radiosurgery. We initially diagnosed the case as radiation-induced neuropathies, which delayed the detection of Aspergillus. CASE DESCRIPTION: A 55-year-old man underwent transsphenoidal surgery for a pituitary adenoma that presented with pituitary apoplexy. Dexamethasone had been continuously administered for hypocortisolism probably caused by pituitary apoplexy. Four years later, radiosurgery was performed for a relapse in the right cavernous sinus. Another 4 years later, he developed painful right ophthalmoplegia, right ptosis, and bilateral visual impairment, successively. We initially suspected that the painful ophthalmoplegia and ptosis were because of radiation-induced cranial neuropathies; however, results of magnetic resonance (MR) imaging and his clinical course were not consistent with those of radiation-induced neuropathies. Therefore, we performed exploratory surgery that revealed a subdural abscess on the planum sphenoidale. Culture of a specimen grew Aspergillus fumigatus. CONCLUSION: Intracranial fungal abscess is a fatal complication unless it is treated early. It is thus important to consider the possibility of parasellar infection and differentiate it from radiation-induced cranial neuropathies when a patient presents with cranial neuropathies after transsphenoidal surgery and radiosurgery.

Abscess↗
PubMed2001

Fusiform aneurysm of the vertebral artery presenting hemifacial spasm treated by intravascular embolization: case report.

BACKGROUND: A rare case of fusiform vertebral artery aneurysm causing hemifacial spasm was successfully treated by intravascular embolization. CASE DESCRIPTION: A 53-year-old man presented with left hemifacial spasm persisting for 2 years. No other clinical symptoms were observed. Vertebral angiography revealed a fusiform aneurysm of the left vertebral artery, and thin-slice spoiled gradient-recalled acquisition magnetic resonance imaging demonstrated the aneurysm compressing the root exit zone of the left facial nerve. The parent artery was occluded together with the aneurysm by intravascular embolization with Guglielmi detachable coils (GDCs). The patient is free of left hemifacial spasm without any complication. CONCLUSION: Hemifacial spasm caused by aneurysms, especially fusiform aneurysms, is quite rare but can be treated by parent artery occlusion and coiling the aneurysm with GDCs.

Cerebral Angiography↗
PubMed2001

Plasma cell granuloma of the pituitary gland. Case report.

BACKGROUND: Plasma cell granuloma, one of the subtypes of inflammatory pseudotumor, is non-neoplastic proliferation of plasma cells and occurs extremely rarely in the intracranial space. We encountered a case of plasma cell granuloma in the pituitary gland, which initially presented with left oculomotor palsy. CASE DESCRIPTION: A 34-year-old female presented with left ptosis. Magnetic resonance image (MRI) demonstrated an intrasellar mass extending to the pituitary stalk with dural enhancement. The lesion was subtotally resected by a transsphenoidal approach. Histopathological findings showed that the resected mass consisted of mature plasma cells, and some cells had infiltrated the surrounding normal pituitary tissue. Immunohistochemical study demonstrated that these cells were positive for leukocyte common antigen, kappa and lambda light chains of IgG, indicating polyclonality of these plasma cells. CONCLUSIONS: We propose that, in the case of an intrasellar mass with unusual neurological symptoms including oculomotor palsy, inflammatory disease of the pituitary gland such as plasma cell granuloma should be included in the differential diagnosis.

Adult↗
PubMed2001

SOCS-1/SSI-1-deficient NKT cells participate in severe hepatitis through dysregulated cross-talk inhibition of IFN-gamma and IL-4 signaling in vivo.

Suppressor of cytokine signaling-1 (SOCS-1), also known as STAT-induced STAT inhibitor-1 (SSI-1), is a negative feedback molecule for cytokine signaling, and its in vivo deletion induces fulminant hepatitis. However, elimination of the STAT1 or STAT6 gene or deletion of NKT cells substantially prevented severe hepatitis in SOCS-1-deficient mice, while administration of IFN-gamma and IL-4 accelerated its development. SOCS-1 deficiency not only sustained IFN-gamma/IL-4 signaling but also eliminated the cross-inhibitory action of IFN-gamma on IL-4 signaling. These results suggest that SOCS-1 deficiency-induced persistent activation of STAT1 and STAT6, which would be inhibited by SOCS-1 under normal conditions, may induce abnormal activation of NKT cells, thus leading to lethal pathological changes in SOCS-1-deficient mice.

Animals↗
PubMed2001

Interleukin-18 is a unique cytokine that stimulates both Th1 and Th2 responses depending on its cytokine milieu.

IL-18 is a potent proinflammatory cytokine able to induce IFNgamma, GM-CSF, TNFalpha and IL-1 in immunocompetent cells, to activate killing by lymphocytes, and to up-regulate the expression of certain chemokine receptors. IL-18 is also essential to host defences against severe infections. In particular, the clearance of intracellular bacteria, fungi and protozoa requires the induction of host-derived IFNgamma, which evokes effector molecules such as nitric oxide. Also, IL-18 plays a part in the clearance of viruses, partly by the induction of cytotoxic T cells, and the expulsion of viruses is impaired in IL-18-deficient mice. IL-18 also enhances tumour rejection by its potent capacity to augment the cytotoxic activity of NK and T cells in vivo. In contrast, recent studies also demonstrate a convincing role for IL-18 in atopic responses, including atopic asthma. IL-18 induces naive T cells to develop into Th2 cells. Moreover, IL-18 also induces IL-13 and/or IL-4 production by NK cells, mast cells and basophils. Therefore, IL-18 should be seen as a unique cytokine that enhances innate immunity and both Th1- and Th2-driven immune responses.

Animals↗
PubMed2001

Somatosensory evoked fields in comatose survivors after severe traumatic brain injury.

OBJECTIVE: To evaluate the cortical function quantitatively in patients in the chronic phase of severe traumatic brain injury. METHODS: Thirteen patients with severe traumatic brain injury due to traffic accident followed by persistent consciousness disturbance and disability were studied. Somatosensory evoked magnetic fields (SEFs) for unilateral median nerve stimulation were measured using a whole-head magnetoencephalography system. The latency and electrical current dipole (ECD) moment for the N20m, P30m, N45m and P60m components were calculated and compared with those of 14 age-matched healthy adults. RESULTS: The peak latency of N20m was longer (P<0.05) and those of P30m and N45m were shorter (P<0.01) in the patients than in normal adults. The ECD moment of N20m and P30m was smaller and that of N45m and P60m was larger in the patients than in normal adults (P<0.01). CONCLUSIONS: These results can be explained by the hypothesis that diffuse brain injury induces decreased and delayed input of the somatosensory afferent and compensational amplification of the response in the primary somatosensory cortex. Middle-latency SEFs may be applicable as a cortical functional measure for patients with severe traumatic brain injury.

Adult↗
PubMed2001

Characterization of mouse mammary tumour virus-induced migration of lymphoid cells into lymph nodes.

We previously found that Mtv-2+ lymph nodes (LN) implanted into Mtv-2- mice underwent marked hyperplasia owing to the influx of lymphocytes. LN grafts infected with exogenous mouse mammary tumour viruses (MMTV), MMTV(FM) transmitted by FM mice and MMTV-2 produced by Mtv-2, also swelled in MMTV-free recipients. Mtv-3 and Mtv-7 also displayed this capability. Mtv-2-induced LN hyperplasia was earlier in onset and greater in extent when major histocompatibility complex (MHC) class II I-E was expressed than unexpressed. Mtv-3-induced LN hyperplasia was suppressed completely by Mtv-3 from a different mouse strain and partially by Mtv-6 slightly different from Mtv-3 in superantigen (SAg) Vbeta specificity. LN hyperplasia occurred bidirectionally in LN transplantation between mice carrying Mtv-2 and Mtv-3, which are different SAg Vbeta specificity. LN hyperplasia induced by MMTV-2 carrying SAg responsive to Vbeta14 alone and MMTV(FM) carrying SAg responsive to Vbeta14 and Vbeta8.2 was completely but partially suppressed by MMTV(FM) and MMTV-2, respectively. CD4+ T cells were essential for MMTV-induced LN hyperplasia. LN in situ also underwent significant hyperplasia when infected with MMTV. Thus, MMTV SAg may entice circulating lymphocytes into lymphoid organs and contribute to more efficient dissemination MMTV in vivo. Secondary lymphoid tissue chemokine (SLC) may not be directly involved in this event.

Animals↗
PubMed2001

Thermal stability of pyrrolidone carboxyl peptidases from the hyperthermophilic Archaeon, Pyrococcus furiosus.

The temperature adaptation of pyrrolidone carboxyl peptidase (PCP) from a hyperthermophile, Pyrococcus furiosus (Pf PCP), was characterized in the context of an assembly form of the protein which is a homotetramer at neutral pH. The Pf PCP exhibited maximal catalytic activity at 90-95 degrees C and its activity was higher in the temperature range 30-100 degrees C than its counterpart from the mesophilic Bacillus amyloliquefaciens (BaPCP). Thermal stability was monitored by differential scanning calorimetry (DSC). Two clearly separated peaks appeared on the DSC curves for Pf PCP at alkaline and acidic pH. Using the oxidized Pf PCP and two mutant proteins (Pf C188S and Pf C142/188S), it was found that the peaks on the high and low temperature sides of the DSC curve of Pf PCP were produced by the forms with an intersubunit disulfide bridge between the two subunits and without the bridge, respectively, indicating the stabilization effect of intersubunit disulfide bridges. The denaturation temperature (Td) of Pf PCP with intersubunit disulfide bridges was higher by 53 degrees C at pH 9.0 than that of BaPCP. An analysis of the equilibrium ultracentrifugation patterns showed that the tetrameric Pf C142/188S dissociated into dimers with decreasing pH in the acidic region and became monomer subunits at pH 2.5. The heat denaturation of Pf PCP and its two Cys mutants was highly reversible in the dimeric forms, but completely irreversible in the tetrameric form. The Td of Pf C142/188S decreased as the enzyme became dissociated, but the monomeric form of the protein was still folded at pH 2.5, although BaPCP was completely denatured at acidic pH. These results indicate that subunit interaction plays an important role in stabilizing PCP from P. furiosus in addition to the intrinsic enhanced stability of its monomer.

Adaptation, Physiological↗
PubMed2001

Successful treatment of low-flow priapism associated with phenothiazine therapy.

We present a case of low-flow priapism that was successfully treated. A 21-year-old man with a history of schizophrenia was admitted with a painful complete erection. He had taken propericiazine, phenothiazine derivatives, before hospitalization and was treated with a glandular-cavernosal shunt (El-Ghorab's procedure). Currently, he is able to have erections without any changes in his quality of life.

Adult↗
PubMed2001

Intraaneurysmal embolization of an unruptured basilar tip aneurysm associated with moyamoya disease.

We describe a patient with moyamoya disease associated with an unruptured basilar tip aneurysm which was treated by endovascular embolization using Guglielmi detachable coils (GDCs). A 53-year-old man presented with left hemiparesis persisting for 3 mon ths before admission. Cerebral angiography revealed occlusion of the bilateral middle cerebral arteries and the left anterior cerebral artery, stenosis of the right anterior cerebral artery, and basal moyamoya vessels. In addition, a saccular small aneurysm was seen at the top of the basilar artery. The aneurysm was completely embolized by intraaneurysmal GDCs. Direct surgical clipping is often selected for the treatment of posterior fossa aneurysms in moyamoya disease. However, complete clipping is usually difficult due to the difficulties in operative technique associated with moyamoya disease. We suggest that the endovascular treatment using GDCs is comparatively safe and effective for the treatment of surgically difficult aneurysms in patients with moyamoya disease.

Cerebral Angiography↗