Microhemorrhages in a patient with reversible posterior leukoencephalopathy syndrome.
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Aged↗
Biomedical subjects
K Maeda
Publications and source records attributed to K Maeda.
Mucinous adenocarcinoma associated with chronic anal fistula reconstructed by gracilis myocutaneous flaps.
Mucinous adenocarcinoma associated with chronic anal fistula is extremely rare, and such tumors have often reached an advanced stage at the time of presentation. Here we report a case of mucinous adenocarcinoma associated with chronic anal fistula that involved repair with gracilis myocutaneous flaps and review other reported cases. A 67-year-old man with an approximate 30-year history of an anal fistula was referred to our hospital due to enlargement of the perianal induration accompanied by mucinous secretion and pain. Physical examination of the perianal region revealed an ulcerated and discharging lesion on the buttocks. Histologic examination of a biopsy specimen of the ulcerated lesion revealed mucinous adenocarcinoma. An abdominoperineal resection was performed with resection of the ischiorectal fossa, coccyx, part of the gluteus maximus, and the obturator internus. The extensive defect was repaired with bilateral gracilis myocutaneous flaps. The patient did not experience a decrease in the strength of hip adduction and survived for 58 months without recurrence until he died of pneumonia. The repair using myocutaneous flaps was considered to contribute to a physically active life without recurrence.
Adenocarcinoma, Mucinous↗
An optical supernova associated with the X-ray flash XRF 060218.
Long-duration gamma-ray bursts (GRBs) are associated with type Ic supernovae that are more luminous than average and that eject material at very high velocities. Less-luminous supernovae were not hitherto known to be associated with GRBs, and therefore GRB-supernovae were thought to be rare events. Whether X-ray flashes--analogues of GRBs, but with lower luminosities and fewer gamma-rays--can also be associated with supernovae, and whether they are intrinsically 'weak' events or typical GRBs viewed off the axis of the burst, is unclear. Here we report the optical discovery and follow-up observations of the type Ic supernova SN 2006aj associated with X-ray flash XRF 060218. Supernova 2006aj is intrinsically less luminous than the GRB-supernovae, but more luminous than many supernovae not accompanied by a GRB. The ejecta velocities derived from our spectra are intermediate between these two groups, which is consistent with the weakness of both the GRB output and the supernova radio flux. Our data, combined with radio and X-ray observations, suggest that XRF 060218 is an intrinsically weak and soft event, rather than a classical GRB observed off-axis. This extends the GRB-supernova connection to X-ray flashes and fainter supernovae, implying a common origin. Events such as XRF 060218 are probably more numerous than GRB-supernovae.
Journal Article↗
Subjective response to neuroleptics: the effect of a questionnaire about neuroleptic side effects.
BACKGROUND: A patient's subjective response to neuroleptics is an important factor in pharmacotherapy of schizophrenia. In this study, we conducted an intervention to assess the effect of a questionnaire about neuroleptic side effects. We hypothesized that paying more attention to a patient's subjective distress associated with neuroleptic side effects would improve the patient's subjective response to neuroleptics. So we made a questionnaire about neuroleptic side effects, and used this questionnaire repeatedly in the usual clinical setting as an intervention. METHOD: We administered this study to 210 outpatients who met the following criteria: (1) diagnosis of schizophrenia or schizoaffective disorder as defined by DSM-IV and (2) no worsening of symptoms in the past 6 months. The patients were divided into the intervention and the control groups. Patients of the intervention group filled out the questionnaire four times during 6 months and were given routine clinical care. Patients of the control group had routine clinical care only. The 10-item Drug Attitude Inventory (DAI-10) was used to evaluate the patients' subjective responses to neuroleptics. RESULTS: After 6 months, the patients' subjective responses to neuroleptics assessed by the DAI-10 significantly improved in the intervention group (p<0.05 for within-group comparison). The most improved response was that the patients felt they were taking medications of their own free choice. CONCLUSION: Paying more attention to the patient's subjective distress associated with neuroleptic side effects may have encouraged patients to participate in pharmacotherapy on their own initiative. This study suggests that our 19-item questionnaire is a useful tool to improve a patient's subjective response to neuroleptics.
Adult↗
Association between a functional polymorphism in the renin-angiotensin system and completed suicide.
Suicide has been suggested to involve disturbances in the stress response system and to be related to genetics. The renin-angiotensin system (RAS) has been shown to affect the stress response, and several functional polymorphisms in RAS-related genes have been predicted to alter protein function. We hypothesized that the dysregulation of RAS was involved in suicide, and examined the association between completed suicides and four functional polymorphisms of RAS-related genes: the angiotensinogen M235T, angiotensin-converting enzyme (ACE) insertion(I)/deletion(D), angiotensin type-1 receptor A1166C, and G-protein-beta3 C825T gene polymorphisms. The I allele of the ACE I/D polymorphism was found to be more frequent in completed suicides than in controls (P = 0.014). The I allele was also found to be more frequent in male completed suicides (P = 0.022) than in male controls, while this was not the case in females. These results suggest that the alteration of RAS function caused by the genetic polymorphism is involved in the susceptibility to suicide in males.
Adult↗
Expression of glucocorticoid receptors in non-neoplastic lymphoid follicles and B cell type malignant lymphomas.
OBJECTIVE: To evaluate the expression of human glucocorticoid receptors (hGRs), such as hGR (4H2), hGR-alpha, and hGR-beta, in non-neoplastic lymphoid follicles and B cell type malignant lymphomas. METHODS: The expression of hGRs in non-neoplastic lymphoid follicles and malignant lymphomas, including diffuse large cell lymphoma, mantle cell lymphoma, and follicular lymphoma, was examined immunohistochemically. HGR (4H2) expression was confirmed by double immunostaining of tissues and in isolated cells from tonsillar germinal centres, and by immunoelectronmicroscopy. RESULTS: In secondary lymphoid follicles of any non-neoplastic diseases--such as chronic tonsillitis, reactive lymphadenitis, and Kimura's disease--the germinal centre cells often expressed hGR (4H2) and hGR-alpha. Double immunocytochemical staining of isolated germinal centre cells showed that the majority of hGR (4H2) positive cells were CD20 positive B cells, and that follicular dendritic cells also expressed hGR. Immunoelectronmicroscopy revealed the presence of nuclear hGR (4H2) in the binucleated follicular dendritic cells and germinal centre cells. The frequency of hGR (4H2) expression in diffuse large B cell lymphoma was higher, that in mantle cell lymphoma was lower, and that in follicular lymphoma was intermediate among the types of malignant lymphoma. The hGR (4H2) expression was less frequent in cases of grade I follicular lymphoma. CONCLUSIONS: There are differences in hGR expression between the germinal centre and the mantle zone in non-neoplastic lymphoid follicles, and differences of hGR (4H2) expression among the types of malignant lymphoma and grades of follicular lymphoma, which probably contribute to the different steroid sensitivities.
B-Lymphocytes↗
Who can get the beneficial effect from lateral lymph node dissection for Dukes C rectal carcinoma below the peritoneal reflection?
PURPOSE: This study was designed to identify those patients with Dukes C rectal carcinoma below the peritoneal reflection who might benefit from lateral lymph node dissection. METHODS: The study involved 104 consecutive Dukes C patients who received total mesorectal excision with lateral lymph node dissection for rectal carcinoma below the peritoneal reflection between 1990 and 2002. The patients were retrospectively divided into three groups: patients without lateral spread (Group I: n = 52), patients with nodal involvement between the inferior hypogastric nerve and the internal iliac artery (Group II: n = 16), and patients with nodal involvement in the obturator space (Group III: n = 36). The patients also were divided into two groups according to the number of lateral nodes involved: less than four (n = 42) and at least four (lateral nodes involved: n = 10). Nodal involvement was determined histologically. RESULTS: The local recurrence and overall five-year survival rates were 5.8 and 66.9 percent in Group I, 18.8 and 59.8 percent in Group II, and 33.3 and 23.6 percent in Group III, respectively. These outcomes did not differ significantly between Groups I and II, but they were significantly worse in Group III than in Groups I and II, with the survival being significantly better in the patients with less than four histologically positive lateral nodes involved (43.2 percent) than in those with at least four positive lateral nodes involved (0 percent). CONCLUSIONS: Lateral lymph node dissection was effective for Dukes C rectal carcinoma below the peritoneal reflection with positive lateral nodes involved in the space between the autonomic nerve and the internal iliac artery and in patients with less than four positive lateral nodes.
Female↗
Carotid artery intima-media thickness and reactive oxygen species formation by monocytes in hypertensive patients.
Carotid artery intima-media thickness (IMT) is a widely accepted index for assessing atherosclerosis, and is known to be a risk indicator for cardiovascular and cerebrovascular events. Oxidative stress and inflammation are also known to play critical roles in the pathogenesis of vascular events. We studied the association between IMT and inflammatory markers, such as oxidative stress in polymorphonuclear leukocytes (PMNs) and mononuclear cells (MNCs) in 156 patients with essential hypertension. Reactive oxygen species (ROS) formation by PMNs and MNCs was measured by gated flow cytometry. CRP and traditional risk factors, such as age, gender, body mass index, hemoglobin A(1c), and total cholesterol were also measured. The subjects were divided into a plaque group (max-IMT>or=1.1 mm, n=40), and a nonplaque group (max-IMT<1.1 mm, n=116). ROS formation by MNCs was significantly increased in the plaque group when compared with the nonplaque group (P<0.0001). Multiple regression analysis revealed a significant correlation between IMT and ROS formation by MNCs (r=0.407, P<0.0001), or CRP (r=0.216, P=0.0029) or hemoglobinA1c (r=0.158, P=0.0270) or age (r=0.157, P=0.0447). No significant correlation was observed between IMT and ROS formation by PMNs. These results suggest that carotid artery IMT may be affected by increased ROS formation by MNCs, and that increased ROS formation by MNCs may be related to the development of atherosclerosis. We propose that ROS formation by MNCs is a marker for prediction of carotid atherosclerosis.
Atherosclerosis↗
Serine racemase binds to PICK1: potential relevance to schizophrenia.
Accumulating evidence from both genetic and clinico-pharmacological studies suggests that D-serine, an endogenous coagonist to the NMDA subtype glutamate receptor, may be implicated in schizophrenia (SZ). Although an association of genes for D-serine degradation, such as D-amino acid oxidase and G72, has been reported, a role for D-serine in SZ has been unclear. In this study, we identify and characterize protein interacting with C-kinase (PICK1) as a protein interactor of the D-serine synthesizing enzyme, serine racemase (SR). The binding of endogenous PICK1 and SR requires the PDZ domain of PICK1. The gene coding for PICK1 is located at chromosome 22q13, a region frequently linked to SZ. In a case-control association study using well-characterized Japanese subjects, we observe an association of the PICK1 gene with SZ, which is more prominent in disorganized SZ. Our findings implicating PICK1 as a susceptibility gene for SZ are consistent with a role for D-serine in the disease.
Adult↗
Inhibitory effects of macrocarpals on the biological activity of Porphyromonas gingivalis and other periodontopathic bacteria.
BACKGROUND/AIMS: Macrocarpals, which are phloroglucinol derivatives contained in eucalyptus leaves, exhibit antimicrobial activity against a variety of bacteria including oral bacteria. This study examined effects of macrocarpals A, B, and C on periodontopathic bacteria, especially Porphyromonas gingivalis. METHODS: Macrocarpals A, B, and C were purified from a 60% ethanol-extract of Eucalyptus globules leaves. To investigate antibacterial activity, representative periodontopathic bacteria were cultured in media with or without various amounts of macrocarpals; subsequently, the optical density at 660 nm was measured. Macrocarpal inhibition of P. gingivalis Arg- and Lys-specific proteinases was assessed by spectrofluorophotometric assay and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis. The effect of macrocarpals on P. gingivalis binding to saliva-coated hydroxyapatite beads was examined with (3)H-labeled P. gingivalis. RESULTS: Growth of P. gingivalis was inhibited more strongly than growth of Prevotella intermedia or Prevotella nigrescens and Treponema denticola by macrocarpals, however, Actinobacillus actinomycetemcomitans and Fusobacterium nucleatum were much more resistant. Macrocarpals inhibited P. gingivalis Arg- and Lys-specific proteinases in a dose-dependent manner. The enzyme-inhibitory effect of macrocarpals was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis in which hemoglobin degradation by P. gingivalis proteinase was inhibited by macrocarpals. P. gingivalis binding to saliva-coated hydroxyapatite beads was also strongly attenuated by macrocarpals. CONCLUSIONS: Macrocarpals A, B and C demonstrated antibacterial activity against periodontopathic bacteria. Among tested bacteria, P. gingivalis displayed the greatest sensitivity to macrocarpals; additionally, its trypsin-like proteinase activity and binding to saliva-coated hydroxyapatite beads were inhibited by macrocarpals. These results indicate that eucalyptus leaf extracts may be useful as a potent preventative of periodontal disease.
Anti-Bacterial Agents↗
Effects of smoking and drinking habits on the incidence of periodontal disease and tooth loss among Japanese males: a 4-yr longitudinal study.
OBJECTIVE: We investigated the risk of periodontal disease and tooth loss, associated with habits of smoking and alcohol consumption, in a longitudinal study. SUBJECTS AND METHODS: The subjects were 1332 Japanese males, 30-59 yr of age, who were free from periodontal disease at the baseline check-up, and who underwent a second check-up 4 yr later. Periodontal disease was diagnosed using the community periodontal index score, based on the clinical probing of pocket depth (> or = 4 mm). Smoking and alcohol consumption patterns were evaluated using a self-administered questionnaire. RESULTS: A dose-response relationship was observed between the amount of smoking and the incidence of periodontal disease in each age group. The overall odds ratios (95% confidence intervals), adjusted for age and alcohol, were 1.51 (0.95-2.22), 1.58 (1.13-2.22) and 2.81 (1.96-4.03), among smokers consuming 1-19, 20 or 21 or more cigarettes per day, respectively, with a significant linear trend (p < 0.0001). A similar association was found between smoking and tooth loss, except for the 50-59-yr-old age group. The adjusted odds ratios were 1.26 (0.60-2.64), 2.01 (1.21-2.32) and 2.06 (1.23-3.48), respectively. A significant linear trend between smoking and tooth loss was also observed (p = 0.01). Ex-smokers showed no significant difference compared with nonsmokers. We also found a significant linear trend between alcohol consumption and tooth loss among 30-39-yr-old subjects, while no relationship was observed between alcohol consumption and periodontal disease. CONCLUSION: Cigarette smoking was found to be an independent risk factor for periodontal disease and tooth loss. Alcohol consumption was a limited risk factor for tooth loss in the younger age group, but was unrelated to periodontal disease. To prevent periodontal disease and tooth loss, health practitioners need to encourage people to stop smoking or not to start.
Adult↗
Paraneoplastic cerebellar degeneration in olfactory neuroepithelioma.
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Aged↗
Local anesthetics facilitate ion transport across lipid planar bilayer membranes under an electric field: dependence on type of lipid bilayer.
In order to elucidate the role of structural change of lipid membrane bilayer in the mode of action of local anesthetic, we studied the effects of local anesthetics, charged tetracaine and uncharged benzocaine, on ion permeability across various lipid planar bilayers (PC, mixed PC/PS (4/1, mol/mol); mixed PC/PE (1/1, mol/mol); mixed PC/SM (4/1, mol/mol)) under a constant applied voltage. The membrane conductances increased in the order of PC<<PC/PS<or=PC/SM<<PC/PE. When the constant voltage of -100 or -70 mV was applied through the lipid bilayer membranes in the presence of positively charged tetracaine, the fluctuating current pulses with the large amplitude generated, but not appeared in the absence of tetracaine. The addition of uncharged benzocaine generated the fluctuating currents with the small amplitude. Both charged tetracaine and uncharged benzocaine facilitated electrophoretically the transport of small ions such as KCl in the buffer solution through the fluctuating pores in the lipid bilayer membranes formed by interaction with the local anesthetic under the negative applied membrane potential. The current pulses also contained actual transport of charged tetracaine together with the transport of the small ions. The amplitude and the duration time of the electrical current generated by adding the local anesthetics were dependent on the type of the lipid, the applied voltage and its voltage polarity.
Anesthetics, Local↗
Enterocele associated with rectocele revealed by dynamic pelvic CT.
Enterocele is often associated with other pelvic floor disorders but it is not always possible to detect by clinical examination. Defecography with peritoneography and/or barium meal intake has recently been developed as a new method to identify enterocele, but this method is an invasive procedure. Multislice computed tomography was performed at rest and during simulated defecation to evaluate an 80-year-old female patient who had a defecation disorder and was diagnosed as having rectocele based on results from defecography and clinical findings. Multiplanar reconstruction images were generated for image evaluation. Using this novel method of dynamic pelvic computed tomography, a third-degree enterocele was clearly demonstrated in this case.
Aged, 80 and over↗
Polyethylene glycol-electrolyte lavage solution causes reversible mucosal elevation surrounding a minute depressed-type rectal cancer.
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Adenocarcinoma↗
Left ventricular hypertrophy and angiotensin II receptor blocking agents.
Angiotensin II plays a significant role in cell growth and proliferation in model systems and in humans. Numerous studies have shown that left ventricular hypertrophy (LVH) increases the risk of coronary heart disease, congestive heart failure, stroke or transient ischemic attack; all-cause deaths, and sudden death. The use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) has provided beneficial effects on LVH regression and on cardiac remodeling in the presence of hypertension and heart failure. The new class of ARBs appears to provide cardioprotective effects that are similar to those of the ACE inhibitors. Most of the beneficial effects provided by these agents appear to be related to a more complete blockade of the angiotensin II type 1 (AT1) receptor. However, costimulation of the angiotensin II type 2 (AT2) receptor appears to increase nitric oxide and thus causes some bradykinin-like effects. Evidence for the role of angiotensin II in promoting LVH as well as abnormal regulation of the angiotensin II signal transduction pathways in model systems and in humans has been reviewed. Secondly, the mechanisms for the beneficial effects of angiotensin II receptor blockers studied in model systems and in humans, including possible involvement in the formation of reactive oxygen species by mononuclear cells, are presented. Finally, results from large-scale interventions such as the Losartan Intervention For Endpoint reduction (LIFE) study, as well as an overview of the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial involving the use of ARB in high-risk patients, are presented.
Angiotensin II↗
Efficacy of Helicobacter pylori eradication on the chronic mucosal inflammation of the remnant stomach after distal gastrectomy for early gastric cancer.
Although eradication of Helicobacter pylori (Hp) after early gastric carcinoma has been recommended, very limited studies have been reported and the method differs from standard therapy. Here, we attempted the eradication of Hp in the remnant stomach after surgery for primary gastric cancer with the standardized method. We examined efficacy and the safeness of the treatment. Thirty-three H. pylori-positive patients after distal gastrectomy were treated with proton pump inhibitor (PPI)-based triple therapies. After eradication, endoscopic and histological changes were classified on the basis of the Updated Sydney System. The eradication rate in the remnant stomach was 90.9% (30 out of 33 cases) after triple therapy. Temporal minor side effects were notified in 3 cases. After eradication, the remnant stomach showed significant decreases in inflammation- and activity-scores. Moreover, significant improvement in glandular atrophy to normal mucosa was found. In conclusion, PPI-based standard therapy is just as effective for Hp eradication in the remnant stomach than it is in the non-operative stomach. Eradication therapy could be performed safely and resulted in a significant improvement in inflammation and atrophy of the mucosal layer in the remnant stomach after early gastric cancer surgery.
2-Pyridinylmethylsulfinylbenzimidazoles↗
The resurgence of Shamonda virus, an African Simbu group virus of the genus Orthobunyavirus, in Japan.
Six virus isolations were made from Culicoides biting midges and blood samples of sentinel cattle in Kagoshima and Miyazaki Prefectures, the southern part of Japan, in 2002. Serological and genetical tests identified these viruses as isolates of Shamonda virus (SHAV), which belongs to the Simbu group of the genus Orthobunyavirus of the family Bunyaviridae. Initially, SHAV was isolated from cattle and Culicoides biting midges in Nigeria in the 1960s, and its presence has not been reported until this study. The present results indicate a wider distribution of SHAV than previously assumed.
Animals↗