Search PubMed⌕ Search

Biomedical subjects

Y Iwata

Publications and source records attributed to Y Iwata.

At least 217 records · Page 12Linked to original sources

[A new treatment of hypertensive intracerebral hematoma--a follow-up study on 46 patients with hematoma treated by CT guided stereotactic method].

During the last 2 years, 46 cases of hypertensive intracerebral hemorrhage in the basal ganglia were treated by CT guided stereotactic aspiration and their outcome was evaluated in terms of the rate of hematoma removal, the change of consciousness level and the recovery of motor and sensory functions. They are aged from 45 to 79 years old, the average 56, and aspirated 1 to 24 days after the onset, two third of them being within 1 week. The whole procedure was done in the CT room under direct CT guidance and by one trial. In putaminal type hemorrhage, the removed hematoma volumes ranged from 9 to 48 ml, average being 23.7 ml, in thalamic type from 5 to 29 ml, average being 15.5 ml. The average rate of removal was 81.1% in 30 cases within 1 week. In most cases, preoperative consciousness was not severely disturbed, in putaminal type, 19 were alert or confused, 4 somnolent, 5 stuperous and in thalamic type, 6, 6, 3 respectively and 2 were semicomatous, one of them had herniation sign. In putaminal type all but 2 cases recovered to alert or confused state, the first one had postoperative bleeding and the other was already apallic preoperatively. In thalamic type, we lost 3 cases, 2 by gastrointestinal bleeding and 1 DIC, by rehemorrhage 2 months after the operation. All but one who was semicomatous preoperatively recovered to alertness. In motor function, some cases of the putaminal bleeding with intact internal capsule remained hemiplegic. On the other hand, most of the cases with partial destruction of the internal capsule on CT recovered well in both types of hematoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Ascending limb of the N20 component of somatosensory evoked potential--an analysis on direct recording from the human midbrain].

Somatosensory evoked potential elicited by median nerve stimulation at the wrist was recorded from five loci on the trajectory of stereotactic rostral mensencephalic reticulotomy. Four distinct positive waves followed by one negative wave, the peak latency being 16.3 msec, were recorded from the rostral midbrain reticular formation near the medial lemniscus. The four positive waves were named as I, II, III, and IV respectively. Peak latency of these positive waves was 12.6, 13.7, 14.7 and 15.8 msec respectively. The first two positive waves (I, II) corresponded to P13 and P15 recorded over the scalp. The other two positive waves (III, IV) changed their polarity to negative at the level of the ventral thalamus and formed the ascending limb of N20 recorded over the scalp. N16 was most prominent at the level of nucleus ventrocaudalis externus. These findings suggest that the ascending limb of N20 is composed of at least three components, wave III, IV, and N16. The present report is compatible with the investigations by Abbruzzese et al.2) and Eisen et al.11) that there are several distinct dipoles between P15 and N20 of somatosensory evoked potential in man.

Afferent Pathways↗

[Significance probability mapping of brain electrical activity--its problem and specified z-statistic mapping].

Significance probability mapping (SPM) of brain electrical activity first described by Duffy et al. is useful tool for studying functional aspects of brain disease. Z-statistic SPM is able to identify the area of brain electrical activity deviated with statistic significance from the control group. The problem of this method is, however, that the nature of deviation, i.e., whether it is increase or decrease of electrical activity, can not be displayed. From this point of view, we attempted to use modified z-statistic method. Statistically deviated region and its nature can be clearly displayed on the same picture by analyzing EEG with this method. This method can be applied to SPM of evoked potentials. SPM is not yet complete method for the assessment of brain electrical activity, but there is much room for adopting other statistic method that is more suitable for the aim of the study. Functional aspects of the brain will be more readily clarified by the use of modified SPM and by combination with findings of CT scan, NMR and PET that can give morphological and metabolic information.

Adult↗

Transcervical resection of submucous myoma.

Thirteen women with chief complaints of menorrhagia and metrorrhagia underwent transcervical resection (TCR) of pedunculated submucous myoma using either an operating hysteroscope or urologic resectoscope. Eight women received TCR with a urologic resectoscope without further operation. Subsequent vaginal hysterectomy was performed on one woman after TCR of a large prolapsed submucous fibroid with a urologic resectoscope because of adenomyosis. Three women underwent TCR of the same type of large prolapsed submucous myoma with an operating hysteroscope. Later, due to other pathologic lesions of the uterus, subsequent vaginal hysterectomies were done on two women and a subsequent abdominal hysterectomy on another woman. Without TCR of these large prolapsed submucous myoma, subsequent vaginal hysterectomies were not possible. Only one woman underwent TCR of submucous myoma with an operating hysteroscope without further operation. All patients showed improvement in such clinical symptoms as menorrhagia, metrorrhagia, and anemia. Before TCR, we make it a rule to use a new diagnostic hysteroscope (4mm external sheath) to reevaluate the position and size of the fibroid. The fluid media used were 10% dextrose for diagnostic hysteroscopy, 5% dextrose for therapeutic hysteroscopy and 10% urigal for urologic resectoscopy. Three months after the operation, second look hysteroscopy is arranged. All patients except one have been followed up at our outpatient department.

Adult↗

Physiological actions of phosphatidylinositol-specific phospholipase C from Bacillus thuringiensis on KB III cells: alkaline phosphatase release and growth inhibition.

Phosphatidylinositol-specific phospholipase C of Bacillus thuringiensis caused the release of alkaline phosphatase from KB III cells and plasma membrane preparations prepared from the cells. Phosphatidylinositol-specific phospholipase C added to the culture of KB III cells inhibited cell growth by 30%. The release of alkaline phosphatase induced by phospholipase C was dependent on, or proportional to, the reaction time and the concentrations of the phospholipase C, KB III cells and plasma membrane preparation. The Arrhenius plot for phosphatase-release reaction showed a single break at 18.1 degrees C for KB III cells or at 27.3 degrees C for the plasma membrane preparation. The activation energies of the phosphatase-release reaction were 3.2 and 29.2 kcal/mol for KB III cells, and 4.3 and 26.5 kcal/mol for the plasma membrane preparation. The released alkaline phosphatase had a mol. wt of 105,000 and isoelectric points of 4.05 (major) and 4.4 (minor).

Alkaline Phosphatase↗

Symptomatic choroidal epithelial cyst in the fourth ventricle.

A case of choroidal epithelial cyst in the fourth ventricle is described. The cyst occupied the fourth ventricle almost completely, and produced an intermittent hemiparesis and hemisensory disturbance. After removal of the cyst wall, the patient recovered completely. On light microscopy, a single epithelial layer with a basement membrane lining the cyst wall was observed. An electron microscopic study was also made.

Cerebral Angiography↗

Usefulness of intraoperative cortical blood flow measurement by heat clearance method for monitoring cerebral ischaemia during therapeutic carotid ligation.

Changes of regional cortical blood flow (rCBF) was monitored by the heat clearance method during the operation of cervical carotid ligation combined with superficial temporal artery and middle cerebral artery anastomosis for the treatment of inaccessible aneurysms of the internal carotid artery in eight patients. There were three types of rCBF responses upon closure of the internal carotid artery, with or without bypass blood flow. Based on the responses, the internal carotid artery was ligated abruptly or occluded gradually. The usefulness of the method for monitoring cerebral ischaemia for therapeutic carotid ligation is discussed.

Body Temperature↗

A new apparatus for CT-guided stereotactic surgery.

Combining whole-body CT scan with a stereotactic system, the authors have developed and applied clinically an apparatus which readily provides intraoperative CT images, making it possible to confirm the location of the target point and ascertain the intraoperative environment. It takes about 9 s to obtain a CT image. Our purpose is to make stereotactic surgery, a kind of blind surgery, as safe and reliable as a visualized procedure by intraoperative CT scanning. By the method, in which there is very little invasion under local anesthesia, evacuation of deep-seated intracerebral hematomas as well as brain abscesses and also biopsy or brachytherapy of brain tumors in the brain can be done with safety and reliability.

Cerebral Hemorrhage↗

CT-guided stereotactic surgery for evacuation of hypertensive intracerebral hematoma.

During the last 3 years, 46 cases of hypertensive intracerebral hemorrhage were treated by CT-guided stereotactic surgery. Our present report is concerned with the evaluation of this procedure in the treatment of hypertensive intracerebral hematoma, in terms of the rate of aspirated hematoma and follow-up study of patients. It is difficult to draw any definite conclusion about the operative indications. CT-guided stereotactic aspiration, however, can be evaluated as a less invasive and more definitive treatment of intracerebral hematoma in the basal ganglia and thalamus.

Aged↗

[Clinical experience on aztreonam].

Aztreonam (AZT), a new monobactam antibiotic, was studied for clinical efficacy in the field of gynecologic infection. AZT was administered at a daily dose of 2 g in 2 divided doses by single shot intravenous injection. The subjects were patients with the following infections: adnexitis (6), pelvic peritonitis (5), endometritis (1) and wound abscess (1). Good response was seen in 10 patients out of 13. The overall efficacy rate of 76.9% was obtained. Slight increase in GOT, GPT and Al-P was seen in 1 case. It was normalized on 6th day after completion of the therapy. No notable side effects were observed.

Adult↗

[A new apparatus and stereotactic method for percutaneous high cervical cordotomy].

The authors devised a stereotactic apparatus for percutaneous cordotomy based on the experience of 191 percutaneous high cervical cordotomies on 150 patients suffering from intractable pain. This apparatus has two major components. One is a head and neck holder and the other is a guide and marker system. The head and neck holder contains fixed neck holder and head holder which can be movable in vertical direction. Using these holders, the operator can keep the patient's neck in neutral position. The marker system contains two markers of origin and a 10mm scale which indicates center line as well. The guide system, stereotactically designed, is movable in three direction and acrylic guide groove is attached. The guide needle for percutaneous cordotomy is inserted along the guide groove. The guide and marker system can be attached in both sides of the head and neck holder, therefore, the operator can insert the needle in both sides of the patient. This apparatus makes it possible to locate the target stereotactically for percutaneous cordotomy, since location of the inserted needle can be determined with the aid of cervical X-ray, even if there is no image intensifier of TV display screen available. Therefore it can be possible to reduce the X-ray exposure of the patient.

Cordotomy↗

[Fundamental and clinical studies on cefminox in the field of obstetrics and gynecology].

Cefminox (CMNX, MT-141), a new cephamycin antibiotic, was studied both fundamentally and clinically with following results. In 33 cases undergone total hysterectomy and adnexectomy, 1 g of CMNX was administered intravenously by the drip infusion route over 1 hour and changes in drug concentration in the venous blood and uterine arterial blood as well as in various uterine tissues including endometrium, myometrium, cervix uteri, portio vaginalis, oviduct and ovary were studied. In addition, in 3 cases also received 1 g of CMNX over 1 hour by the drip infusion route, changes in the concentration of CMNX in the pelvic dead space exudate were investigated. In each tissue studied, the drug concentration higher than 40 micrograms/g was attained at 20 minutes after completion of drip infusion, showing good transfer of CMNX. In the pelvic dead space exudate, the peak concentration of 24.7 micrograms/ml appeared at 4 hours after completion of drip infusion and at 12 hours still a concentration of 4.5 micrograms/ml was maintained. In the treatment of 15 cases of obstetrical and gynecological infections, CMNX was used. In all of the cases treated, clinical results better than good were obtained, with excellent results in 2 cases and good results in 13 cases. In none of the cases side effects or laboratory abnormalities were observed. From these results CMNX is considered to be a useful drug for the treatment of various infections in the field of obstetrics and gynecology.

Adnexa Uteri↗

[Evaluation of anticonvulsant-induced bone changes by a microdensitometric method].

The effect of long-term anticonvulsants on bone change was evaluated by microdensitometric method (MD method) in 221 outpatients of Neurological Institute Tokyo Women's Medical College. Laboratory findings including serum Ca, P, Al-p were compared with severity of bone change. Following results were obtained; In 221 patients, 159 cases (72%) were normal, 31 cases (14%) were in the initial stage of abnormality, 23 cases (10%) in grade I, 7 cases (3%) in grade II and one case (1%) in grade III of abnormality. Incidence of abnormality was high in the age of 26-35 years old and in the age over 56 years old. Total dose, serum concentration of diphenylhydantoin (DPH) as well as phenobarbital (PB) and also duration of administration of PB correlated positively with severity of bone change. Duration of administration of DPH and valproic acid (VPA), total dose and serum concentration of VPA did not correlate with severity of bone change. Serum Ca correlated with severity of bone change, but P and Al-p did not correlate with severity of bone change. Pattern of bone change was estimated by two parameters of MD method (MCI and GSmax). Results showed that most of the osteopathy (grade I-III by MD method) fell into osteoporotic type. Based on these results, it is suggested that roentgenologic and biochemical supervision of the patients is required during long-term anticonvulsant therapy.

Absorptiometry, Photon↗

[Laboratory and clinical studies on cefpimizole in the field of gynecology].

Cefpimizole (AC-1370), a new cephalosporin antibiotic, was evaluated for its distribution in uterine tissue, penetration into retroperitoneal exudate and therapeutical effects on some infections in gynecology. The following results were obtained; The levels of AC-1370 in the cubital vein were similar to those in the uterine artery and this remained in the course of examinations after an 1 g intravenous injection. Seven patients with gynecological infections received AC-1370 by intravenous injection. The overall efficacy rate was 85.7%. No adverse reaction was observed in any of the cases treated with AC-1370, nor was there any marked changes in the laboratory findings.

Adult↗