Biomedical subjects

Mitsuo Iida

Publications and source records attributed to Mitsuo Iida.

190 records · Page 11Linked to original sources

PubMed2002

Solitary pontine tuberculoma.

A 66-year-old man, with a history of pulmonary tuberculosis 40 years before admission, complained of headache and dysarthria that lasted for 2 weeks and was followed by diplopia. MRI revealed an isolated nodular lesion in the pons with a marked enhancement mimicking brain tumor and other diseases. Antituberculous drugs were started under the presumptive diagnosis of tuberculoma. The lesion was completely resolved after 9 months of treatment and thus, the final diagnosis was confirmed. An empiric administration of antituberculous drug may be an important and non-invasive diagnostic tool as well as a treatment in such cases.

Aged↗

PubMed2002

Islet hyperperfusion during prediabetic phase in OLETF rats, a model of type 2 diabetes.

Although it has been hypothesized that initial hyperperfusion followed by late hypoperfusion in islet circulation occurs in rodent models of type 2 diabetes, islet blood flow has not been measured during prediabetic phase. We studied islet blood flow in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of slowly progressive obese type 2 diabetes. Islet blood flow was measured by the two-color microsphere method under anesthesia at different ages. Islet blood flow was significantly higher in young OLETF rats compared with control Long-Evans Tokushima Otsuka (LETO) rats when the former were not obese or diabetic and had normal insulin secretion at 5 weeks of age (LETO 4.6 +/- 1.1, OLETF 8.8 +/- 1.2 ml. min(-1). mg(- 1), P < 0.01). At 6 months of age, islet hyperperfusion was observed in OLETF rats, and >40% of whole pancreatic blood flow was diverted into islets in OLETF rats. Prevention of obesity by food restriction increased basal islet blood flow. On the other hand, long-term hyperglycemia induced by sucrose feeding decreased fractional islet blood flow as well as glucose-stimulated islet blood flow. Our results indicate that hyperperfusion is present during the preobese and prediabetic phase in our type 2 diabetes rats.

Animals↗

PubMed2002

[Efficacy and safety of combination therapy with losartan and hydrochlorothiazide in elderly hypertension].

We examined the effect and safety of combination therapy with low-dose diuretics (hydrochlorothiazide: HCTZ) and angiotensin II receptor antagonist (losartan) in elderly cases of hypertension, using ambulatory blood pressure monitoring (ABPM). Elderly hypertensive patients (mean age 75 +/- 2 years) were treated with either losartan (25-50 mg/day) or HCTZ (12.5 mg/day) for at least 4 weeks, and then 24-hour blood pressure (BP) was measured by ABPM. Combination therapy with addition of other drug was initiated in 14 patients whose 24-hour systolic BP or daytime systolic BP was over 140 mmHg (160 mmHg for the patients of 80 years or older). After 4 weeks of the combination therapy, ABPM was repeated. Blood cell count and blood chemistry were also done before and after initiation of combination therapy. In the losartan-preceding group (n = 9), the combination therapy with HCTZ reduced 24-hour BP by 19.3 +/- 2.3/6.6 +/- 2.3 mmHg. Similarly, daytime and nighttime BP decreased by 21.4 +/- 4/8.4 +/- 2.8 mmHg and 15.2 +/- 4/4.2 +/- 2.4 mmHg, respectively. In the HCTZ-preceding group, the combination with losartan also decreased 24-hour BP by 12.2 +/- 4.8/3.4 +/- 1.4 mmHg. The decreases of daytime and nighttime BP were 13.8 +/- 6.6/4 +/- 1.1 mmHg and 10 +/- 4.7/3 +/- 2.4 mmHg, respectively. Heart rate did not change with combination therapy in the losartan-preceding group, while heart rate during daytime tended to decrease by addition of losartan in the HCTZ-preceding group (3.8 +/- 1.7/min). Serum electrolytes, uric acid, lipids, renal function and body weight did not change during the study period. Thus, combination therapy of losartan/hydrochlorothiazide seems useful in the treatment of elderly hypertension, showing additive BP lowering effect without metabolic adverse effects.

Aged↗

PubMedDate not supplied

Gastric emptying in patients with Type 2 diabetes mellitus and diabetes associated with mitochondrial DNA 3243 mutation using 13C-octanoic acid breath test.

Although the (13)C-octanoic acid breath test (OBT) has been applied to diabetic patients for assessing gastric emptying, such studies are still limited. Gastric emptying was measured using solid meal containing (13)C-octanoic acid in 52 patients with Type 2 diabetes mellitus and 4 diabetic patients with mitochondrial DNA (mitDNA) 3243 mutation. Delayed gastric emptying was detected in 29% of patients with Type 2 diabetes mellitus, and multiple regression analysis showed that gastric emptying was independently associated with gastrointestinal symptoms and cardiac autonomic neuropathy. Gastric emptying was not related to gastric dysrhythmia in cutaneous electrogastrography (EGG). Diabetic patients with mitDNA 3243 mutation showed delayed gastric emptying. Because the pathogenesis of delayed gastric emptying is multifactorial in diabetic patients, the recently developed OBT is useful for studying gastric emptying in various clinical settings of diabetic patients.

Adult↗

PubMedDate not supplied

Brain ischemia as a potential target of gene therapy.

Brain infarction is one of the most important age-associated medical conditions, and the age-related neuronal vulnerability to brain ischemia is suggested to play an important role. Recent advancements in gene transfer techniques have provided promising approaches to the treatment of brain ischemia. In experimental studies, the ischemic penumbra area can be targeted by gene transfer even after ischemic insult, and post-ischemic gene therapy seems effective in attenuation of ischemic damage in both global and focal brain ischemia. Perivascular approaches of gene transfer to the cerebral blood vessels through the subarachnoid space may lead to prevention of brain ischemia caused by vasospasm after subarachnoid hemorrhage. Gene transfer to cerebral blood vessels and ischemic brain tissue may offer future therapeutic approaches to stroke.

Adenoviridae↗

PubMedDate not supplied

Effects of fluvastatin on endothelium-derived hyperpolarizing factor- and nitric oxide-mediated relaxations in arteries of hypertensive rats.

Endothelial cells release endothelium-derived hyperpolarizing factor (EDHF), as well as nitric oxide (NO). It has recently been suggested that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) improve NO-mediated endothelial function, partially independently of their cholesterol-lowering effects. It is, however, unclear whether statins improve EDHF-mediated responses. Eight-month-old stroke-prone spontaneously hypertensive rats (SHRSP) were treated with fluvastatin (10 mg/kg per day) for 1 month. Age-matched, normotensive Wistar Kyoto (WKY) rats served as controls. Both EDHF- and NO-mediated relaxations were impaired in SHRSP compared with WKY rats. Fluvastatin treatment did not affect blood pressure and serum total cholesterol. The acetylcholine (ACh)-induced, EDHF-mediated hyperpolarization in mesenteric arteries did not significantly differ between fluvastatin-treated SHRSP and untreated SHRSP and the responses in both groups were significantly smaller compared with those of WKY rats. Endothelium-derived hyperpolarizing factor-mediated relaxations, as assessed by the relaxation to ACh in mesenteric arteries contracted with noradrenaline in the presence of N(G)-nitro-l-arginine and indomethacin, were virtually absent and similar in both SHRSP groups. In contrast, NO-mediated relaxation, as assessed by the relaxation in response to ACh in rings contracted with 77 mmol/L KCl, was improved in fluvastatin-treated SHRSP compared with untreated SHRSP (maximum relaxation in control and fluvastatin groups 42.0 +/- 5.2 and 61.2 +/- 3.8%, respectively; P < 0.05). Hyperpolarization and relaxation in response to levcromakalim, an ATP-sensitive K(+) channel opener, were similar between the two SHRSP groups. These findings suggest that fluvastatin improves NO-mediated relaxation, but not EDHF-mediated hyperpolarization and relaxation, in SHRSP. Thus, the beneficial effects of the statin on endothelial function may be mainly ascribed to an improvement in the NO pathway, but not EDHF.

Acetylcholine↗

PubMedDate not supplied

Prolongation of the QT interval in primary aldosteronism.

1. Only limited information is available concerning the changes in the electrocardiogram in primary aldosteronism. The aim of the present study was to determine factors influencing the QTc interval in patients with primary aldosteronism. 2. Nineteen patients with primary aldosteronism caused by a Conn's adenoma and 69 patients with essential hypertension, in whom all possible causes of secondary hypertension had been excluded, were included in the present study. Before and 10-20 days after adrenalectomy, blood and electrocardiographic examinations were conducted. 3. Systolic and diastolic blood pressures in primary aldosteronism were found to be comparable to those in essential hypertension. However, the QTc interval was significantly prolonged and serum potassium concentrations were significantly decreased in patients with primary aldosteronism compared with patients with essential hypertension (492.7+/-20.3 vs 428.5+/-3.1 msec for QTc interval, respectively (P<0.01); 3.07+/-0.12 vs 4.07+/-0.05 mEq/L for serum potassium concentrations, respectively (P<0.01)). The QTc interval was significantly correlated with serum potassium concentrations in primary aldosteronism (P=0.0011; r=-0.6902), but not in patients with essential hypertension. 4. Blood pressure significantly decreased after adrenalectomy. Furthermore, serum potassium concentrations increased significantly and did not correlate with the QTc interval after adrenalectomy (P=0.54; r=-0.1500). 5. Our results indicate that the QTc interval is prolonged in patients with primary aldosteronism, probably owing to hypokalaemia.

Adrenalectomy↗

PubMedDate not supplied

Inflammatory diseases associated with Takayasu's arteritis.

The etiology of Takayasu's arteritis is unknown; however, abnormality of the immune system plays an important role. To clarify a possible association between inflammatory diseases and Takayasu's arteritis, the authors retrospectively reviewed the medical records of 36 patients (2 men and 34 women), admitted to their department with this diagnosis. They found that 11 of the 36 patients had at least 1 other chronic or subacute inflammatory disease: Chronic tonsillitis, tuberculous lymphadenitis of the neck, chronic hepatitis B (infectious diseases); pyoderma gangrenosum, erythema nodosum (skin lesions); subacute thyroiditis, chronic thyroiditis (autoimmune diseases); Crohn disease, and ulcerative colitis (inflammatory diseases with unknown etiology). The present observation revealed a high prevalence of other inflammatory diseases in patients with Takayasu's arteritis and raises the possibility that Takayasu's arteritis may be associated with abnormality of the immune system activated by other inflammatory diseases, such as infection, autoimmune diseases, or inflammatory diseases of unknown origin.

Adolescent↗

PubMedDate not supplied

GRAFT infection of thoracic aorta due to group C beta-hemolytic streptococcus--a case report.

A fatal case of late-onset graft infection of the thoracic aorta due to group C beta-hemolytic streptococcus is described. A 37-year-old male patient, who had a history of total aortic arch replacement for acute aortic dissection 8 years before, was admitted to the department. He suffered from toxic shock syndrome, disseminated intravascular coagulation (DIC), and acute renal failure. Group C beta-hemolytic streptococcus was detected from his blood; however, echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) failed to detect the focus of the infection. In spite of intensive care, including antibiotic therapy, artificial ventilation, and continuous hemodiafiltration, he died on the 18th day of hospitalization. Autopsy revealed that a small abscess was present at the proximal anastomotic segments of the patient's graft. A bite inflicted by his dog, 14 days before admission, was suspected to be the source of this bacterium. A rare case of graft infection of thoracic aorta in terms of causative organism, long period from graft replacement to graft infection, and site of infection is presented and discussed.

Abscess↗

PubMedDate not supplied

Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography in patients with severe carotid stenosis.

BACKGROUND AND PURPOSE: Conventional ultrasonography techniques do not allow visualization of the distal cervical segment of the internal carotid artery (ICA). In a study of patients with severe ICA stenosis, we performed transoral carotid ultrasonography (TOCU) to assess its ability to image this segment of the artery. METHODS: The study participants consisted of 20 consecutive patients who had severe carotid stenosis and who underwent carotid endarterectomy between 1999 and 2000. TOCU, conventional carotid ultrasonography, and cerebral angiography were prospectively performed before and after carotid endarterectomy. RESULTS: In all patients, the distal portion of the ICA could be clearly detected by B mode using TOCU and no plaque was observed. The diameter of the distal portion of the ICA significantly increased after carotid endarterectomy (3.9 +/- 0.5 mm [mean +/- SD]), compared with before (3.5 +/- 0.8 mm), when it was estimated by TOCU (P <.01). In seven patients, the postoperative diameter of the distal ICA increased >10%. The mean increase in the postoperative diameter was estimated to be 15.0 +/- 23.0% by TOCU, which significantly correlated with the findings (23.9 +/- 33.7%) based on cerebral angiography (P <.01). The diameter increased >10% postoperatively in 71% of the patients with the degree of cross-sectional stenosis >95% as shown by carotid ultrasonography and in 86% of the patients whose preoperative diameter was <3.0 mm. CONCLUSION: TOCU provides additional information regarding the characteristics of the distal ICA that can be obtained neither by conventional carotid ultrasonography nor by angiography.

Aged↗