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Biomedical subjects

Eiju Sato

Publications and source records attributed to Eiju Sato.

8 recordsLinked to original sources

Sentinel lymph node radiolocalization in clinically negative neck oral cancer.

BACKGROUND: The sentinel node concept has become one of the most interesting topics in the treatment of head and neck cancer. The aim of this article is to report the results of our feasibility study and clinical application of sentinel lymph node (SLN) radiolocalization and biopsy in patients with clinically negative neck oral cancer. METHODS: Individuals with previously untreated N0 oral cancer participated in the study. The radioactive tracer used was 99m Tc phytate. Lymphoscintigrams were taken in the feasibility study, and fusion images of SPECT and CT were obtained in the clinical SLN biopsy (SLNB) group. In the feasibility study, metastases to SLNs and other nodes were analyzed in permanent specimens. In the clinical application group, we investigated the comparative effectiveness of multi-slice frozen section analysis and imprint cytology for the intraoperative diagnosis of SLNB. RESULTS: Fifteen individuals participated in the feasibility study. Six SLNs in five patients were cancer-positive, and two thirds of the SLNs were micrometastases. The SLN concept was established, and SLNs with the highest to the third highest radioactivity reflected the patients' neck status accurately. Twelve patients participated in the clinical application group of SLNB. Intraoperative diagnosis of the three hottest SLNs correctly predicted the neck status of 10 patients. Three patients underwent modified radical neck dissection on the basis of the intraoperative diagnosis of cancer metastasis to SLNs, whereas neck dissections were spared in patients with no evidence of such metastases. There were two false-negative cases. One involved a failure of the intraoperative diagnosis of SLNB, and the other had cancer-negative SLNs and cancer-positive non-SLNs. Considering intraoperative diagnosis, multi-slice frozen section analysis was found to be superior to imprint cytology in its sensitivity, specificity, and overall accuracy on a lymph node basis. No differences were found in any of these indices of intraoperative SLNB on a patient basis. The fusion images of SPECT and CT proved very useful during intraoperative SLNB. CONCLUSIONS: The sentinel node concept was established in the head and neck region. Analyzing the three hottest SLNs suffices to predict a patient's neck status. Multi-slice frozen section analysis was shown to be superior to imprint cytology for detecting micrometastasis to SLN. Intraoperative SLNB based on fusion images of SPECT and CT proved to be an easy, accurate, and reliable method.

Feasibility Studies↗

Central retinal artery occlusion after radial optic neurotomy in a patient with central retinal vein occlusion.

PURPOSE: To describe a patient with a central retinal vein occlusion (CRVO) who developed central retinal artery occlusion after radial optic neurotomy. DESIGN: Interventional case report. METHODS: A 70-year-old woman with CRVO underwent a radial optic neurotomy on her right eye. Her preoperative visual acuity in the affected eye was 20/400. RESULTS: Radial optic neurotomy was performed after phacoemulsification and aspiration for a cataract with intraocular lens implantation. At the insertion of a CRVO knife, pulsating bleeding occurred from the cup of the optic disk; the bleeding was stopped within 2 minutes by elevating the intraocular pressure to 80 mm Hg. On the following day, the patient noticed that she had lost light perception. Fluorescein angiography showed a marked delay of arterial filling, indicating a central retinal artery occlusion. Retinal circulation returned to normal 2 months later; however, her vision was still no light perception. CONCLUSIONS: Ophthalmologists should be aware that severe complications such as central retinal artery occlusion can be associated with radial optic neurotomy, which is an unproven surgical procedure with a questionable pathophysiologic mechanism.

Aged↗

Morphological and functional changes of the macula after vitrectomy and creation of posterior vitreous detachment in eyes with diabetic macular edema.

The purpose of this study was to determine the morphological and functional changes in the macula after pars plana vitrectomy with the creation of a posterior vitreous detachment in eyes with diabetic macular edema (DME). A simple posterior vitreous detachment was created during pars plana vitrectomy accompanied by simultaneous cataract surgery in 19 eyes of 17 patients with DME. The visual acuity (log MAR units), multifocal electroretinograms (mfERGs), and optical coherence tomographically (OCT)-determined foveal thickness were determined preoperatively and at 6 months postoperatively. The median preoperative log MAR visual acuity was 0.7 (20/100; range, 0.3-1.1), and it improved significantly to 0.4 (20/50; range, 0.15-1.0) postoperatively (p = 0.016). The median foveal thickness was 510 (range, 194-800) microm preoperatively and was significantly reduced to 201 (range, 60-631) microm postoperatively (p =0.0002). The median of response density of the mfERGs in the macular area was 6.3 nV/ deg2 (range, 2.8-14.8) preoperatively, and 6.1 nV/deg2 (range, 2.4-14.3) postoperatively, a non-significant change (p = 0.27). The median of peak latency of the macular response was 30.0 ms (range, 25.0-44.2) preoperatively and it decreased significantly to 28.3 ms (range, 26.7-35.0) postoperatively (p = 0.003). In conclusion, vitrectomy with the creation of a PVD in eyes with DME improved the visual acuity and foveal thickness significantly. In addition, a decrease of the peak latency of the macular mfERGs suggested an improvement of the physiological function of the macula although the amplitude of the mfERGs was not changed significantly.

Aged↗

Vitrectomy with or without arteriovenous adventitial sheathotomy for macular edema associated with branch retinal vein occlusion.

PURPOSE: compare the results of vitrectomy with or without arteriovenous (AV) crossing sheathotomy for macular edema associated with branch retinal vein occlusion (BRVO). DESIGN: Interventional case series. METHODS: A retrospective study of 36 eyes with BRVO-associated macular edema. Twenty eyes underwent AV sheathotomy (AS group), and 16 eyes underwent posterior vitreous detachment (PVD group). Best-corrected visual acuity (BCVA), fluorescein angiography (FA), and optical coherence tomography to determine foveal thickness were conducted preoperatively and at 12 months postoperatively. RESULTS: The mean postoperative BCVAs were significantly better in both the AS and the PVD group (P = .008 and P = .001, respectively). Foveal thickness decreased significantly 1 month after surgery in both groups (P = .002 and P = .007) and continued to decrease up to 12 months. The postoperative mean BCVA and improvement of BCVA and foveal thickness were not significantly different for the two groups at any postoperative period. Postoperative FA showed reperfusion of the occluded vein in 10 eyes in the AS group and 2 eyes in the PVD group, and formation of shunt vessels at the AV crossing site or around the macular region in all of the other eyes of both groups. CONCLUSIONS: Both AV sheathotomy and simple PVD significantly reduced macular edema associated with BRVO. However, there was no significant difference in the improvement of macular function following either procedure. Postoperative improvement of retinal circulation by either reperfusion of the occluded vein or collateral vessel formation was found. This accounted for functional and morphologic improvements.

Aged↗

Binocular interaction reflected in visually evoked cortical potentials as studied with pseudorandom stimuli.

PURPOSE: To study the interaction of visual signals from both eyes with visual evoked cortical potentials (VECPs) elicited by pseudorandom binary sequence (PRBS) stimuli. METHODS: A PRBS was used to drive two independent LED arrays to elicit VECPs. The right and left eyes were simultaneously stimulated by two different series of PRBS stimuli. The impulse response function of each eye was calculated from the raw data by cross-correlating the PRBS and the response. The effect of changing the luminosity of the LEDs parametrically on the responses obtained from the two eyes was evaluated. RESULTS: The impulse response, obtained from 10 volunteers with normal vision, had characteristics similar to responses to the conventional VECP, with a major positive peak at 110 ms (P110). When two eyes were bilaterally exposed to two PRBS stimuli of the same luminosity, the P110 amplitudes of both eyes were decreased by the same amount from that obtained by stimulating only one eye. When the luminosity in the two eyes was different, the VECP amplitude in the eye with the dimmer stimuli decreased, and the amplitude in the contralateral eye increased. CONCLUSIONS: The results clearly demonstrate that interocular luminance interaction can be detected electrophysiologically in normal subjects by using PRBS- driven stimuli in which the feasibility of recording response from the two eyes independently.

Adult↗

Comparison of Yatabe-Guilford personality test results in retinitis pigmentosa and glaucoma patients.

PURPOSE: To determine the psychological state and personality traits of patients with retinitis pigmentosa (RP) or glaucoma so that a closer and better relationship can be developed with the patients. METHODS: The Yatabe-Guilford personality test was administered to 75 RP patients and 42 glaucoma patients. The latter group included 29 cases of primary open-angle glaucoma, 6 of primary angle-closure glaucoma, and 7 of normal-tension glaucoma. The patients were being treated at the Department of Ophthalmology, Chiba University Hospital. As controls, 47 age-matched volunteers were tested. RESULTS: A comparison of these three groups showed that the proportions of patients with cyclic tendency, rhathymia, and lack of cooperativeness traits were significantly higher in the RP group than in the glaucoma group. The lack of cooperativeness value was especially higher in the RP than in the glaucoma group and the control group (Fisher exact test, P <.05). On the other hand, the nervousness value was significantly higher in the glaucoma group than in the RP group and than in controls (Fisher exact test, P <.05). Factors of sex, age, type of disease, corrected visual acuity, and central visual fields did not influence the profiles of the RP and glaucoma groups. CONCLUSION: RP patients had relatively well-stabilized personalities and were optimistic, while glaucoma patients tended toward nervousness in comparison with RP patients and controls.

Adult↗

Protective action of nipradilol against ischemia-induced retinal damage in rats.

The purpose of this study was to investigate whether nipradilol, a beta-blocker having both vasodilating and alpha(1)-blocking activities, can protect retinal cells from the injury induced by ischemia and reperfusion. Rats were anesthetized and, after an intravitreal injection of nipradilol, the intraocular pressure was raised for 45 min to induce retinal ischemia and reperfusion. Before, and 3 and 7 days after the ischemia, electroretinograms were recorded. After the ischemia, the mean amplitude of the b-waves in rats receiving 5 microl of 1.0 x 10(-6) M nipradilol was significantly larger than of controls (injected with phosphate-buffered saline). Histologically, the reduction in the number of retinal ganglion cells (1.0 x 10(-6) M), and the thickness of the inner and outer plexiform layers and the inner nuclear layer (1.0 x 10(-6), 10(-7) and 10(-8) M) was suppressed by nipradilol. These results indicate that nipradilol protected the retina against retinal ischemia and reperfusion and should be considered for therapeutic use in cases of transient retinal ischemia.

Animals↗