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Biomedical subjects

Toshihiko Kinoshita

Publications and source records attributed to Toshihiko Kinoshita.

At least 19 recordsLinked to original sources
PubMed2007

Increased omega complexity and decreased microstate duration in nonmedicated schizophrenic patients.

To explore brain functions in schizophrenic patients, the global analytic strategy of multichannel EEG was performed that combines measures of global complexity (Omega), total power (Sigma) and generalized frequency (Phi), and EEG microstate analysis was applied to multichannel EEG data for 24 nonmedicated patients and 24 healthy subjects. The patients had higher Omega and Sigma values, and lower Phi values compared with healthy subjects. Three topographical classes were obtained from all EEG data by EEG microstate analysis. The mean duration of one topographical class in the patients was shortened compared to healthy subjects. These results indicated looser cooperativity, or decreased connectivity of the active brain process and deviant brain information processing in schizophrenic patients.

Adolescent↗
PubMed2007

Placental mesenchymal dysplasia.

Placental mesenchymal dysplasia is a very rare disorder in which the placenta is enlarged and contains cystic villi and dilated vasculature. The authors present a new case report of placental mesenchymal dysplasia with severe fetal growth restriction.

Adult↗
PubMed2006

Effects of the serotonin type 2A, 3A and 3B receptor and the serotonin transporter genes on paroxetine and fluvoxamine efficacy and adverse drug reactions in depressed Japanese patients.

In this study, we tested the influence of the serotonin type 2A, 3A and 3B receptor genes (HTR2A, HTR3A, HTR3B) in addition to a polymorphism in the promoter region of the serotonin transporter (SERTPR), and investigated the different characteristics of clinical responses to paroxetine and fluvoxamine. A total of 100 Japanese patients affected by major recurrent depression were enrolled in a randomized 6-week study. The clinical response was evaluated using the Hamilton Rating Scale for Depression (HAM-D), and adverse drug reactions were assessed at each visit. Patients with the l allele of SERTPR showed a better response to SSRIs than s/s genotype carriers (p = 0.015-0.042), more significantly to fluvoxamine. The -1438G/G genotype of HTR2A was associated with a good response to SSRIs (p = 0.010-0.039), especially to fluvoxamine, and significantly with severe nausea in paroxetine-treated patients (p = 0.013). The 178C/C genotype of the HTR3A was associated with an antidepressant response (p = 0.022-0.042), and more significantly in paroxetine-treated patients (p = 0.002-0.042). These effects were independent of one another. We replicated the finding that the SERPTR polymorphism was associated with a response to SSRIs. We additionally found that HTR2A and HTR3A polymorphisms are associated with the efficacy, and the HTR2A polymorphism is also associated with adverse drug reactions. Furthermore, the effects of these polymorphisms varied from one SSRI to another and thus may depend on the characteristics of each SSRI.

Adult↗
PubMed2006

Neural disorganization in the superior cerebellar peduncle and cognitive abnormality in patients with schizophrenia: A diffusion tensor imaging study.

Disconnection in the frontal-thalamic-cerebellar circuit is thought to be associated with cognitive abnormality in patients with schizophrenia. The superior cerebellar peduncle is involved in neural connectivity in the circuit. Because diffusion tensor imaging (DTI) can detect neural disconnection, we investigated whether there was neural disruption in the superior cerebellar peduncle in patients with schizophrenia. DTI was performed in 21 schizophrenic subjects and 21 age- and sex-matched healthy subjects. Cognitive cluster scores were attained by using the Positive and Negative Syndrome Scale (PANSS). Schizophrenic subjects had significantly lower fractional anisotropy (FA) in the right and left superior cerebellar peduncles than healthy subjects. Higher FA in the left superior cerebellar peduncle was associated with worse cognitive function in patients with schizophrenia. These findings suggest that there is neural disruption in the superior cerebellar peduncle in patients with schizophrenia, which may be involved in the cognitive abnormalities found in schizophrenia.

Brain Mapping↗
PubMed2006

The HEARTSTRING proximal seal system is a possible source of atheroembolism.

It is necessary to use side clamps to construct proximal anastomoses in off-pump coronary artery bypass, and this can be related to neurologic complications. Recently a new device, the HEARTSTRING device, was developed. We present a 78-year-old man who underwent emergent bypass surgery using the HEARTSTRING device to avoid a side clamp. We found atherosclerotic debris from the punched hole and, unfortunately, a postoperative neurological complication resulted. We strongly suggest that it is most important that potential candidates for the HEARTSTRING device be carefully selected to reduce possible neurologic complications. We report that while this new device is useful, there is a potential pitfall in using it; that it is a possible source of atheroembolism.

Aged↗
PubMed2006

Pulmonary torsion following right upper lobectomy.

We report on a case of postoperative lobar torsion in a 51-year-old woman following right upper lobectomy. A right middle lobar torsion was diagnosed by postoperative observation with chest X-ray and bronchofiberscopy. An emergency rethoracotomy was performed and a middle lobectomy was carried out. The postoperative course was uneventful and the patient was discharged on the 17th day after rethoracotomy. Careful postoperative observation with chest radiography and bronchofiberscopy is important for the precise diagnosis of a lobar torsion. In a case of lobar torsion following lobectomy, rethoracotomy should be immediately carried out.

Adenocarcinoma↗
PubMed2005

Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: the ratio of visceral fat to subcutaneous fat in the abdomen.

BACKGROUND: Defining regional fat distribution is of importance because of regional variation in adipocyte metabolism. In order to investigate whether maternal body fat distribution changes during pregnancy we measured the abdominal maternal fat thickness. METHODS: A longitudinal study of the thickness of the preperitoneal fat layer (P) and subcutaneous fat layer (S) in the abdomen was conducted; ultrasonography was used to obtain the measurements and the P/S ratio was calculated during each trimester as well as postpartum. RESULTS: When compared with the first and second trimesters, a significant increase in both the P and P/S ratios was observed in the third trimester; thus, regional fat distribution changes during pregnancy. CONCLUSION: Intra-abdominal visceral fat accumulation increases during pregnancy.

Adult↗
PubMed2005

EEG microstate duration and syntax in acute, medication-naive, first-episode schizophrenia: a multi-center study.

In young, first-episode, productive, medication-naive patients with schizophrenia, EEG microstates (building blocks of mentation) tend to be shortened. Koenig et al. [Koenig, T., Lehmann, D., Merlo, M., Kochi, K., Hell, D., Koukkou, M., 1999. A deviant EEG brain microstate in acute, neuroleptic-naive schizophrenics at rest. European Archives of Psychiatry and Clinical Neuroscience 249, 205-211] suggested that shortening concerned specific microstate classes. Sequence rules (microstate concatenations, syntax) conceivably might also be affected. In 27 patients of the above type and 27 controls, from three centers, multichannel resting EEG was analyzed into microstates using k-means clustering of momentary potential topographies into four microstate classes (A-D). In patients, microstates were shortened in classes B and D (from 80 to 70 ms and from 94 to 82 ms, respectively), occurred more frequently in classes A and C, and covered more time in A and less in B. Topography differed only in class B where LORETA tomography predominantly showed stronger left and anterior activity in patients. Microstate concatenation (syntax) generally were disturbed in patients; specifically, the class sequence A-->C-->D-->A predominated in controls, but was reversed in patients (A-->D-->C-->A). In schizophrenia, information processing in certain classes of mental operations might deviate because of precocious termination. The intermittent occurrence might account for Bleuler's "double bookkeeping." The disturbed microstate syntax opens a novel physiological comparison of mental operations between patients and controls.

Acute Disease↗
PubMed2005

Diffusion tensor imaging study of the middle cerebellar peduncles in patients with schizophrenia.

Recent evidence from neuroimaging studies suggests that neural dysfunction is involved in the pathophysiology of schizophrenia. Diffusion tensor imaging (DTI) is a technique that has the potential to detect subtle disruptions of neural connectivity. Fractional anisotropy (FA), which is measured by DTI, is a measure of the directionality of diffusion anisotropy. Decrease in FA indicates abnormalities of white matter due to increased water diffusion accompanied by an increase in extracellular space. In the literature, previous studies reported that patients with schizophrenia showed widespread lower FA in the white matter. These findings suggest that patients with schizophrenia have microstructural lesions in the cerebral white matter. We used DTI to determine whether neural connectivity was disturbed in the middle cerebellar peduncles in schizophrenic subjects. We found a significant FA reduction in the middle cerebellar peduncle in patients with schizophrenia. Therefore, neural disconnectivity between the cerebellum and cerebrum was considered present in patients with schizophrenia and may be involved in the pathology of schizophrenia. This review provides current findings regarding DTI study on the cerebellar peduncle in patients with schizophrenia.

Adult↗
PubMed2005

Controlled clinical comparison of paroxetine and fluvoxamine considering the serotonin transporter promoter polymorphism.

The present study aimed to compare the effects of two currently used selective serotonin reuptake inhibitors (SSRIs) in Japan taking the individual background in 5-HTT gene-linked polymorphic region (5HTTLPR) genotype into account. Clinical responses to paroxetine and fluvoxamine were evaluated by total and cluster depressive symptoms for 81 Japanese patients who were diagnosed with major depression. Patients with the l allele had a greater percentage reduction on the total score (P=0.059) and somatic anxiety items (P=0.026) of the 21-item Hamilton Depression Rating Scale (HAM-D) score compared to s/s genotype carriers. Paroxetine was significantly more effective than fluvoxamine in the s/s carriers, as evaluated on the percentage reduction in total score (P=0.012) and core (P=0.049) HAM-D after 4 weeks of medication, but not in the l/s carriers. These findings suggest that the genetic test may be useful in investigating the efficacy of the two SSRIs, and that normalization by the 5HTTLPR genotypes may lead to improvement of the precision of comparative analysis.

Adult↗
PubMed2005

[Effect of acupuncture treatment for a patient with severe axial dystonia appearing during treatment for schizophrenia].

We performed acupuncture treatment on first consultation for a female 28-year-old patient with severe axial dystonia, causing involuntary movement and abnormal posture of the neck and body, which had developed during treatment for schizophrenia. Involuntary movement involving elevation of the right shoulder began to occur in October X-1. Drugs were prescribed by her doctor, but her involuntary movement worsened and spread to the whole body. Thereafter, she began receiving acupuncture treatment at the out patient clinic for dystonia at the Kansai Medical College Hospital in July X. Involuntary movements of her neck involved repeated left lateral bending or a rigidly straight posture while sitting and standing. Her neck also showed a left lateral bend and right rotation. Her body showed a left lateral bend and right shoulder elevation. The neck problems in this case were induced by a hypertonicity of the left sternocleidomastoid (SCM), which caused the left lateral bending and right rotation of the neck. Problems in her body involved left lateral bending due to hypotonicity of the left abdominal muscle and hypotonicity of the left back muscles, which were unable to control the left lateral bending of the body. The right shoulder elevation was caused by a hypertonicity of the right trapezius and this was another of her problems. Acupuncture treatments were given using a penetrating needle method. The treatment points were left LI4 to decrease the hypertonicity of the left SCM, left ST41 to increase the hypotonicity of the left abdominal muscles, right BL60 to increase the hypotonicity of the right back muscles and right TE5 to decrease the hypertonicity of the right trapezius. At the initial stage of acupuncture treatment, the patient was not able to attend the hospital regularly enough to obtain sufficient improvement by acupuncture. In December X+1, she started to receive acupuncture treatment weekly, and the posture of the neck and body improved. In May X+3, her neck and body postures remained erect while sitting and she did not show involuntary movement. For problems of dystonia, we perform acupuncture treatment, using meridian and acupressure points selected based on the oriental medicine system, and we achieved improvement of symptoms in this case. The patient also achieved improved stability with regard to the symptoms of schizophrenia. It is suggested that acupuncture treatment has had a positive effect on tardive dystonia including axial dystonia.

Acupuncture Therapy↗
PubMed2004

EEG Global Field Power spectrum changes after a single dose of atypical antipsychotics in healthy volunteers.

Effects of four novel atypical antipsychotic drugs (olanzapine, perospirone, quetiapine, and risperidone) on scalp-recorded multi-channel EEGs were compared with two conventional antipsychotic drugs (chlorpromazine and haloperidol) and placebo in 14 healthy male volunteers. All subjects went through seven sessions. In each session, EEGs were recorded before and 2, 4 and 6 hours after drug administration. Global Field Power (GFP) in delta frequency band (1.5-6 Hz) increased around the time of peak serum concentration of quetiapine and risperidone compared to baseline. The increase of GFP in delta activity after quetiapine was significantly prominent in comparison to two other atypical antipsychotic drugs, perospirone and olanzapine, as well as to typical antipsychotic drugs, chlorpromazine and haloperidol (p<0.05). The increase in GFP of delta after risperidone was more prominent in comparison to after haloperidol (p<0.05). The greater sedative effects after quetiapine and risperidone may reflect the high affinity to A1 and H1 receptor bindings of these drugs. According to Low Resolution Electromagnetic Tomography (LORETA), olanzapine increased the delta in the posterior region indicating a frontal shift of brain activity, suggesting that olanzapine may be useful against negative symptoms in schizophrenics.

Adult↗
PubMed2004

Successful electroconvulsive treatment of depression associated with a marked reduction in the symptoms of tardive dyskinesia.

This report describes improvement of tardive dyskinesia (TD) in a patient who received electroconvulsive therapy (ECT) for depression. The patient, an elderly Asian male, was treated for major depression with ECT and showed a rapid improvement of TD that may have been caused by any number of drugs or combination of drugs. We discuss the possibility of improving TD by treating the depression with ECT.

Antidepressive Agents↗
PubMed2004

Global approach to multichannel electroencephalogram analysis for diagnosis and clinical evaluation in mild Alzheimer's disease.

To establish an early diagnosis of Alzheimer's disease (AD), we evaluated brain spatial dynamics and cognitive function in mild AD. Seventeen patients with the diagnosis of mild AD and 17 age-matched controls were examined for Omega (global complexity), Sigma (total power) and Phi (generalized frequency) by 19-channel electroencephalography (EEG). As a result, the mild AD group showed significantly higher Omega values than the control group. The Phi values were highly correlated with the Mini-Mental State Examination scores and the full IQ and performance IQ scores of the Japanese Wechsler Adult Intelligence Scale Revised. These results indicate an increase in spatial complexity of the brain electric field in mild AD, as well as a close relationship between slowing of the global frequency of field changes and the cognitive decline in mild AD.

Aged↗
PubMed2004

Subtle disruption of the middle cerebellar peduncles in patients with schizophrenia.

Diffusion tensor imaging (DTI) was used to investigate subtle disruption in the middle cerebellar peduncles in patients with schizophrenia. Fractional anisotropy (FA) was measured in 25 patients with schizophrenia and 21 healthy subjects using DTI. The FA of the right and left middle cerebellar peduncles was significantly lower in the schizophrenic patients compared to healthy subjects. FA in the left middle cerebellar peduncles was significantly correlated with the dosage of neuroleptics in patients with schizophrenia. There were no significant differences of mean diffusivity in the right and left middle cerebellar peduncles between patients with schizophrenia and healthy subjects. The findings of the study suggest that antipsychotics may improve the subtle disruption in the middle cerebellar peduncles in patients with schizophrenia.

Adult↗
PubMed2004

Reduced white matter volume of the caudate nucleus in patients with schizophrenia.

To examine volumetric abnormality, the caudate nucleus was measured in patients with schizophrenia and healthy subjects using magnetic resonance imaging. The absolute and relative volumes of white matter in the caudate nucleus were found to be significantly smaller in patients with schizophrenia compared to those in healthy subjects. There were significant correlations between dosages of neuroleptics during the previous year and absolute gray matter volumes of the caudate nucleus as well as relative white matter volumes in patients with schizophrenia. These findings suggest that reduced white matter volume of the caudate nucleus may be a factor affecting the abnormal connectivity of the corticostriatal loop, and that neuroleptic medication would be related to white matter alteration in patients with schizophrenia. Our result replicates a previous study reporting that there is a lack of negative correlation between age and caudate nucleus volume. We also suggest that the disease process of schizophrenia might interfere with normal aging.

Adult↗
PubMed2003

Inter- and intraoperator reliability of brain tissue measures using magnetic resonance imaging.

Grey matter, white matter and cerebrospinal volume in the human brain were measured using magnetic resonance image analysis software BRAINS. Ten volunteers were scanned in the MR sequence (3D-SPGR; 1.5-mm slice thickness and T2 images; 3mm slice thickness). Two operators obtained ten volume measures of grey matter,white matter and cerebrospinal fluid (CSF) in the intracranial box, frontal box, temporal box, parietal box and occipital box. The same data set of ten scans was segmented and the volumes measured on a second occasion by one operator using the same procedure. The interoperator and intraoperator reliabilities for measures of the three brain tissues were very good, with reliability coefficients (intraclass correlation coefficients) ranging between 0.971 and 0.999. The segmentation and measurement are useful for volumetric studies in the human brain using BRAINS.

Adult↗