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Biomedical subjects

H Tsuneoka

Publications and source records attributed to H Tsuneoka.

At least 19 recordsLinked to original sources

Feasibility of ultrasound cataract surgery with a 1.4 mm incision.

PURPOSE: To study the feasibility of performing ultrasound (US) phacoemulsification cataract surgery through a 1.4 mm incision using conventional phacoemulsification equipment but removing the infusion sleeve from the US tip. SETTING: Department of Ophthalmology, Jikei University, Tokyo, Japan. METHODS: The infusion sleeve was removed from a 20 gauge US tip, and the sleeveless tip was inserted in a 1.4 mm incision in a postmortem porcine eye, providing infusion through a side port; phacoemulsification was performed with the US tip occluded. Temperature at the incision site was measured with a thermometer to determine whether a thermal burn occurred during the process. A hooked infusion cannula with a widened inner channel and 3 apertures was used to stabilize the anterior chamber depth. RESULTS: Ultrasound phacoemulsification produced almost no temperature elevation at the incision site as long as the infusion liquid was adequately circulated around the US tip. With the 20 gauge US tip, an adequate volume of leakage was maintained through the 1.4 mm incision; no thermal burns developed at the incision site. The use of a hooked infusion cannula made it possible to stabilize the anterior chamber and to apply the bimanual nucleofractis technique to emulsify and aspirate the lens nucleus. CONCLUSION: Using a sleeveless 20 gauge US tip, US cataract surgery was safely performed through a 1.4 mm incision without producing thermal burns at the incision site.

Animals↗

[Bartonella henselae infection in domestic cat and dog fleas].

We studied on the infection of domestic cat and dog fleas with Bartonella henselae by polymerase chain reaction (PCR). A total of 62 fleas (36 Ctenocephalidis felis from cats, 24 C. felis from dogs and 2 Ctenocephalidis canis from dogs), stored in 70% ethanol, were analyzed by PCR for B. henselae specific DNA. Of the 62 fleas, C. felis from cats and dogs were positive for B. henselae specific DNA in 12 of the 36 (33.3%) and in 5 of the 24 (20.8%), respectively, and C. canis from dogs was positive in 2 of the 2 (100%). Our results demonstrated that pet fleas were infected with B. henselae, and suggest that flea transmission of B. henselae between cats or dogs may occur, and direct transmission of B. henselae from pet fleas to human may cause cat scratch disease.

Animals↗

[Serological cross-reaction among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody method].

We studied the serological cross-reactions among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody (IFA) method, using sera from 8 patients with cat scratch disease (CSD), 13 patients with C. pneumoniae infection and 12 patients with acute Q fever. B. henselae IgG antibody was negative in 13 patients with C. pneumoniae infection, and was positive in 3 (titers being 1:64) of 12 patients with Q fever, whereas B. henselae IgM antibody was negative in all the patients with C. pneumoniae infection or Q fever. C. burnetii IgG antibody was removed by absorption of these 3 sera with C. burnetii antigens, whereas B. henselae IgG antibody did not change. C. pneumoniae IgG antibody was positive in 3 (titers being 1:125 in two, 1:32 in one) of 8 patients with CSD. Both C. pneumoniae and B. henselae IgG antibody titers were significantly reduced by absorption of these 3 sera with B. henselae antigens. C. burnetii IgG or IgM antibodies were negative in all patients with CSD. In conclusion, no serological cross-reaction between B. henselae and C. burnetii was observed. On the other hand. B. henselae IgG antibody cross-reacted to C. pneumoniae antigens, whereas C. pneumoniae IgG antibody did not cross-react to B. henselae antigens. Our findings suggest that determination of B. henselae IgG or IgM antibodies were not influenced by C. pneumoniae and C. burnetii antigens.

Bartonella henselae↗

[An adult case of systemic cat-scratch disease with hepatosplenic involvement].

A previously healthy 25-year-old female was admitted to our hospital in November, 1997, for treatment of a spike-fever of 2 weeks' duration. She had a cat in her house but reported no history of cat bites or scratches. No peripheral lymphadenopathy was detected. White blood cell count was within normal limits, but an increased C-reactive protein level of 11.4 mg/dl was noted. Infectious disease was suspected but ruled out as blood cultures were negative. Empiric therapy with clarithromyoin, isoniazid, and rifampicin was ineffective. In January, 1998, abdominal ultrasonogram revealed multiple hypoechoic mass lesions in the spleen and liver, and a splenectomy was performed in March. Histopathologic examination showed numerous necrotizing and caseating granulomas, which tested positive for Bartonella henselae DNA by PCR. Furthermore, the patient tested positive for B. henselae antibody by immunofluorescence assay. A diagnosis of systemic cat-scratch disease with hepatospnenic involvement was made. Combination therapy with minocycline, sulbactam/cefoperazone, and tosufloxacin was administered and her inflammatory findings improved gradually. We report an adult case of systemic cat-scratch disease with liver and spleen involvement in the non-immunocompromised host.

Adult↗

[Two patients with Bartonella henselae infection from a dog].

Two patients were reported as having been infected with Bartonella henselae after having contact with a dog. Both of the patients owned a dog, but had no contact with cats. One patient was a 10-year-old boy who had experienced a fever of 38-39 degrees C for 11 days, as well as having bilateral cervical lymphadenopathy. The boy's serum IgM antibodies to B. henselae were negative on the 6th and 16th day of his illness, whereas his IgG value, using indirect fluorescence antibody (IFA) method, was found to be elevated from 1:256 to 1:1,024. B. henselae DNA was detected, by PCR method, in swabs from the gingiva and buccal membrane of the dog with which the boy had been in contact. The boy was first treated with cefdinir (300 mg daily) for 6 days without beneficial effect. He responded, however, to minocycline (100 mg daily) with symptom resolution in four days. The other patient was a 64-year-old man who had experienced a fever of 38-39 degrees C for 27 days, as well as having right inguinal lymphadenopathy. The man's serum IgM antibody to B. henselae was negative, although his IgG value, determined by IFA, was 1:1,024. In addition, B. henselae DNA was detected, by PCR method, in parafin-embedded tissue obtained from the biopsied inguinal lymph nodes. The man was treated with cefazolin (2 g daily). His fever resolved, but his lymph nodes remained swollen. After a regimen of erythromycin (1,200 mg daily), the swelling in his inguinal lymphnodes gradually disappeared. Careful review of suspected CSD victims' history of contact with animals is important in making a prompt diagnosis of B. henselae infection.

Animals↗

[Wound temperature during ultrasmall incision phacoemulsification].

PURPOSE: We studied the change in wound temperature during phacoemulsification(PEA) through an ultrasmall incision using an ultrasound tip with the infusion sleeve removed. METHODS: We observed an increase in the ultrasound tip temperature on thermographs when it was turned on under various conditions. We also measured the wound temperature using a thermometer during the use of ultrasound in PEA by occlusion when a 20 gauge ultrasound tip was inserted without an infusion sleeve into postmortem porcine eyes through a 19 gauge incision and when the infusion cannula was inserted through the side port. RESULTS: The ultrasound tip temperature did not rise if sufficient infusion liquid was circulated around the tip. When the 20 gauge ultrasound tip was used and the incision width was more than 1.5 mm, there was no thermal burn in the wound. CONCLUSION: Ultrasmall incision cataract surgery was conducted using a sleeveless ultrasound tip without the occurrence of a thermal burn in or around the incision wound.

Animals↗

Scleral corneal 1-plane incision cataract surgery.

The scleral corneal 1-plane incision for cataract surgery technique uses a single knife to perforate the anterior chamber from the sclera via the cornea by making a corneal valve that is 1.0 to 1.5 mm long. The technique is easy and reproducible. Even if incisions are widened to 6.0 mm, they readily self-seal with little surgically induced corneal topographic changes. Because surgical manipulations through a short scleral tunnel are easy and intraoperative mishaps can be dealt with smoothly, this incision technique can be used by those with relatively little surgical experience.

Anterior Chamber↗

[Clinical evaluation of commercial serological test for Bartonella infection].

We evaluated the usefulness of a serological diagnostic kit (Bartonella IFA IgG, IgM; MRL Diagnostics) for Bartonella henselae infection. Of the 110 healthy individuals, 107 (97.3%) were with titers being less than 1:64 for IgG antibody to B. henselae, 2 were with titers being 1:64 and 1 with 1:128, IgM antibody to B. henselae was negative in all individuals. Serological diagnosis of cat scratch disease (CSD) using indirect fluorescence antibody (IFA) methods (in-house and diagnostic kit) was made in either elevated titers of IgM (> or = 1:20) or IgG (> or = 1:256) antibodies, or a four-fold rise in IgG titer between acute and convalescent sera. Of the 18 individuals with serological diagnosis of CSD by in-house IFA method in 26 CSD clinical diagnosed patients, 15 (83%) were compatible with the results of the diagnostic kit, whereas 3 (17%) were not compatible. Of the 8 without serological diagnosis, 1 (13%) was serologically diagnosed as CSD, and the others were negative. Overall, the serological diagnosis was made in 16 of 26 (62%). The specificity and sensitivity of this kit were 100% and 62%, respectively. The cross-reaction between B. henselae and Bartonella quintana was observed in sera from controls and patients. Our results show that the diagnostic kit as well as in-house method is an useful tool for the serological diagnosis of cat scratch disease.

Adolescent↗

Bartonella henselae infection as a cause of fever of unknown origin.

Fourteen of 41 patients (34%) with a serological diagnosis of Bartonella henselae infection were found to have prolonged fever or fever of unknown origin, suggesting that generalized systemic B. henselae infection is not rare in immunocompetent healthy individuals.

Adolescent↗

[Three children with systemic cat scratch disease].

Three girls with systemic cat scratch disease, aged 10, 13 and 9 years, were reported. They presented a prolonged fever and back pain in the early stage of the disease, and had no regional lymphadenopathy. Two of them had hepatosplenic granulomas, one with multiple 5 mm hypoechoic lesions in the liver and spleen, and the other with a single 2.5 cm hypodense lesion in the left hepatic lobe. The latter patient underwent a partial left hepatic lobectomy. All patients had elevated titers of antibodies to Bartonella henselae. Polymerase chain reaction detected B. henselae DNA in tissue specimens of the patient who underwent a hepatic lobectomy. Cat scratch disease should be recognized as a cause of fever of unknown origin because the prevalence of B henselae infection might be higher in Japan.

Adolescent↗

[Sensitivity of Helicobacter pylori to amoxicillin and clarythromycin with special reference to eradication therapy].

We isolated strains of Helicobacter pylori from gastric mucosa of patients with peptic ulcer before and after eradication therapy, and studied their sensitivity to amoxicillin (AMPC) and clarythromycin (CAM). Of 85 strains of H. pylori isolated before therapy, MIC90 was 0.025 microgram/ml and no strains were resistant to AMPC. On the other hand, MIC90 of CAM was 0.05 microgram/ml and seven (8.2%) were already resistant to CAM. The H. pylori strains from eight cases of failed eradication therapy with lansoprazole + AMPC remained AMPC sensitive. However H. pylori strains from nineteen cases (82.6%) out of 23 of failed eradication therapy with lansoprazole + CAM became CAM resistant. The situation was similar for the cases of failed eradication therapy with lansoprazole + AMPC + CAM. Drug sensitivity tests prior to eradication therapy are to be recommended. A disc method may be used as a simple alternative to MIC measurement.

2-Pyridinylmethylsulfinylbenzimidazoles↗

[Determination of anti-Bartonella henselae antibody by indirect fluorescence antibody test--comparison of two types of antigen: non-cocultivated B. henselae and cocultivated B. henselae with Vero cells].

Serum anti-Bartonella henselae IgG and IgM antibody titers for the diagnosis of cat scratch disease (CSD) were determined by indirect fluorescence antibody (IFA) tests. B. henselae as antigen were harvested either by cocultivating with Vero cells (cocultivated B. henselae) or by cultivating without them (non-cocultivated B. henselae). Based on the results on 110 healthy adults, cut off values were set at 1:32 for IgG, and < 1:20 for IgM antibodies. According to these criteria, IgG antibody was positive in 2.7% of the 110 adults, while nobody was positive for IgM antibody. The titers did not change depending on the types of antigen used. On the other hand, IgG antibody titers against cocultivated B. henselae tended to be higher than those against non-cocultivated B. henselae in 33 CSD suspected patients; 75.8% of the patients were anti-B. henselae IgG positive when tested with cocultivated B. henselae as antigen, while only 48.5% of the same patients gave positive results with non-cocultivated B. henselae. Anti-B. henselae IgM antibody was positive in 24.2% of the 33 CSD suspected patients against both types antigen. Vero cells themselves seemed to nonspecifically bind some IgM (but not IgG). We recommended cocultivated B. henselae as antigen for IgG IFA, and non-cocultivated B. henselae for IgM IFA in the serological tests of CSD.

Adult↗