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Biomedical subjects

Akitoshi Yoshida

Publications and source records attributed to Akitoshi Yoshida.

At least 19 recordsLinked to original sources
PubMed2007

Retinal circulatory changes associated with interferon-induced retinopathy in patients with hepatitis C.

PURPOSE: To evaluate the effect of interferon (IFN) therapy on retinal microcirculation. METHODS: Thirty-six patients with chronic hepatitis C who were treated with high-dose IFN were included in this prospective study. The changes in vessel diameter and blood velocity were measured, and the retinal blood flow (RBF) and wall shear rate (WSR) were calculated in the retinal arteries before and 2, 4, 8, 16, and 24 weeks after IFN therapy by using laser Doppler velocimetry. RESULTS: Retinal blood velocity, RBF, and WSR significantly (P < 0.0001) increased in all patients, as early as 2 weeks after IFN therapy. The increase in RBF was independently correlated with a decrease in the red blood cell count. In 22 (61%) of the 36 patients asymptomatic retinopathy developed during treatment. In patients with retinopathy, the blood velocity and WSR increased, but the vessel diameter did not change, whereas the vessel diameter increased but the blood velocity and WSR did not change in patients without retinopathy 2 weeks after IFN therapy. Multiple logistic regression analysis showed that patient age and the change in WSR at week 2 were risk factors for the development of IFN-induced retinopathy. CONCLUSIONS: RBF increases in association with IFN therapy in patients with chronic hepatitis C. In addition, the increased WSR in patients with retinopathy indicates that retinal vascular endothelial dysfunction may be associated with IFN-induced retinopathy, because wall shear stress should be constant under physiologic conditions.

Adult↗
PubMed2006

Effect of systemic administration of simvastatin on retinal circulation.

OBJECTIVE: To investigate the effect of systemic administration of simvastatin on the retinal circulation. METHODS: The effects of systemic administration of simvastatin on the retinal circulation after 90 minutes and after 7 days were studied in a placebo-controlled, double-masked, clinical trial among 12 healthy men. We used laser Doppler velocimetry to measure vessel diameter and blood velocity and calculated the blood flow in retinal arteries and veins. We also measured the intraocular pressure and the plasma nitrite/nitrate levels, the stable end products of nitric oxide metabolism. RESULTS: There were no significant changes in any retinal circulatory parameters at 90 minutes after administration of simvastatin. Daily administration of simvastatin for 7 days significantly increased blood velocity and blood flow in retinal arteries and veins but did not significantly change vessel diameter. The intraocular pressure significantly decreased at 90 minutes and at 7 days after administration of simvastatin. Simvastatin also significantly increased the plasma nitrite/nitrate levels. CONCLUSION: Simvastatin induced an increase in blood velocity and blood flow in retinal arteries and veins, increased the plasma nitrite/nitrate levels, and decreased the intraocular pressure, probably through the increase in nitric oxide.

Administration, Oral↗
PubMed2006

Noninvasive evaluation of wall shear stress on retinal microcirculation in humans.

PURPOSE: To evaluate wall shear stress (WSS) on retinal microcirculation noninvasively. METHODS: Retinal vessel diameter (D) and mean centerline blood velocity (V(max, mean)) were measured in the retinal arterioles and venules at first- and second-order branches in 13 subjects using laser Doppler velocimetry (LDV). Retinal blood flow (RBF) and wall shear rate (WSR) were calculated using these two parameters. Blood viscosity at the calculated shear rate was also measured using a cone-plate viscometer. WSS was calculated as the product of the WSR and the blood viscosity. RESULTS: In the first-order branches, the averaged D, V(max, mean), RBF, and WSR(mean) were 108 +/- 13 microm, 41 +/- 10 mm/s, 11 +/- 4 microL/min, and 1539 +/- 383 s(-1) in the arterioles and 147 +/- 13 microm, 23 +/- 3 mm/s, 12 +/- 4 microL/min, and 632 +/- 73 s(-1) in the venules, respectively. The apparent blood viscosities at the measured shear rates were 3.5 +/- 0.3 centipoise (cP) in the arterioles and 3.8 +/- 0.4 cP in the venules. Therefore, the averaged WSS was 54 +/- 13 dyne/cm2 in the arterioles and 24 +/- 4 dyne/cm2 in the venules. The WSS in the second-order arterioles was significantly lower than that in the first-order branches (P = 0.002), but the WSS in the first-order venules was similar to that in the second-order venules. CONCLUSIONS: The authors demonstrated that the WSS in the retinal vessels could be evaluated noninvasively in humans using LDV and cone-plate viscometry. This system may be useful for further clinical investigation of the role of shear stress in the pathogenesis of various retinal disorders.

Adult↗
PubMed2005

Adenosine agonist regulation of outward active transport of fluorescein across retinal pigment epithelium in rabbits.

To investigate the effect of an adenosine agonist, 2-5'-N-ethylcarboxamidoadenosine (NECA), on the outward active transport of fluorescein across the retinal pigment epithelium (RPE) in rabbits. High (5x10(-4)-2x10(-3) M) and low (1x10(-5)-1x10(-4) M) concentrations of NECA or phosphate buffered saline (PBS) were intravitreously injected into Dutch-belted rabbits. Sodium fluorescein was injected intravenously 180 min after NECA. Differential vitreous fluorophotometry was performed 3 hr after the sodium fluorescein injection and the vitreal fluorescein/fluorescein monoglucuronide (F/FG) ratio then was calculated. The F/FG ratios are inversely proportional to the outward active transport of fluorescein across the RPE. Retinal detachments were induced by injection of PBS into the subretinal space after the intravitreous injection of low- or high-dose NECA or PBS, and the size of the blebs was monitored. In eyes that received a low-dose injection of NECA, the F/FG ratio was higher compared with controls (P<0.05); in eyes that received a high-dose intravitreal injection, the F/FG ratio was significantly lower compared with controls (P<0.05). The effect of low-dose NECA on the F/FG ratio was suppressed by the A2 receptor antagonist, ZM241385, and the effect of high-dose NECA was suppressed by the A1 receptor antagonist, 8-cyclopentyl-1, 3-dipropylxanthine. The A3 receptor antagonist MRS1191 did not influence the effect of low- or high-dose NECA. Intravitreal injection of high-dose NECA enhanced the reabsorption of subretinal fluid compared with PBS; however, low-dose NECA inhibited reabsorption of subretinal fluid (P<0.02 and 0.05, respectively). Intravitreous injection of high-dose NECA accelerates the active outward transport across the RPE via A1 receptors and low-dose NECA decelerates it via A2 receptors.

Adenosine↗
PubMed2005

Relationship between the parameters of retinal circulation measured by laser Doppler velocimetry and a marker of early systemic atherosclerosis.

PURPOSE: To examine the relation between intima-media thickness (IMT) in the common carotid artery, which is generally recognized as a marker of early atherosclerosis, and retinal circulatory parameters. METHODS: The vessel diameter and blood velocity of retinal arterioles were measured with laser Doppler velocimetry (LDV) in 33 patients with coronary artery disease (CAD), because they were thought to have general atherosclerosis. The retinal blood flow (RBF) and wall shear rate (WSR), an index of wall shear stress in retinal vessels, were calculated from the two parameters. The carotid IMT was evaluated with B-mode ultrasonography. RESULTS: The patients were divided into two groups: those with an IMT >0.70 mm and those with an IMT < or =0.70 mm. The blood velocity, WSR, and upstroke time in the retinal arterioles were significantly higher in the group with an IMT >0.70 mm compared with the group with an IMT < or =0.70 mm. There were no significant differences in vessel diameter and RBF between the groups. Positive correlations were found between the carotid IMT and blood velocity (r = 0.51, P = 0.002) and WSR (r = 0.60, P = 0.0001). Multiple regression analysis showed that the retinal WSR and blood velocity correlated independently with the IMT in patients with CAD. CONCLUSIONS: The present findings from this pilot study suggest that the retinal circulatory parameters measured by LDV may be associated with systemic atherosclerosis. These results support recent studies showing an association between retinal microvascular changes and cardiovascular disease.

Aged↗
PubMed2004

The effect of ocular warming on ocular circulation in healthy humans.

OBJECTIVE: To examine the effect of ocular warming on retinal blood flow (RBF) and subfoveal choroidal blood flow (CBF) in humans. METHODS: Ocular warming was induced in 10 healthy volunteers using an ocular warming lamp for 10 minutes. The ocular surface temperature was measured before and after warming. The RBF in the retinal artery and vein and the CBF in the foveal region were examined with a retinal laser Doppler velocimetry system and a laser Doppler flowmeter, respectively. Ocular blood flow measurements were performed before and 3, 6, and 9 minutes after warming. RESULTS: The ocular surface temperature significantly increased just after warming and returned to baseline 10 minutes later. Three minutes after warming, the mean +/- SE RBF significantly increased in the retinal artery (14.2% +/- 3.5%, P = .01) and vein (15.8% +/- 3.6%, P = .006). Six minutes after warming, the RBF returned to baseline in the artery and vein. Three and 6 minutes after warming, the mean +/- SE CBF significantly decreased 16.6% +/- 4.2% and 24.2% +/- 4.7%, respectively (P = .001 for both). Nine minutes after warming, the measurements returned to baseline. CONCLUSIONS: The RBF increased and the CBF decreased in the foveal region after cessation of ocular warming in healthy young volunteers. The CBF in the foveal region may contribute to maintaining a constant retinal temperature in response to ocular warming.

Adult↗
PubMed2004

Irregularity of photoreceptor layer after successful macular hole surgery prevents visual acuity improvement.

PURPOSE: To investigate the association between a photoreceptor irregularity and visual acuity (VA) after macular hole (MH) surgery. DESIGN: Prospective observational case series. METHODS: Twenty-four eyes with an idiopathic MH that resolved after vitreous surgery were examined by new optical coherence tomography (OCT 3000). The images were divided into regular photoreceptor, detected as a straight line above the retinal pigment epithelium reflex, and irregular, which cannot be detected by it. RESULTS: Regular images were observed in 12 eyes (80%) and irregular images in 3 eyes (20%) with good VA (>or=0.7). Regular images were seen in 3 eyes (33%) and irregular images in 6 eyes (67%) with poor VA (<0.7). The percentage of regular images in the group with good VA was significantly higher than that in the group with poor VA (P <.05). CONCLUSION: A photoreceptor irregularity after MH surgery may prevent VA improvement.

Aged↗
PubMed2004

Effect of nucleotide P2Y2 receptor agonists on outward active transport of fluorescein across normal blood-retina barrier in rabbit.

BACKGROUND: To evaluate the effect of nucleotide P2Y(2) receptor agonists INS542 and uridine 5'-triphosphate (UTP) on the outward active transport of fluorescein across rabbit blood-retina barrier (BRB) in vivo. METHODS: Injection (0.1 ml) of INS542 (0.1 or 1mM), phosphate buffered solution, or UTP (1 or 10mM) was made in Dutch-belted rabbits. Differential vitreous fluorophotometry (DVF) was performed 3hr later and the fluorescein (F)/fluorescein monoglucuronide (FG) ratio was then calculated. F/FG ratios are inversely proportional to outward active transport of F across BRB at the level of the retinal pigment epithelium (RPE). In another set of experiments, the effect of 0.1 ml vitreous injection of INS542 (1mM) on F/FG ratios was evaluated at different time points ranging from 0.5 to 48hr before conducting DVF. RESULTS: F/FG ratios obtained 3hr after intravitreal injection were as follows (mean+/-standard error): 0.49+/-0.14 (0.1mM INS542), 0.19+/-0.04 (1mM INS542), 0.48+/-0.09 (PBS), 0.40+/-0.08 (1mM UTP) and 0.36+/-0.05 (10mM UTP). The F/FG ratio for 1mM INS542 was significantly lower than in the other groups (P<0.05). In the time course experiments, a significant decrease in the F/FG ratios was observed between 1 and 12hr following administration of INS542 when compared with F/FG ratios obtained in the contralateral (untreated) eye. CONCLUSION: Intravitreal administration of INS542 (but not UTP) enhances outward active transport of F across RPE in intact rabbit eye, indicating that activation of P2Y(2) receptors in vivo directly stimulates RPE active transport.

Animals↗
PubMed2004

Time course of development of posterior vitreous detachment in the fellow eye after development in the first eye.

PURPOSE: To determine when posterior vitreous detachment (PVD) develops in the fellow eye after development in the first eye. DESIGN: Prospective, observational case series. PARTICIPANTS: Fifty-one patients with acute unilateral PVD participated in the study. METHODS: All patients underwent a comprehensive ocular examination, including a dynamic vitreous examination using biomicroscopy with and without a preset lens and retinal examination with scleral depression, every 3 months at least until PVD developed in the fellow eye. RESULTS: Posterior vitreous detachment developed in 4 eyes (8%) within 6 months, 12 eyes (24%) within 1 year, 24 eyes (47%) within 18 months, 33 eyes (65%) within 2 years, 41 eyes (80%) within 30 months, and 46 eyes (90%) within 3 years. In 5 eyes (10%), PVD did not develop during the follow-up period of more than 3 years. CONCLUSIONS: Posterior vitreous detachment develops frequently in the fellow eye from 6 months to 2 years after development in the first. These findings are useful for the management of patients with unilateral PVD.

Aged↗
PubMed2003

Reproducibility and clinical application of a newly developed stabilized retinal laser Doppler instrument.

PURPOSE: To describe a newly developed stabilized retinal laser Doppler instrument, to report the reproducibility of retinal blood flow measurements, and to present examples of its clinical application. DESIGN: Experimental study. METHODS: The intrasession, intersession, and interobserver reproducibility of retinal blood flow measurements obtained using the Canon Laser Blood Flowmeter model CLBF 100 was assessed. Intrasession: the coefficients of variation (CV) for repeated measurements (5X) of retinal vessel diameter (D), time-average centerline blood velocity (V(av)), and blood flow (F) were calculated at 18 sites along temporal retinal arteries and 18 sites along temporal retinal veins using both eyes in six healthy volunteers. Intersession: the correlation coefficients and average differences between two sets of measurements at the same 36 retinal sites made by one examiner on two different days were calculated. Interobserver: the correlation coefficients and average differences between two sets of measurements at nine sites (five arterial and four venous) in five eyes of five of the volunteers made by two examiners on the same day were calculated. Results from two patients, one with branch retinal vein occlusion (BRVO), and one with central retinal vein occlusion (CRVO), are used to illustrate abnormal retinal circulatory characteristics. RESULTS: intrasession: CV (mean +/- SD) for D, V(av), and F were 5.5% +/- 2.2%, 13.1% +/- 6.3%, and 13.8% +/- 4.7% in arteries and 3.5% +/- 2.1%, 11.9% +/- 5.9%, and 12.7% +/- 5.5% in veins. Intersession/interobserver: strong correlations between measurements made by one examiner on two different days and by two examiners on the same day were found in D, V(av), and F. Average differences in F were 16.4% +/- 12.8% for intersession and 12.6% +/- 7.0% for interobserver comparisons. Results from the patient with BRVO show marked differences in flow characteristics in the affected quadrant compared with an unaffected quadrant in the same eye, and to the fellow eye. Results from the patient with CRVO show a dramatic improvement in flow characteristics after clearing of the occlusion. CONCLUSIONS: The reproducibility results and the fact that blood flow is measured in actual units of microl/min indicate that the instrument can be used for reliable comparison of blood flow characteristics at different retinal vascular sites in the same eye, at comparable sites in both eyes, and for comparison between patients and healthy control subjects.

Adult↗
PubMed2003

Role of nitric oxide in regulation of retinal blood flow during hypercapnia in cats.

PURPOSE: To investigate whether nitric oxide (NO) contributes to the regulation of retinal circulation during hypercapnia in cats. METHODS: NG-nitro-L-arginine-methylester (L-NAME; n=8), a NOS inhibitor; NG-nitro-D-arginine-methylester (D-NAME; n=6), the inactive isomer; or phosphate-buffered saline (PBS; n=8) was injected intravitreously into the cat's eye. A selective neuronal nitric oxide synthase (nNOS) inhibitor, 7-nitroindazole (7-NI; n=6), was injected intraperitoneally. Hypercapnia was induced for 10 minutes by inhalation of 5% carbon dioxide with 21% oxygen and 74% nitrogen. The vessel diameter and blood velocity were measured simultaneously in large retinal arterioles in cats by laser Doppler velocimetry and the retinal blood flow (RBF) calculated. Retinal vascular resistance (RVR) was also estimated. RESULTS: In the PBS group, the vessel diameter (9.5% +/- 2.7%, P<0.05), blood velocity (15.6% +/- 4.4%, P<0.05), and RBF (37.2% +/- 3.7%, P<0.05) increased, and the RVR decreased (-26.0% +/- 2.7%, P<0.05) during hypercapnia. In the L-NAME group, those changes were greatly suppressed in response to hypercapnia. D-NAME was inactive with regard to RBF during hypercapnia. The RBF responses to hypercapnia after the 7-NI injection were significantly attenuated compared with those before 7-NI injection (P<0.05). CONCLUSIONS: These results indicate that NO contributes to the increase in RBF during hypercapnia. Furthermore, the NO synthesized by the action of nNOS may participate in regulation of RBF during hypercapnia.

Animals↗
PubMed2003

[The current status and prospects of telemedicine in Asahikawa Medical College Hospital].

Asahikawa Medical College Hospital Telemedicine Center was established in July 1999. We describe the current status and problems of telemedicine in Asahikawa Medical College Hospital Telemedicine Center. Nine hundred and seventy-one cases were consulted using telemedicine system between July 1999 and November 2002. The fields for which telemedicine techniques were frequently used for consultation were radiology, ophthalmology and pathology. The purposes of telemedicine in the field of ophthalmology were referential to surgery and diagnostic supports. Telemedicine techniques contribute to decreasing the economic and time burdens of patients. Problems with the use of telemedicine techniques include deterioration of image quality especially in the field of ophthalmology, the difficulty of real-time telemedicine conditions, and the costs of communication.

Computer Systems↗
PubMed2002

Association of preoperative photoreceptor displacement and improved central scotoma after idiopathic macular hole surgery.

OBJECTIVE: To investigate the relationship between preoperative photoreceptor displacement and postoperative scotoma after unilateral idiopathic macular hole surgery. DESIGN: Prospective nonrandomized comparative self-controlled trial. PARTICIPANTS: Twenty patients who underwent successful surgery for unilateral idiopathic macular hole participated in the study. METHODS: Kinetic perimetry using red and green filter glasses, black binocular fixation targets, and red and green selective monocular stimuli was performed preoperatively. Scanning laser ophthalmoscope (SLO) microperimetry was performed preoperatively and postoperatively. RESULTS: Sixteen patients had photoreceptor displacement preoperatively. In preoperative SLO microperimetry, all eyes with a macular hole had a scotoma; postoperatively, 12 of 16 had no scotoma. All four eyes with no preoperative photoreceptor displacement were noted to have a postoperative scotoma. The prevalence of postoperative scotoma in patients with preoperative photoreceptor displacement (4 of 16; 25%) was significantly lower than that in patients without preoperative photoreceptor displacement (4 of 4; 100%) (P = 0.03). CONCLUSIONS: The presence or absence of photoreceptor displacement preoperatively should affect postsurgical visual function. Photoreceptor damage may occur in eyes without photoreceptor displacement preoperatively, resulting in scotoma postoperatively.

Aged↗
PubMed2002

Detection of drusen in the fellow eye of Japanese patients with age-related macular degeneration using scanning laser ophthalmoscopy.

OBJECTIVE: To study the prevalence of drusen in the fellow eye of Japanese patients with age-related macular degeneration (AMD). DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: Seventeen eyes of 17 Japanese patients with unilateral AMD. MAIN OUTCOME MEASURES: To compare the frequency of drusen based on photography and scanning laser ophthalmoscopy with confocal and ring apertures and a diode laser (780 nm). RESULTS: Using the scanning laser ophthalmoscope (SLO) with a ring aperture, drusen were detected clearly as in topographic imaging. In the fellow eyes of the study patients with AMD, photography showed drusen in 10 cases (58.8%); however, SLO imaging detected drusen in 15 cases (88.2%). The number of drusen detected using SLO imaging was significantly greater than when using photography (P < 0.05). CONCLUSIONS: Scanning laser ophthalmoscope imaging is superior to photography for detecting drusen in the fellow eyes of Japanese patients with unilateral AMD. The prevalence of drusen in the fellow eye of Japanese patients with AMD is much higher than previously speculated.

Aged↗
PubMed2002

Inhibitory effect of bucillamine on laser-induced choroidal neovascularization in rats.

PURPOSE: We investigated the inhibitory effects of bucillamine on formation of laser-induced choroidal neovascularization (CNV) in a rat model. METHODS: Bucillamine administration (approximately 150 mg/kg/day) was started 1 week before photocoagulation and continued to the end of the study. Control groups received drinking water. Two weeks after photocoagulation, choroidal neovascularization development was evaluated using simultaneous fluorescein and indocyanine green angiography, and the maximal thickness of the lesions was measured histologically. RESULTS: The incidence of CNV formation was 99.5 +/- 0.2% [mean +/- standard deviation (SD)] in control rats and 64.3 +/- 15.1% with bucillamine (P < 0.01). Histological study showed that the thickness of the CNV lesions was 23.4 +/- 6.5 microm (mean +/- SD) in the bucillamine-treated rats, which was significantly decreased compared to that in controls (60.8 +/- 9.2 microm) (P < 0.01). CONCLUSIONS: Our results suggest that bucillamine may inhibit the development of laser-induced CNV in rats.

Animals↗
PubMed2002

Inhibitory effects of bucillamine on increased blood-retinal barrier permeability in streptozotocin-induced diabetic rats.

PURPOSE: To investigate the effect of bucillamine for prevention of increasing blood-retinal barrier (BRB) permeability in streptozotocin (STZ)-induced diabetic rats. METHODS: The groups included control and STZ-induced diabetic rats treated with or without bucillamine. Six months after intervention, the concentrations of reduced and oxidative glutathione (GSH and GSSG) in the retina were measured biochemically. In addition, vitreous fluorescein, which leaks from the vessels after intravenous injection of fluorescein sodium, was measured to evaluate BRB permeability. To evaluate the scavenging ability against the reactive oxygen species (ROS) in vitro, the second-order rate constant for the reaction of bucillamine with ROS was estimated from the kinetics based on the rate constant for the reaction of ROS. RESULTS: The BRB permeability was significantly higher (p = 0.01) in diabetic rats not treated with bucillamine, and bucillamine inhibited the BRB permeability. The GSH concentration and the GSH/GSSG ratio in the retinas decreased in diabetic rats not treated with bucillamine; bucillamine inhibited the decrease of the GSH concentrations. The ROS scavenging activity of bucillamine was similar with that of GSH. CONCLUSIONS: In diabetic retinas, oxidative stress might increase, which may be one of the causes of BRB breakdown. The antioxidant effects of bucillamine might take part in inhibition of increased permeability of the BRB in diabetes.

Animals↗