Biomedical subjects
Publications and source records attributed to A Sano.
To achieve prolonged breath-holding, oxygen was administered just before dynamic CT and high resolution lung CT. Oxygen administration has proved to be a supportive means to improve the quality of CT studies.
In rats with an interrupted enterohepatic circulation of bile acids, levels of serum taurine-conjugated bile acids were increased significantly 3 h after intravenous administration of taurine. Similarly, serum taurine- or glycine-conjugated ursodeoxycholic acid (UDCA) was increased significantly 2 h after UDCA administration. These findings suggested that the administered taurine or UDCA was taken up into hepatocytes and utilized to form conjugated bile acids, which were thereafter regurgitated into the systemic circulation from the liver. The proportion of regurgitated taurine-conjugated bile acids relative to total serum bile acids measured by taurine loading (30%) almost coincided with that of regurgitated taurine- or glycine-conjugated UDCA relative to total serum bile acids measured by UDCA loading (31.6%). Thus, the present study showed conclusively that at least 30% of serum bile acids are derived from newly conjugated bile acids that are regurgitated from the liver in rats with bile fistula.
The purpose of this study was to determine the clinical usefulness of the full can and empty can tests for determining the presence of a torn supraspinatus tendon. The two tests were performed in 143 shoulders of 136 consecutive patients. In each test, the muscle strength was determined by manual muscle testing, and the presence of pain during the maneuver was recorded. We interpreted the tests as positive when there was 1) pain, 2) muscle weakness, or 3) pain or muscle weakness or both. Shoulders were examined by high-resolution magnetic resonance imaging with 95% accuracy for full-thickness rotator cuff tears. There were 35 shoulders with full-thickness tears of the supraspinatus tendon. The accuracy of the tests was the greatest when muscle weakness was interpreted as indicating a torn supraspinatus tendon in both the full can test (75% accurate) and the empty can test (70% accurate). However, there was no significant difference between the accuracy of the tests when this criterion was used. Pain was observed in 62 shoulders (43%) during the full can test and in 71 shoulders (50%) during the empty can test, but the difference was not statistically significant. Muscle weakness should be interpreted as indicative of supraspinatus tendon tear. Using this indicator, both tests are equivalent in terms of accuracy, but considering pain provocation, the full can test may be more beneficial in the clinical setting.
To investigate the role of some adverse environmental conditions in chlamydospore formation by the mycelial form of P. brasiliensis, we cultured four P. brasiliensis isolates (18, Bt4, 1183, Pb9) at 25 degrees C within solid agar medium either rich or poor in nutrients. Isolates 18 and 1183 were also cultured under anaerobiosis in a nitrogen atmosphere. Isolate 18 produced great number of terminal and intercalary chlamydospore after 7-10 days of culture in a medium poor in nutrients (2% agar with 0.1% dextrose and polypepton). The three other isolates also produced chlamydospores under the same conditions, but in lower numbers. Chlamydospore production by isolate 18 was abolished when the fungus was cultured in two agar media rich in nutrients (brain heart infusion and potato dextrose agar). Anaerobic incubation of isolate 18 under an atmosphere of N2 showed small mycelial outgrowth with numerous chlamydospores. At the electron microscopical level, the chlamydospores showed one or various nuclei and numerous mitochondria, indicating great potential for further development. Accordingly, chlamydospores produced multiple budding after only 24 h incubation at 35 degrees C. The results demonstrate that under adverse environmental conditions P. brasiliensis mycelial form produces chlamydospores within a short period of time.
Interaction between Paracoccidioides brasiliensis (Pb) and inflammatory cells in hamster testis was studied sequentially by transmission electron microscopy. In early lesions (six hours after inoculation), polymorphonuclear neutrophils (PMNs) were the major and mononuclear cells and eosinophils were the minor constituents of the inflammatory cells. PMNs were later replaced by mononuclear cells. Viable Pb cells were phagocytosed or surrounded by inflammatory cells. Preserved Pb cells usually had broad host-parasite interphases, whereas dying ones had narrow interphases. The outer layer of the fungus wall was sometimes broken by PMN in some focal points, broken pieces being peeled off and phagocytosed. Small Pb cells were uninuclear, and were often related to broad interphase. Large Pb cells were multinucleated with irregularly shaped wall, and sometimes had lomasome and/or myelin like structures. Different interaction patterns of Pb with inflammatory cells may be due to functionally different host cell flow to the inoculation site or due to the age of Pb cells or both.
In an attempt to isolate Paracoccidioides brasiliensis from nature 887 samples of soil from Botucatu, SP, Brazil, were collected cultured in brain heart infusion agar supplemented with dextrose, in potato dextrose agar and in yeast extract starch dextrose agar, all with antibiotics, at 25 degrees and 37 degrees C. Five thermo-dependent dimorphic fungi morphologically resembling P. brasiliensis were isolated; two from armadillo holes; further studies of the biology, antigenicity and genetic features of the five dimorphic fungi are necessary to clarify their taxonomy and their possible relation to P. brasiliensis. In addition, 98 dematiaceous fungi and 581 different species of Aspergillus spp. were also isolated. Our findings emphasize that armadillos and their environment are associated with thermo-dimorphic fungi and confirm the ubiquity of pathogenic dematiaceous fungi and Aspergillus spp.
To determine the characteristic distribution of tissue-bound bile acids in the human alimentary tract and colon polyps, we measured the concentration of bile acids in the mucosal tissues of the alimentary tract obtained at autopsy and polyps obtained by endoscopic polypectomy, using enzymatic fluorimetry and gas-liquid chromatography. The concentration of tissue-bound bile acid, especially chenodeoxycholic acid, was significantly higher in the ileum or ascending colon than in the other portions of the alimentary tract. The bile acid level of polyps was also higher in the ascending colon than in the other portions of the colon. These results suggest that the high concentration of tissue-bound bile acids is obtained at the site of absorption of bile acids in the alimentary tract.
BACKGROUND/AIMS: An early diffuse type in the pattern of the postoperative intrahepatic recurrence of hepatocellular carcinoma has been recognized. The purpose of this study was to elucidate risk factors for diffuse recurrence of hepatocellular carcinoma. METHODOLOGY: The subjects involved in the present study were 114 patients with hepatocellular carcinomas resected in Tenri Hospital during the past 12 years. Univariate analysis was used for retrospective determination of the factors related to diffuse recurrences after surgery in 10 cases among 114 patients. RESULTS: The risk factors linked to diffuse recurrence were microscopical portal infiltration (P < 0.01), elevated alpha-fetoprotein (more than 1000 ng/mL) (P < 0.05), the absence of preoperative transcatheter arterial embolization (P < 0.01), and two or more segmentectomies of the liver (P < 0.01). Six of 10 patients with microscopical portal infiltration and elevated alpha-fetoprotein (more than 1000 ng/mL) had diffuse recurrence (P < 0.01). Six of 8 patients with two or more segmentectomies without preoperative TAE had diffuse recurrence (P < 0.01). CONCLUSIONS: When patients with the diagnosis of operable hepatocellular carcinoma have portal infiltration and elevated alpha-fetoprotein (more than 1000 ng/mL), two or more segmentectomies of the liver without preoperative transcatheter arterial embolization should be avoided.
A 35-year-old woman with locally advanced stage IIIB breast cancer (medullary carcinoma) 12 cm in diameter underwent neoadjuvant chemotherapy consisting of three courses of intraarterial infusion [adriamycin (ADR), mitomycin (MMC), cisplatin (CDDP), 5-fluorouracil (5FU)] and four cycles of systemic chemotherapy (ADR, epirubicin, cyclophosphamide, MMC, CDDP) for three months. The tumor markedly diminished after the first course of intraarterial infusion chemotherapy, with a 3-cm tumor remaining after the completion of preoperative administration. Pathologically complete response was noted in specimens resected following breast conservation surgery. Postoperative radiotherapy was added and adjuvant chemohormonal therapy was continued for two years. The patient is alive without recurrence and has been able to conserve the breast for the past eight years, neoadjuvant chemotherapy including intraarterial infusion enabled breast conservation treatment even for huge-sized locally advanced breast cancer.
PURPOSE: To investigate the MR appearance of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. MATERIALS AND METHODS: A retrospective review of MR images and conventional tomograms in 147 patients. RESULTS: In the sagittal plane, proton-density images identified the ossified lesions more clearly than did T1- and T2-weighted images. All axial sequences identified the lesions much frequently. T1-weighted images often showed areas of increased intensity within the lesions of the continuous and mixed type, especially within the thick lesions. Fat images by Dixon technique demonstrated same areas of increased intensity, which strongly suggested fatty marrow formation. On conventional tomograms, configurations of radiolucent areas within the lesions corresponded to areas of increased intensity on T1-weighted images. CONCLUSION: Proton-density sagittal and axial images are important in establishing the diagnosis of OPLL. The areas of increased intensity on T1-weighted images and radiolucent areas suggest marrow formation.
We report on an adult case of preduodenal portal vein illustrated by computed tomography (CT) and angiography. These diagnostic modalities were initially performed to evaluate a coexisting pancreatic cancer. Contrast-enhanced CT demonstrated unusual positioning of the portal vein ventral to the duodenum. The superior mesenteric-portal vein, which was L-shaped and convexly caudad, strongly suggested this anomalous condition.
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Three cases of percutaneous retrieval of foreign bodies that migrated into the pulmonary artery are described in this paper. All of the intravascular foreign bodies were attributed to SVC catheters for intravenous hyperalimentation (IVH) therapy, an accidentally cut strip of indwelling SVC catheter in two patients and a fragment of guide wire used for the insertion of the SVC catheter in one patient. They were all successfully removed by fluoroscopic angiographic procedures using a snare loop retriever and grasping forceps. The technical aspects of the procedures are discussed here.
A rare congenital anomaly of the left lower pulmonary artery is presented. A 39-year-old woman was admitted to our hospital for evaluation of a splenic mass. Abdominal CT disclosed abnormal vessels in the left lower lobe. Angiography revealed a large systemic artery from the descending aorta supplying the basilar segments of the left lower lobe. Continuous thin sliced CT revealed the anatomical details of this anomaly and showed that the tracheobronchial tree had a normal connection with the lung parenchyma. Although the volume of the left lower lobe was reduced, there were no symptoms related to this lesion. Since the splenic lesion was malignant lymphoma limited to the spleen, only splenectomy was performed. In spite of intensive systemic chemotherapy following the operation, there were no pulmonary complications. Although surgery may be necessary in the future, observation alone has been carried out for more than 3 years because of the lack of symptoms and normal pulmonary function. Continuous thin sliced CT was useful in evaluating this anomaly.
Experimental Penicillium marneffei infection in mice was investigated histopathologically and by electron microscopy. Viable conidia (5 x 10(6) cells) of P. marneffei were inoculated into each mouse of group A (BALB/c mice) and group B (BALB/c-nu/nu-SIc mice) through the tail vein. All the mice were sacrificed at intervals and the livers were examined. In group A, the conidia were phagocytosed by Kupffer cells soon after inoculation, and proliferated by fission in the cytoplasm. Marked proliferation of yeast cells was observed 7 and 14 days after inoculation. With proliferation of the fungus, the number of lysosomes in Kupffer cells increased, and numerous granulomas were formed in the liver. These granulomas consisted mainly of macrophages with yeast cells, together with a few polymorphonuclear leukocytes, lymphocytes and giant cells. From 28 days on yeast cells were gradually cleared from the granulomas, and 56 days after inoculation almost all the granulomas disappeared. In group B, at an early stage of infection, similar pathological changes to those seen in mice of group A were observed. However, as the infection progressed, the number of granulomas continued to increase and yeast cells continued to proliferate although lymphocytes did not infiltrate these granulomas. With proliferation of yeast cells the liver tissue was replaced with both yeast cells engulfed by macrophages and extracellular yeasts, and dissemination occurred.