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Biomedical subjects

T Ishiguchi

Publications and source records attributed to T Ishiguchi.

At least 19 recordsLinked to original sources

Gastric distension-induced pyloric relaxation: central nervous system regulation and effects of acute hyperglycaemia in the rat.

1. The pylorus plays an important role in the regulation of gastric emptying. In addition to the autonomic neuropathy associated with long-standing diabetes, acute hyperglycaemia per se has effects on gastric emptying. In this study, the role of the central nervous system in modulating the effects of hyperglycaemia on gastric distension-induced pyloric relaxation was investigated. 2. Gastric distension-induced pyloric relaxation was significantly reduced by subdiaphragmatic vagotomy, hexamethonium (20 mg kg(-1)) and N (G)-nitro-L-arginine methyl ester (L-NAME; 10 mg kg(-1)), a nitric oxide synthase (NOS) biosynthesis inhibitor, in anaesthetized rats. In contrast, neither splanchnectomy nor guanethidine (5 mg kg(-1)) had an effect. 3. An intravenous (I.V.) infusion of D-glucose (20 %) for 30 min, which increased blood glucose concentrations from 5.4 to 12.8 mM, significantly inhibited gastric distension-induced pyloric relaxation. 4. An intracerebroventricular (I.C.V.) injection of D-glucose (3 micromol) also significantly inhibited gastric distension-induced pyloric relaxation without affecting peripheral blood glucose concentrations. 5. I.V. infusion of D-glucose significantly elevated hypothalamic neuropeptide Y (NPY) concentrations. 6. Intracerebroventricular (I.C.V.) administration of NPY (0.03--3 nmol) and a Y1 receptor agonist, [leu(31), pro(34)] NPY (0.03--3 nmol), significantly inhibited gastric distension-induced pyloric relaxation in a dose-dependent manner. 7. I.C.V. administration of a Y1 receptor antagonist, BIBP 3226 (30 nmol), and of a NPY antibody (titre 1:24 000, 3 microl) abolished the inhibitory effects of hyperglycaemia on gastric distension-induced pyloric relaxation. 8. Taken together, these findings suggest that gastric distension-induced pyloric relaxation is mediated via a vago-vagal reflex and NO release. Acute hyperglycaemia stimulates hypothalamic NPY release, which, acting through the Y1 receptor, inhibits gastric distension-induced pyloric relaxation in rats exposed to acute elevations in blood glucose concentrations.

Acute Disease↗

High- and moderately high-methionine uptake demonstrated by PET in a patient with a subacute cerebral infarction.

In patients with cerebral tumors, high accumulations of L-methyl-11C-methionine (11C-Met) have been reported in some cases of cerebral ischemic disease, but no high accumulations of 11C-Met in areas where only transient arterial occlusions are most likely to occur have been reported. Herein we present a case of a high accumulation of 11C-Met in an area of frontal interhemispheric cerebral infarction and a moderately high accumulation with an unclear margin in a distant frontal convexity area. A craniotomy revealed a subacute stage of cerebral infarction in the interhemispheric lesion, and an ischemic change in the distant convexity area. Sixteen months after onset, CT scans demonstrated an infarction area in the interhemispheric lesion only, and no atrophic changes were observed in the distant convexity area indicating that no serious tissue damage had occurred.

Adult↗

Detection of subtle pulmonary disease on CR chest images: monochromatic CRT monitor vs color CRT monitor.

To clarify the diagnostic efficacy of color soft-copy computed radiographic (CR) images of the chest in the detection of subtle pulmonary abnormalities. Twenty observers compared 87 soft-copy CR images on four types of CRT monitor (nonmagnified monochromatic CRT, magnified monochromatic CRT, nonmagnified color CRT, and magnified color CRT). Of 87 test images, 45 (including two identical sets of 12 images to test intraobserver variability) were abnormal and 42 (including two identical sets of 12 images) were normal. Of the 45 abnormal images, 15 showed subtle abnormalities, 15 showed mild abnormalities, and 15 showed obvious abnormalities. In the receiver operating characteristic (ROC) analyses, there were no statistically significant differences among the four types of CRT display formats in the detection of subtle abnormalities. Color CRT monitors can replace monochromatic CRT monitors without any loss in the ability to detect subtle interstitial lung disease.

Adult↗

Delayed rupture of a pseudoaneurysm following pancreatoduodenectomy: report of a case.

We report herein the case of a 63-year-old man in whom delayed rupture of a pseudoaneurysm occurred 120 days following pancreatoduodenectomy. Color Doppler examination indicated a pseudoaneurysm originating from the ligated gastroduodenal artery. Transcatheter arterial embolization was done at the common hepatic artery, proximal and distal to the pseudoaneurysm, with microcoils. The patient had a minor elevation of liver enzymes, which subsequently returned to normal. Due to the absence of any postoperative complications such as pancreatic anastomotic leakage, we assumed that the pseudoaneurysm formation had been caused by a weakness in the arterial wall according to skeletonization resulting from lymphadenectomy and intraoperative radiation therapy. To our knowledge, this case represents the longest interval between pancreatoduodenectomy and rupture of a pseudoaneurysm ever to be reported in the literature.

Aneurysm, False↗

Three-dimensional image display without special eyeglasses: observation of magnetic resonance angiography using the stereoscopic liquid crystal display.

The authors have developed a new stereoscopic liquid crystal display that provides real-time 3-dimensional image viewing without special eyeglasses. The device consists of 3 major parts: (1) an image display composed of a 10.4-inch color liquid crystal plate with a resolution of 640 x 480, (2) an automatic head tracking system, and (3) a special backlight unit for the right and left eyes. Eight radiologists interpreted 60 cases of magnetic resonance angiography (29 cases of cerebrovascular disease and 31 normal cases) to compare film display and the liquid crystal display (ie, pseudo 3-dimensional display and true 3-dimensional display). Using a continuously distributed scale ranging from 0% to 100%, the observers ranked their confidence levels in determining the presence or absence of steno-occlusive disease, aneurysm, and arteriovenous malformation (AVM) and their locations. For statistical evaluation, receiver operating characteristic (ROC) analysis and Brier score were used. For detecting AVM, film reading showed a significantly higher value in the area under the binormal ROC curve (Az) than did pseudo-3-dimensional display (P < .05). Excluding this, however, no significant difference existed in Az values among the 3 viewing methods. Also, there was no significant difference in Brier score between not only the stereoscopic view and nonstereoscopic view groups, but also the senior and junior groups. Subjective estimation of true 3-dimensional display showed that vessels were more distinguishable with less eye fatigue compared with stereoscopic film reading. The stereoscopic liquid crystal display provided almost equal efficacy to film reading; however, the short optimum distance for observation and the low resolution should be improved.

Cerebrovascular Disorders↗

The inhibitory effect of herbal medicine -Dai Kenchu To (DKT)- on the colonic motility in rats in vitro.

Dai-Kenchu-To (DKT) is a herbal medicine and is currently used as the treatment of paralytic ileus in Japan. We investigated the mechanism of beneficial effects of DKT in vitro. DKT-extract powder (DKT-EP; 30-300 microg/ml) caused a significant inhibition on carbachol (CCH: 10(-6))-induced contraction in a concentration dependent manner of the rat distal colon. DKT-EP (100 microg/ml) consists of 20 microg/ml of Zanthoxylum Fruit, 30 microg/ml of Ginseng Root and 50 microg/ml of Ginger Rhizome. Although each of them had no effect on CCH-induced muscle contraction, the combination of three ingredients caused a significant inhibition on CCH-induced contraction.

Animals↗

Centrally administered neuropeptide Y delays gastric emptying via Y2 receptors in rats.

It has been shown that centrally administered neuropeptide Y (NPY) delays gastric emptying. To determine the receptor subtypes of NPY mediating the inhibitory effects on gastric emptying, effects of intracerebroventricular injection of NPY, [Leu31,Pro34]NPY (a Y1 agonist) and NPY-(3-36) (a Y2 agonist) on solid gastric emptying and postprandial antropyloric motility were studied in conscious rats. Intracerebroventricular injection of NPY and NPY-(3-36), but not [Leu31,Pro34] NPY, delayed solid gastric emptying in a dose-dependent manner (0.03-3 nmol). After the feeding (40 min), contractions with low frequency and high amplitude of the antrum were frequently observed, and the peak contraction of the antrum occurred most often 3-6 s before the peak contraction of the pylorus. Intracerebroventricular injection of NPY and NPY-(3-36) (3 nmol), but not [Leu31,Pro34]NPY, significantly reduced antral contractions and the number of antropyloric coordination events. It is suggested that centrally administered NPY impairs postprandial antral contractions and antropyloric coordination via Y2 receptors, resulting in delayed gastric emptying.

Animals↗

Inhibitory neural pathway regulating gastric emptying in rats.

The relaxation of the pylorus is one of the most important factors for promoting gastric emptying. However, the role of inhibitory neurotransmitters in the regulation of pyloric relaxation and gastric emptying remains unclear. In this study, we investigated the effects of NO biosynthesis inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME), and calcium dependent potassium channel blocker, apamin, on vagal stimulation-induced pyloric relaxation and gastric emptying in rats. Sodium nitroprusside (SNP), adenosine 5'-triphosphate (ATP), vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) caused pyloric relaxations in a dose dependent manner in vivo. Apamin (120 microg/kg) significantly reduced ATP and PACAP-induced pyloric relaxations without affecting SNP- or VIP-induced relaxations. Vagal stimulation (10 V, 1 ms, 1-20 Hz)-induced pyloric relaxation was significantly inhibited by L-NAME (10 mg/kg). The combined administration of L-NAME and apamin almost completely abolished vagal stimulation-induced pyloric relaxation. L-NAME and apamin significantly increased spontaneous contractions in the antrum, pylorus and duodenum. Increased motility index by L-NAME and apamin was significantly higher in the pylorus and duodenum, compared to that of antrum. L-NAME and apamin significantly delayed liquid gastric emptying. These results suggest that besides NO, probably ATP and PACAP, act as inhibitory neurotransmitters in the rat pylorus and regulate gastric emptying.

Adenosine Triphosphate↗

Role of ultrasonography in the detection of intraductal spread of breast cancer: correlation with pathologic findings, mammography and MR imaging.

The purpose of this study was to assess the role of US in the detection of intraductal spread of breast cancer in comparison with mammography (MMG) and MRI. In 46 patients with breast cancer, US features of the intraductal component were classified as ductal type or distorted type. Histopathologically, 29 of 46 (63%) cases had intraductal components, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 89, 76, and 85%, respectively. Each US pattern demonstrated good correspondence to the histologic components, and the distorted type correlated well with comedo-type carcinoma. Mammography was performed in all cases, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 55, 100, and 72%, respectively. In comedo type, MMG could diagnose the extent of intraductal spread more accurately compared with US examination. Magnetic resonance imaging comparison was available in 25 cases. Magnetic resonance imaging depicted intraductal extension as an enhanced area during the early phase of a contrast enhancement study with a sensitivity of 93%. Ultrasound and MRI were closely related in terms of morphologic characteristics: the ductal type of US image correlated well with linear enhancement on MRI, whereas the distorted type correlated with regional or segmental enhancement. Current US examination is useful in depicting the intraductal spread of breast cancer; however, US has a tendency to underestimate intraductal component of comedo type compared with MMG and MRI.

Breast↗

Diagnostic utility of tumor vascularity on magnetic resonance imaging of the breast.

The objective of this study was to examine the relation of tumor vascularity on magnetic resonance imaging (MRI) with differential diagnosis malignant from benign lesions and tumor invasiveness in breast carcinoma. Forty-nine patients with breast cancer or benign lesion (median 49 yrs) were examined with dynamic MRI. Scanning of the entire breast was performed at 1.5 T with a three-dimensional fast spin echo sequence, using an original polarity altered spectral and spatial selective acquisition (PASTA) technique for fat suppression. Subsequently 0.1 mmol/Kg Gd-DTPA was administered and 3-6 images were obtained. The presence or absence of intratumoral, marginal and peritumoral vascularity on MRI was recorded. The excised specimen was histopathologically examined for the size of lesion, the presence and extent of local invasion. Tumor size on MRI correlated closely with the size at morphologic examination (r = 0. 96). Intratumoral (p = 0.04), marginal (p = 0.05) and peritumoral vascularity (p = 0.01) were less common in benign than in malignant lesions. Among the latter, intratumoral (p = 0.01) and marginal (p = 0.03) vascularity were more common in invasive carcinomas than in DCIS. In the subset of invasive carcinomas (n = 31); however, the tumors exhibiting intratumoral vascularity were markedly larger (p = 0.03). The presence of intratumoral and marginal vascularity on MRI can help predict both the differential diagnosis malignant from benign lesions and the presence tumor invasion in breast carcinomas.

Adolescent↗

Clinical results of implantation of an endovascular covered stent-graft via midsternotomy for distal aortic arch aneurysm.

UNLABELLED: We have been implanting endovascular stent grafts (EVG) via midsternotomy for distal aortic arch surgery since February 1997. The early clinical results are evaluated. METHODS: There were 11 true aneurysms (8 fusiform, 3 saccular) and one chronic type B dissection. The average age was 68 yr (63-81). EVGs were PTFE-covered two-8 bend Z stents in the first eight cases and made with the same stents and ultrathin woven Dacron grafts in the last four cases. RESULTS: Total arch replacement and aortocoronary bypass grafting were combined in one and two patients, respectively. The average retrograde cerebral perfusion time was 42+/-8 min. The cardiopulmonary bypass time averaged 211+/-26 min. All patients awoke early after operation (4.5+/-1.2 h). All but one case was extubated within 24h. There was no operative mortality, but paraplegia and cerebral infarction were complicated in one case each. Their maximum diameter (73.9+/-21.2mm) decreased significantly after operation (68.7+/-20.1mm) and one year thereafter (63.1+/-16.0 mm). True aneurysms were thrombosed completely. A chronic type B dissection revealed impending rupture due to false lumen infection one year after operation. The whole descending aorta replacement was performed but the patient died 6 months thereafter due to cerebro-vascular complication. CONCLUSION: Implantation of EVGs reduces operative invasion for distal arch surgery. This procedure should improve mortality, while long-term results have not been clarified.

Aged↗

Orphanin FQ causes contractions via inhibiting purinergic pathway in the rat colon.

BACKGROUND & AIMS: We have previously shown that orphanin FQ (OFQ) preferentially stimulates muscle contraction in the rat colon. However, the mechanism of action of OFQ remains unclear. METHODS: We studied the effects of OFQ on muscle contractions and inhibitory junction potentials (IJPs) in rat colon. The site of action of OFQ was also investigated by in situ hybridization of OFQ receptors. RESULTS: OFQ (10(-10) to 10(-6) mol/L) caused circular muscle contractions that were blocked by tetrodotoxin (10(-7) mol/L), suggesting the contractions were nerve mediated. Suramin (a nonselective P(2)-purinoceptor antagonist; 10(-4) mol/L) and reactive blue 2 (a P(2Y)-purinoceptor antagonist; 3 x 10(-5) mol/L), but not pyridoxalphosphate-6-azophenyl-2',4' disulfonic acid (PPADS; a P(2X)-purinoceptor antagonist; 3 x 10(-5) mol/L), abolished OFQ-induced colonic contractions. Focal stimulation of interganglionic fiber tracts evoked biphasic IJPs in colonic circular muscle cells. Suramin and reactive blue 2 inhibited the peak amplitude of the IJP, whereas PPADS had no effect. Cumulative addition of OFQ (10(-10) to 10(-6 )mol/L) significantly inhibited the IJPs. In situ hybridization revealed that OFQ receptor messenger RNA was expressed in the colonic myenteric plexus but not in the smooth muscle cells, suggesting that the site of action of OFQ is neuronal. CONCLUSIONS: These results suggest that OFQ causes muscle contractions by inhibiting purinergic inhibitory motorneurons in the rat colon.

Animals↗

Endovascular stent-graft deployment: temporary vena caval occlusion with balloons to control aortic blood flow-experimental canine study and initial clinical experience.

Vena caval occlusion was evaluated in animal experiments. In five patients with thoracic aortic aneurysms, two balloon catheters were introduced via the femoral vein to the inferior vena cava and superior vena cava and inflated before stent-graft deployment. Aortic pressure and flow were immediately decreased, which minimized the downstream shift of the stent-grafts. Temporary vena caval occlusion is safe and effective for precise aortic stent-graft deployment.

Aged↗

Nitrergic and purinergic regulation of the rat pylorus.

The role of nitric oxide (NO) and ATP in the regulation of nonadrenergic, noncholinergic (NANC) inhibitory transmission in the pylorus remains unclear. In the presence of atropine and guanethidine, electric field stimulation induced NANC relaxations in a frequency-dependent manner (1-20 Hz) in the rat pylorus. NANC relaxations were significantly inhibited by N(G)-nitro-L-arginine methyl ester (L-NAME; 10(-4) M). P(2X) purinoceptor antagonist pyridoxal phosphate-6-azophenyl-2',4'-disulfonic acid (PPADS; 3 x 10(-5) M) and P(2Y) purinoceptor antagonist reactive blue 2 (2 x 10(-5) M) had no effect on NANC relaxations. However, the combined administration of L-NAME and PPADS, but not reactive blue 2, evoked greater inhibitory effects on NANC relaxation than that evoked by L-NAME alone. alpha-Chymotrypsin and vasoactive intestinal polypeptide antagonist did not affect NANC relaxations. ATP (10(-5)-10(-3) M) and P(2X) purinoceptor agonist alpha, beta-methyleneadenosine 5'-triphosphate (10(-7)-10(-5) M), but not P(2Y) purinoceptor agonist 2-methylthioadenosine 5'-triphosphate (10(-7)-10(-5) M), induced muscle relaxations in a dose-dependent manner, and relaxations were significantly reduced by PPADS and unaffected by TTX. These studies suggest that NO and ATP act in concert to mediate NANC relaxation of the rat pylorus. ATP-induced relaxation appears to be mediated by P(2X) purinoceptors located on smooth muscle cells.

Adenosine Triphosphate↗

An experimental teleradiology transmission system using a high-speed ATM backbone network.

We evaluated the performance of an experimental teleradiology system based on a high-speed ATM backbone network. Image acquisition, transmission and the disk-to-display processing times were measured. Computerized tomography (CT) scans printed on 14 inch x 17 inch (36 cm x 43 cm) films were digitized and transferred over the network. The average time for the entire process was 1 min 30 s. Three radiologists interpreted 20 cases. For CT image interpretation, the reading time for one case ranged from 2 to 12 min (mean 6 min 46 s) on a monitor, and from 1 to 3 min (mean 1 min 31 s) with the original film. The ATM backbone network operating at 156 Mbit/s provided sufficient speed for remote consultation. However, further improvements in the operability of the system, especially the image viewing station, are necessary before it will be satisfactory for clinical use.

Computer Systems↗

[Study on evaluation method of patient dose in diagnostic radiology required for introducing the guidance level: investigation of entrance surface dose of patient using direct measurement by TLD].

Using direct measurement, we investigated entrance surface doses of patients for routine radiographs in attempt to develop evaluation methods of patient dose in order to establish the guidance level in Japan. To date, patient doses have been evaluated by calculations based on radiographic conditions, or model experiments using phantoms. Their patient doses are then evaluated based on several assumptions. Direct measurement of patient dose is difficult to perform in many patients due to its time requirement, level of expertise required and difficulty in providing an explanation of the procedure to the patient. However, such direct measurement is essential since it incorporates all aspects of radiography from the radiographic equipment used, to the actual conditions of each patient without assumption. In this study, we examined the (1) need for introducing the guidance level, (2) controversial points in the calculation method for patient dose evaluation, (3) evaluation accuracy required for introducing the guidance level, and (4) necessity for a standardized method.

Guidelines as Topic↗

MR imaging of the enlarged endolymphatic duct and sac syndrome by use of a 3D fast asymmetric spin-echo sequence: volume and signal-intensity measurement of the endolymphatic duct and sac and area measurement of the cochlear modiolus.

BACKGROUND AND PURPOSE: In enlarged endolymphatic duct (EED) and sac (EES) syndrome, deformity of the EED and EES is congenital; however, hearing loss is acquired. To investigate the pathophysiology of progressive sensorineural hearing loss in EED and EES syndrome, we measured the volume of the EED and EES, the diameter of the EED and EES, the area of the cochlear modiolus, and the signal intensity of the EES and compared our findings against degree of hearing loss. METHODS: Thin-section MR images of 33 ears in 17 patients with EED and EES syndrome were studied. All studies were obtained on a 1.5-T MR unit using a quadrature surface phased-array coil. Heavily T2-weighted 3D fast asymmetric spin-echo images were obtained with a voxel size of 0.3 x 0.3 x 0.8 mm without zero-fill interpolation. Two radiologists traced the areas of the EED and EES manually, and the volume was calculated. The area of the cochlear modiolus, diameter of the EED and EES, and signal intensity of the EES were also measured by drawing regions of interest manually. The signal intensity ratio of EES/CSF was calculated. These measured values were compared against audiographic data, and the degree of linear correlation was determined. RESULTS: The volume of the EED and EES, the area of the modiolus, the diameter of the EED and EES, and the signal intensity of the EES did not show significant correlation with degree of hearing loss. CONCLUSION: These findings suggest that there is a microscopic area of damage or fragility in the inner ear not visible even with thin-section heavily T2-weighted MR imaging.

Adolescent↗