Multiple dermoid cysts on the cheek.
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Biomedical subjects
Publications and source records attributed to K Niitsuma.
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AIM: To compare statistically the clinical effects and postoperative course of the scanning CO(2) laser and conventional surgical method to evaluate the clinical effectiveness of the former for the treatment of ingrown nail deformities. METHODS: We performed vaporization of the nail matrix using the scanning CO(2) laser in 25 cases with ingrown nail deformities. RESULTS: In 21 cases, the recurrence of ingrown nail deformity was not observed during follow-up. All cases were free of postoperative infection. Use of the scanning CO(2) laser reduced postoperative pain, and all patients were able to return to their daily activities by day 3 post-surgery without any problems. CONCLUSIONS: Statistically, the operating time and the duration of postoperative pain were reduced significantly by the scanning CO(2) laser. Furthermore, patients treated with CO(2) laser were able to return to daily life significantly sooner.
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Pleural effusions seldom accompany nontuberculous mycobacterial infections. We reported one such case of M. avium lung infection with pleural effusion. A 40-year old male was admitted to our hospital complaining of right chest pain and general fatigue. His chest X-ray showed a consolidation in the right lower lung field. The day after admission, a right pleural effusion appeared. The fluid was exudative and microbiological examinations of the effusions, including staining and culturing, proved negative. However, one month afteradmission, acid fast bacilli were observed in his sputum and a subsequent sputum culture specimen revealed the presence of M. avium. Treatment with antimycobacterial agents was promptly commenced and the patient's effusion and lung consolidation was gradually resolved.
We investigated the susceptibility of Pseudomonas aeruginosa (isolated from the sputum of patients with respiratory infection in 4 medical institutions in Fukushima Prefecture) to 8 beta-lactam antibiotics including three carbapenems and relationships among MICs of antibiotics tested. The MIC90 values for a total of 216 strains were 6.25 micrograms/ml for meropenem, 12.5 micrograms/ml for imipenem and ceftazidime, 25 micrograms/ml for panipenem and cefsulodin, 50 micrograms/ml for cefpirome and over than 200 micrograms/ml for cefoperazone and piperacillin. The frequency of resistance of these strains to each antibiotic was as follows: The resistant strains were 19 (8.8%) for meropenem, 34 (15.7%) for imipenem and ceftazidime, 50 (23.1%) for cefsulodin, 72 (33.3%) for panipenem, 76 (35.2%) for piperacillin and 90 (41.7%) for cefpirome. Eighteen strains (18.3%) of 19 meropenem resitant straisn were resistant to imipenem and panipenem, but 16 strains of the 34 imipenem-resistant strains and 54 strains of the 72 panipenem-resistant strains were susceptible to meropenem. In investigation of isolation of multi-resistant Pseudomonas aeruginosa, the susceptibility of strains tested to 7 antibiotics except cefoperazone was as follows: The strains susceptible to all the 7 antibiotics were 92 strains (42.6%), and 33 strains (15.2%) were resistant to 2 antibiotics, 31 strains (14.4%) were resistant to 1 antibiotic, 21 strains (9.7%) were resistant to 3 antibiotics, 13 strains (6.0%) were resistant to 5 antibiotics, 9 (4.2%) were resistant to 4 and 7 antibiotics, and 8 strains (3.7%) were reistant to 6 antibiotics. Since the emergence of these multi-resistant strains is closely related to frequent use of antibiotics for nosocomial infections, special attention should be paid to the antimicrobial susceptibility of Pseudomonas aeruginosa and the situation of antibiotic resistant strains.
Varicella pneumonia is the most common complication of adult varicella. Symptoms may be severe and the mortality rate high in patients who are immunodeficient or pregnant. Symptoms may be mild and progression more favorable in adults previously in good health. We report two cases of varicella infection complicated by severe pulmonary involvement in adult patients who were previously healthy. Case 1 was a 36-year-old male who 6 days after developing varicella was clinically observed to have dyspnea and hemopytsis. He died of acute respiratory failure on the following day. Case 2 was a 28-year-old male whose respiratory symptoms started the third day after developing varicella. These symptoms were relieved by treatment with acyclovir and gammaglobulin. Careful observation is and an early treatment of varicella should be undertaken not only for patients with suppressed cellular immunity, but also for healthy adults, to prevent severe complications.
Exercise performance in essential hypertension (EH) and its relations to blood pressure (BP) response and left ventricular hypertrophy (LVH) were studied. Twenty-three patients with mild to moderate EH and 12 controls underwent symptom-limited (except BP elevation more than 250 mm Hg) ergometer exercise. Exercise performance was evaluated by the oxygen uptake (VO2/kg) at anaerobic threshold (AT) and at peak exercise (Peak). Left ventricular geometry and function, and left ventricular mass index (LVMI) were measured using echocardiography. The endpoints of 12 patients (group A) and controls were fatigue. The endpoints of 11 patients (group B) were BP elevation. Though both group A and group B had concentric hypertrophy, group B showed severe LVH compared to group A and controls. The VO2/kg at AT or at Peak was not different among the three groups. Neither BP response or LVMI correlated with exercise performance in EH. We conclude that exercise performance is not disturbed in EH; that BP response to exercise is not related to exercise performance in EH; and that concentric LVH may be a compensatory mechanism to maintain exercise capacity against exaggerated BP elevation in EH.
The treadmill test (TM), handgrip test (HG) and cold-pressor test (CP) are now frequently used clinically for multiple purposes. However, gas exchange analysis has not been a common procedure during HG. In particular, during CP, it has not been previously reported. Relationships between these 3 tests and blood pressure, heart rate (HR), respiratory gas exchange and the sympathetic nervous activity of normal subjects have not been reported, either. This study was undertaken to clarify these points. Symptom-limited TM was performed in 11 normal male subjects with a mean age of 45 +/- 8 yrs according to the Bruce protocol, with the HG using the weight-sustaining method (equal weight of 50% maximal voluntary contraction) for 3 min, and CP for 2 min. Systolic and diastolic blood pressures (Ps, Pd) were recorded; HR was measured every 30 sec, and gas exchange variables, such as oxygen uptake (VO2) and carbon dioxide production, were documented every 10 sec using an aereomonitor AE-280 (Minato Medical Science Co). In 10 of 11 subjects, concentrations of plasma noradrenaline (PNA) and plasma adrenaline (PAD) were measured at rest and at the times of peak values of the 3 tests. The peak values of Ps and HR were much higher during TM than during HG and CP (p < 0.01), while the peak values of Pd during HG and CP were higher than during TM (p < 0.01). The VO2 increased significantly for all of the 3 tests (TM: +781%, HG: +65%, CP: +20%), with the increment being the greatest during TM. Both PNA and PAD increased significantly for the 3 tests, with the increments of PNA and PAD being the greatest during TM. The percent change in PAD was more prominent during HG and CP than during TM. This tendency was not as clear for PNA as for PAD. There was no correlation of delta Ps and delta Pd between the 3 tests, but values of delta HR correlated partially. No significant correlations of peak VO2 were observed between the 3 tests. The peak PNA correlated between HG and CP (r = 0.77, p < 0.01), and the peak PAD correlated between TM and CP (r = 0.67, p < 0.05). In summary, numerous differences in hemodynamic and respiratory responses and in sympathetic nervous activation were observed in the 3 tests. When the 3 tests are undertaken, careful attention should be paid for their characteristics, discrepancies and limitations.
The plasma concentration of atrial natriuretic peptide (pANP) was investigated at fixed times during 48 h following the onset of an initial attack of mild acute myocardial infarction (AMI) in 11 patients. Six hours after onset, the mean pANP was elevated, but 6 h later pANP had returned to the baseline level. Forty-eight hours after onset the mean pANP increased again. Thus, the curve of the time course of pANP consisted of 2 peaks separated by a dip. Six hours after onset, systemic hemodynamics and humoral factors were measured in 27 patients. At 48 h they were measured in 14 patients. The late elevation of pANP correlated with mean pulmonary arterial wedge pressure (r = 0.63, n = 14, p less than 0.05), while the early elevation of pANP did not (r = 0.31, n = 27, n.s.). The early elevation of pANP correlated with plasma concentrations of both noradrenaline (r = 0.55, n = 27, p less than 0.01) and creatine phosphokinase (r = 0.54, n = 27, p less than 0.01). In addition, noradrenaline levels positively correlated with mean pulmonary arterial wedge pressure (r = 0.38, n = 27, p less than 0.05). The cause of the early elevation of pANP in AMI is unclear, but it is suggested that injury to myocardium and activated sympathetic nerve activity may be responsible in part.
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Penetration of minocycline hydrochloride (MINO) into lung tissue and sputum was investigated. MINO (100 mg) was intravenously infused over 30 min to 14 patients before lung surgery: the concentration of MINO was determined in 16 lung tissue samples which were collected between 0.25 and 5.0 h after infusion. The mean concentration of MINO in lung tissue sample was 2.92 +/- 1.43 microg/g, and the mean lung tissue/plasma ratio of MINO concentration was 3.71 +/- 2.36. MINO was infused intravenously over 60 min twice daily to 5 patients with a chronic respiratory disease for 3-7 days. The concentration of MINO in sputum and in serum was determined on day 3. The mean maximum concentration of MINO in sputum sample was 2.12 +/- 2.20 microg/g, and the mean sputum/serum ratio of MINO concentration was 0.56 +/- 0.47. The concentration of MINO in sputum showed little time-related variation and remained as high as 0.74 microg/g until 10 h after infusion. The concentration of MINO in sputum and in serum after intravenous drip infusion was about twice as high as that after oral administration at the same dose. The breakpoint was 1.88 for MINO, as calculated by the formula established by the Japan Society of Chemotherapy.
Rats in which the sciatic nerves were cut were divided into two groups: animals with nerve sutured and animals with nerve not sutured. In the unsutured group, the levels of R-cadherin expression increased and then decreased to values lower than those of controls. In the sutured group, the levels of R-cadherin expression increased and then decreased to almost control values. These results suggest that R-cadherin plays some role in cells of normal and regenerating muscles.