PubMed Health⌕ Search

Biomedical subjects

H Kitahara

Publications and source records attributed to H Kitahara.

At least 19 recordsLinked to original sources
PubMed2004

Rotation of the spinal cord in idiopathic scoliosis.

We undertook a radiographic analysis with pre-operative computed tomographic myelography in 78 patients with idiopathic scoliosis in order to analyse rotation of the spinal cord and to investigate its clinical significance. The angle of rotation of the cord had a statistically significant relationship to both that of the apical vertebra and the size of the primary curve. The relationship between the rotation of the cord and that of the apical vertebra was divided into three types. The cord rotated in the same direction as the apical vertebra in 55 patients and rotated in the opposite direction in the remaining 23 patients. In the first group, the angle of rotation of the cord was more than that of the vertebra in six patients, but less than it in 49 patients. These results suggest that the neuraxis in idiopathic scoliosis may be under tension in the axial dimension.

Adolescent↗
PubMed2003

Coxsackievirus and adenovirus receptor (CAR)-positive immature osteoblasts as targets of adenovirus-mediated gene transfer for fracture healing.

Adenovirus vectors are expected to be a powerful tool for gene therapy to treat severe fractures. Adenovirus invades cells through binding to the coxsackievirus and adenovirus receptor (CAR) on the cell membrane. CAR expression is low in normal adult animals, but it is induced on regenerating cells in some experimental models. We made a rib fracture model in mice and evaluated the histological changes and CAR mRNA expression by RT-PCR 1, 5, 10, 14, and 21 days after the fracture. CAR mRNA was expressed exclusively in the fractured ribs at each time point, but not in the normal ribs. We detected the CAR protein immunohistochemically in fibroblast-like cells in the fracture callus on days 10 and 14 after fracture. In situ hybridization showed that these fibroblast-like cells expressed mRNA of type I collagen and osteopontin, but not osteocalcin, defining the cells as immature osteoblasts. We then transferred small doses (10(4)-10(8) PFU) of lacZ-expressing adenovirus vector into immature osteoblasts on day 14. beta-galactosidase was detected only on the immature osteoblasts at every dose. Immature osteoblasts play an important role in the matrix replacement step in fracture healing. CAR-mediated gene transfer into immature osteoblasts can be reasonable for adenovirus-mediated treatment of fracture healing.

Adenoviridae↗
PubMed2002

Expression of basic fibroblast growth factor and its receptor-1 in cardiac myxoma.

BACKGROUND: To clarify the significance of basic fibroblast growth factor (bFGF) in angiogenesis or proliferative activity in cardiac myxoma, the expression of bFGF and its receptor (FGFR-1) were immunohistochemically examined. METHODS: Formalin-embedded tissues of cardiac myxomas were obtained by surgical resection from 15 patients and analyzed by immunostaining of bFGF and FGFR-1. The microvessel density was measured in the 15 myxomas using platelet derived endothelial cell adhesion molecule-1. For evaluation of proliferative activity of the cardiac myxomas, proliferating cell nuclear antigen (PCNA) immunostaining was performed, and the PCNA labeling index was measured in each section. RESULTS: bFGF and FGFR-1 were observed in 73.3% and 67.7% of the myxomas, respectively. There was a close correlation between the expression of bFGF and FGFR-1. This co-expression was frequently observed in the myxoma cells around the microvessels appearing as a ring structure. Regarding possible relationships between the expression of bFGF or FGFR-1 and the clinicopathologic features, there were no parameters excluding the macroscopic type of myxoma. The microvessel density in the myxomas with bFGF or FGFR-1 expression was higher than that in myxomas without it. The PCNA labeling index in myxomas with bFGF expression was higher than that in myxomas without it, and the PCNA labeling index tended to be higher in myxomas with FGFR-1 expression than that in myxomas without it. CONCLUSIONS: bFGF and/or FGFR-1 was expressed in some of cardiac myxoma, and may be an important role for tumor angiogenesis and proliferative activity.

Aged↗
PubMed2001

Using cineradiography for continuous dynamic-motion analysis of the lumbar spine.

STUDY DESIGN: Cineradiography was used to analyze continuous dynamic motion in the lumbar spine. OBJECTIVES: To identify motion patterns of the lumbar spine in asymptomatic volunteers and symptomatic patients with L4 degenerative spondylolisthesis, and to use the findings to discuss segmental instability in this disorder. SUMMARY OF BACKGROUND DATA: The use of radiographic findings to assess lumbar spine instability remains controversial. Although some studies have reported on lumbar kinematics during actual movement, the motion patterns in asymptomatic volunteers and symptomatic patients with L4 degenerative spondylolisthesis have not been fully clarified. METHODS: While asymptomatic volunteers (n=20; mean age, 27; control group) and symptomatic patients with L4 degenerative spondylolisthesis (n=41; mean age, 63; degenerative spondylolisthesis [DS] group) flexed from a sitting neutral position and back to the neutral position (flexion course), cineradiography was used to record lateral segmental lumbar motions. Twelve frames were selected during the flexion course, and flexion-extension angle (f-e angle) and translation in the sagittal plane were measured at each motion segment (L2-L3, L3-L4, L4-L5, and L5-S1). The DS group was classified into 2 subgroups according to percentage of slip: DS group I, with a slip equal to or less than 15%; and DS group II, with a slip of more than 15%. The motion pattern was compared between the groups. RESULTS: In the control group, f-e angle and translation at the L2-L3, L3-L4, and L4-L5 segments moved simultaneously, although the L5-S1 segment showed an initial delay. The amount of f-e angle and translation changed almost symmetrically. In both f-e angle and translation, the L4-L5 segment showed a large motion pattern. In DS group I (n=21), the L4-L5 segment showed a large motion pattern in f-e angle and an intermediate motion pattern in translation. In DS group II (n=20), the L4-L5 segment showed an intermediate motion pattern in f-e angle, and a small motion pattern in translation. The relative range of f-e angle at the L4-L5 segment had the largest range in DS group I, and the relative translation showed a serial decrease from the control group through DS group II. A significant correlation between f-e angle and translation (harmonious motion pattern) was noted at the L2-L3, L3-L4, and L4-L5 segments in the control group. The harmonious motion pattern at the L4-L5 segment was significantly less in the DS group than in the control group. The loss of harmonious motion pattern (disordered motion pattern) at L4-L5 was well-revealed in the DS group II. CONCLUSIONS: Motion analyses using cineradiography helped to explain the phenomena of lumbar spine kinematics. Based on continuous dynamic-motion analysis with cineradiography, large f-e angle and disordered motion pattern during the flexion-backward course in the DS group I was considered to be caused by segmental instability. The decreased translation and disordered motion pattern throughout the flexion course in the DS group II was considered to be caused by restabilization.

Adult↗
PubMed2001

Coronary arteriovenous fistula with annuloaortic ectasia and aortic regurgitation.

Cardiac catheterization in a 57-year-old man disclosed a left coronary artery-coronary sinus fistula with annuloaortic ectasia and severe aortic regurgitation. During surgery, the fistula vessel was exposed and clamped before infusing cardioplegic solution for cardiac arrest. The proximal orifice of the fistula was closed directly and the distal orifice doubly ligated. A modified Bentall's procedure was conducted without difficulty. The postoperative course was uneventful.

Aortic Valve Insufficiency↗
PubMed2001

Mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome.

Cases of valvular disease accompanied by systemic lupus erythematosus and antiphospholipid antibody syndrome are uncommon. Here, we present a surgical case of mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome. Mitral valve replacement was performed, and the postoperative course was uneventful. Pathohistological findings of the mitral valve showed degenerative change due to chronic inflammation, proliferative fibrous change and calcification without thrombus formation.

Antiphospholipid Syndrome↗
PubMed2001

Natural history of scoliosis in children with syringomyelia.

We performed a retrospective review of 27 scoliotic patients with syringomyelia using MRI. Their mean age at the first MRI examination was 10.9 years, and at the final review 15.8 years. The mean ratio of the diameter of the syrinx to the cord on the midsagittal MRI (S/C ratio) decreased from 0.49 to 0.24; 14 patients showed a decrease of 50% or more (reduction group). In this reduction group, the cerebellar tonsillar herniation decreased from a mean of 11.3 mm to 6.0 mm, and some improvement in dissociated sensory disturbance was seen in nine of 13 patients. The scoliosis improved by 5 degrees or more in six patients in the reduction group. Our results indicate that spontaneous shrinkage of syringomyelia in children is not unusual and is associated with improvement in the tonsillar herniation, the scoliosis and the neurological deficit.

Adolescent↗
PubMed2000

Enhanced reactivity of electron-deficient enynes in the palladium-catalyzed homo-benzannulation of conjugated enynes

We report the high reactivity of electron-deficient enynes in the homo-benzannulation of conjugated enynes in the presence of Pd(PPh3)4. The introduction of electron-withdrawing groups enabled us to carry out the benzannulation of 1-substituted enynes as well as 1,2- and 2,4-disubstituted enynes. Polysubstituted benzenes were prepared in a highly regioselective manner in good to excellent yields.

Journal Article↗
PubMed2000

Determination of the photochemical efficiency of o-quinodimethane ring closure in room-temperature solutions by using time-delayed, two-color photolysis technique

Photochemical efficiency of o-quinodimethane (3) ring closure at room temperature was determined by using a time-delayed, two-color photolysis technique. o-Quinodimethane (3) was generated by the photolysis of 1,2-bis[(phenylseleno)methyl]benzene (1) by a KrF (248 nm) laser pulse and thus-generated 3 was photolyzed by a subsequent XeCl (308 nm)/XeF (351 nm) laser pulse with varying delay time of 0 to 3 s. The time profile of 3 was monitored by the chemical analyses of benzocyclobutene (5) (a photochemical product of 3), which was formed by a one-photon process, and the spiro dimer of 3 (4) (a thermal product of 3) in the two-color photolysis experiments. The time profile of 3 followed a second-order decay kinetics. The photochemical efficiency was obtained by the analysis of the delay-time dependence of the product yields; those of the consumption of 3 and the conversion 3-->5 by a single pulse of the excimer laser were 81% and 5.7% for the XeCl laser, and 73% and 2.3% for the XeF laser. This difference was attributed to the different excited states involved in the photolysis. In contrast to the photolysis of 3 in argon or rigid organic matrixes, it was revealed that photochemical conversion 3-->5 was not the main path in the solutions, and intermolecular reactions predominated.

Journal Article↗
PubMed2000

Vertebral decancellation for severe scoliosis.

STUDY DESIGN: The results of staged surgery including vertebral decancellation were reviewed retrospectively for 21 patients with severe scoliosis. OBJECTIVES: To evaluate the benefits and limitations of vertebral decancellation as new anterior surgical procedure. SUMMARY OF BACKGROUND DATA: The curvatures of severe scoliosis are often very rigid, and surgical correction using the anterior or posterior approach may not achieve the desired correction. Some studies reported neurologic complications might appear due to the aggressive approach or excessive correction force. METHODS: Twenty-one patients (average age, 17.0 years) with severe scoliosis, in whom Cobb angle was over 80 degrees (average angle, 107 degrees), underwent staged anterior and posterior spinal reconstruction. Vertebral decancellation was performed as anterior procedure, and until posterior instrumentation, halo traction was carried out. The transition of curvatures in coronal and sagittal planes was assessed in this series. RESULTS: The average correction rate of lateral curvature at the final follow-up was 46%. The average loss of correction was 2.5 degrees. Kyphosis, measured between T5 and T12, changed from 41 degrees to 36 degrees. Lordosis, measured between L1 and S1, changed from 56 degrees to 45 degrees. Transient neurologic deficit was seen in one case after vertebral decancellation. CONCLUSIONS: Staged surgery including vertebral decancellation is an effective surgical method for patients with severe scoliosis, where an inflexible rigid curve or the risk of occurrence of neurologic complications due to temporary correction may exist.

Adolescent↗
PubMed2000

Expression of vascular endothelial growth factor and angiogenesis in cardiac myxoma: a study of fifteen patients.

OBJECTIVE: To clarify the association between angiogenesis and the clinicopathologic features in cardiac myxoma, vascular endothelial growth factor expression in the myxoma was examined by using reverse transcriptase polymerase chain reaction and immunohistochemistry, and the microvessel density was determined by counting microvessels in the myxoma by using immunostaining for platelet endothelial cell adhesion molecule 1. METHODS: Seven fresh-frozen and 15 formalin-embedded tissues were analyzed by means of reverse transcriptase polymerase chain reaction and immunostaining for vascular endothelial growth factor, respectively. The microvessel density was measured in the 15 formalin-embedded tissues. Furthermore, immunostaining for proliferating cell nuclear antigen was performed, and the proliferating cell nuclear antigen-labeling index was calculated. RESULTS: All of the 7 analyzed myxomas were positive for vascular endothelial growth factor messenger RNA, as determined by means of reverse transcriptase polymerase chain reaction, whereas atrial septum and atrium tissues were negative. Positive immunohistochemical reaction for vascular endothelial growth factor was observed in the cells of all 15 myxomas. The size of myxomas with high vascular endothelial growth factor expression was smaller than that of myxomas with low vascular endothelial growth factor expression. The microvessel density in myxomas with high vascular endothelial growth factor expression was higher than that in myxomas with low vascular endothelial growth factor expression. There was an inverse correlation between the tumor size and the ratio of the microvessel density in the central part to the microvessel density in the peripheral part of myxomas. Furthermore, there was an inverse correlation between the proliferating cell nuclear antigen-labeling index and the tumor size, and the prolferating cell nuclear antigen-labeling index in myxomas with high vascular endothelial growth factor expression was higher than that in myxomas with low vascular endothelial growth factor expression. CONCLUSIONS: Cardiac myxomas produce vascular endothelial growth factor, which probably induces angiogenesis for tumor growth.

Adult↗
PubMed2000

Normalized spleen/liver ratios on 111In-labelled platelet scintigraphy to predict the outcome of partial splenic embolization in patients with idiopathic thrombocytopenic purpura.

In this study, we examined the use of 111In-labelled platelet imaging to predict the outcome of partial splenic embolization (PSE) in patients with idiopathic thrombocytopenic purpura (ITP). Thirty-eight patients with a clinical diagnosis of ITP underwent 111In-labelled platelet scintigraphy. Twenty-four patients with intractable ITP underwent PSE after 111In-labelled platelet scintigraphy. The conventional spleen/liver ratio at 1 h and 192 h and the normalized spleen/liver ratio [(spleen uptake at 192 h/liver uptake at 192 h)/(spleen uptake at 1 h/liver uptake at 1 h)] were compared between responders and non-responders to PSE. Patients with ITP showed a significant reduction in platelet counts, increased platelet associated IgG, decreased platelet survival, and an increased conventional spleen/liver ratio at 192 h. No significant difference was found between patients who had and who had not undergone previous medical treatment. A significant difference was observed in the mean conventional spleen/liver ratio at 192 h between responders and non-responders, but there was substantial overlap among individuals. The mean normalized spleen/liver ratio was significantly higher in responders than non-responders; there was less overlap between the two groups with the normalized spleen/liver ratio than the conventional spleen/liver ratio. The therapeutic outcome of PSE is predicted more accurately using a normalized spleen/liver uptake ratio of 111In-labelled platelets in patients with idiopathic thrombocytopenic purpura than a conventional splenic/hepatic uptake ratio on delayed images.

Adult↗
PubMed2000

Quantitative analysis of bowel gas using plain abdominal radiograph in patients with irritable bowel syndrome.

OBJECTIVE: Ideally, the diagnosis of irritable bowel syndrome (IBS) would be achieved using a minimal number of procedures. It is presumed that bowel gas is related to IBS, and it is easily visualized by plain abdominal radiograph. In the present study, to clarify the relationship between IBS and the quantity of bowel gas, the measured bowel gas volume using plain abdominal radiographs was compared with the pathology of IBS. METHODS: Plain abdominal radiographs were digitized and transmitted to a computer (computed radiography) in 30 IBS patients and 30 normal controls. The quantity of bowel gas, determined as the pixel value on images and standardized by physique, was defined as the gas volume score (GVS). Using the mean +/- 2SD of GVS in the control group as the normal score, IBS patients were divided into three groups: high, normal, and low. To examine the sequential reproducibility of a similar quantity of bowel gas, a second plain abdominal radiography was performed about 2 months later, and the GVS were compared. The colonic transit time was determined using radiopaque markers. RESULTS: There was a strong correlation between the quantities of bowel gas measured by two independent gastroenterologists. The mean GVS of IBS patients was significantly higher than that in the control group (p < 0.001). The sequential reproducibility was recognized in all 10 IBS patients. There was no significance between colonic transit time and GVS, nor between symptoms and GVS. CONCLUSIONS: Abdominal gas was analyzed objectively by using GVS, and GVS was considered to represent a useful tool for the diagnosis of IBS.

Adult↗
PubMed2000

Acetabular labrum: abnormal findings at MR imaging in asymptomatic hips.

PURPOSE: To determine the prevalence of abnormalities of the acetabular labrum in asymptomatic hips by means of magnetic resonance (MR) imaging and to correlate such abnormalities with age and the portion of the labrum. MATERIALS AND METHODS: MR imaging was performed in 71 asymptomatic hips that were radially sectioned perpendicular to the acetabular labrum at 30 degrees intervals. RESULTS: The shape of the labrum was triangular in 80% (304 of 382) of the labral segments, round in 13% (49 of 382), irregular in 7% (27 of 382), and not identified in 1% (two of 382). A homogeneous low signal intensity was observed in 56% (212 of 382). The frequencies of labral irregularity or its absence and of high signal intensity increased both with subject age and with a more anterior anatomic labral location. CONCLUSION: In asymptomatic hips, abnormal findings regarding the shape and signal intensity of the acetabular labrum can be detected by means of MR imaging. The fact that the findings vary according to age and labral portion should be considered in interpreting MR images in patients suspected of having a labral lesion.

Acetabulum↗
PubMed2000

Primary cardiac malignant fibrous histiocytoma in the right ventricular infundibulum treated with a cavo-pulmonary shunt and coronary embolization.

A 51-year-old woman presented with progressive right ventricular infundibular wall thickening and outflow obstruction. She had had an aorto-coronary bypass for left main coronary artery disease 1 year after radiation therapy for left mammary cancer. Enhanced computed tomography showed a mass in the right ventricular free wall with no connection to the mediastinum; the tumor extended into the main pulmonary artery, but there was no other evidence of a primary or metastatic tumor. A biopsy specimen was obtained and based on the microscopic and immuno-histochemical findings (vimentin and Kp-1 positive) the diagnosis was primary cardiac malignant fibrous histiocytoma, which is very rare. A cavo-pulmonary artery connection lessened her symptoms, but embolization of the coronary artery to try and to reduce the mass had minimal effect. Four months after the tumor was diagnosed she died of extended pulmonary artery obstruction.

Arterial Occlusive Diseases↗
PubMed2000

Correlation between bone marrow edema and collapse of the femoral head in steroid-induced osteonecrosis.

OBJECTIVE: The purpose of this study was to clarify whether bone marrow edema is detectable on initial MR imaging of steroid-induced osteonecrosis of the femoral head. SUBJECTS AND METHODS: Forty-eight hips with osteonecrosis were examined consecutively with MR imaging and radiography. In a previously reported screening program, osteonecrosis was diagnosed on MR imaging when subchondral bands of abnormal signals were present. In the screening program, the MR images of 200 hips of 100 patients receiving high-dose steroid therapy were examined prospectively. Subchondral bands were detected in 48 hips at a mean of 14 weeks after the initiation of steroid therapy. RESULTS: On follow-up MR imaging of 47 hips (one hip excluded) bone marrow edema was initially observed in 13 hips after the onset of hip pain. MR imaging of the remaining 34 hips did not reveal bone marrow edema and the patients were all asymptomatic. MR imaging of 31 of the 34 hips continued to show subchondral bands and MR imaging of the other three hips indicated that the subchondral bands had disappeared. When bone marrow edema was detectable, abnormal findings on radiography were slight but 11 (85%) of the 13 hips progressed to advanced osteonecrosis. Bone marrow edema was highly correlated with the subsequent collapse of the femoral head (p<0.0001). CONCLUSION: Bone marrow edema was not present on initial MR imaging of osteonecrosis. Bone marrow edema should be considered a marker for potential progression to advanced osteonecrosis, and careful examinations for osteonecrosis are necessary when bone marrow edema is seen.

Adolescent↗
PubMed1999

Gait analysis before and after unilateral total knee arthroplasty. Study using a linear regression model of normal controls -- women without arthropathy.

Stepwise multiple regression analysis (forward method) was performed with 22 gait variables obtained from the free and slow gait of 35 normal controls (women without knee arthropathy). These 22 variables were target variables, and velocity, age, body height, and body weight were explanatory variables. Velocity showed the greatest effect on the gait variables, followed by weight, age, and height. Of the 22 target variables, 16 could be explained by a significant level of difference of P < 0.01. A linear regression model of normal gait was then established, based on the judgment that these 16 gait variables were greatly affected by four variables -- velocity, age, height, and weight. Since this model does not perfectly represent the observed values, we compared the observed value/predicted value ratios in different groups to compensate for their differences. The free gait velocity in 20 osteoarthritic patients, 1 year or more after unilateral total knee arthroplasty (TKA), and who had no pain in the contralateral knee was lower than in the normal controls. In comparisons using linear regression models, step length was shorter, step width was longer, and gait cycle was shorter than in controls. Single support time was shorter and double support time was longer. Of the ground reaction forces, the first peak of the vertical component and the peak of the driving force of the fore-aft component were smaller than in controls. The total range of motion (TRM) in the stance phase was less than in controls. These results show quantitatively not only that the velocity of gait after TKA is lower than in normal controls, but also that gait patterns are different. In eight osteoarthritic patients assessed before and after TKA, and who had no pain in the contralateral knee, free gait velocity increased 6 months post-operation, but showed no further changes at 1 year. A linear regression study comparing the gait before TKA and 6 months post-TKA revealed that step time, single support time, double support time, and step width, and -- with regard to ground reaction forces -- the peaks of the driving force and the braking force of the fore-aft component, and TRM in the stance phase all approached the levels in the normal controls. No further changes were observed 1 year postoperatively. Although our models were not perfect, we were able to clarify the differences in gait variables between a TKA group and normal controls and the improvements from pre- to post TKA by normalizing the influence of the four independent variables, (velocity, age, weight, and height) with particular emphasis on gait velocity.

Aged↗