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Biomedical subjects

H Fukuda

Publications and source records attributed to H Fukuda.

At least 307 records · Page 17Linked to original sources

Oculomotor sequence learning: a positron emission tomography study.

The purpose of this study was to identify the brain regions activated in relation to oculomotor sequence learning. Nine healthy subjects participated in the study, which consisted of three positron emission tomography scans. In the initial learning task, subjects were instructed to track a sequence of seven successive positions of visual targets and to memorize the order of the targets as well as their spatial locations. In the saccade task, subjects were instructed to track visual targets presented at random locations. In the control task, subjects were instructed to gaze at a fixation point. Fields showing significant regional cerebral blood flow change were determined from task-minus-control subtraction images. We determined that fields in the pre-supplementary motor area (pre-SMA), the intraparietal cortex, and the prefrontal cortex were activated not only in the learning-minus-control images but also in the learning-minus-saccade images. Although prefrontal and parietal activations were bilateral, pre-SMA activation was confined to the left hemisphere. The results indicate that these fields function as a part of the neural network involved in the learning of sequential saccadic eye movements.

Adolescent↗

Brief naps during post-lunch rest: effects on alertness, performance, and autonomic balance.

This study was designed to examine the effects of brief naps taken after lunch on alertness, performance, and autonomic balance. Three groups each comprising ten healthy subjects, who had slept normally at home the previous night, were randomly assigned to groups taking one of three 'lengths of nap (0, 15, and 45 min) after lunch. The P300, an event-related potential which is a neurophysiological correlate of cognitive function, subjective sleepiness (visual analogue scale), and electrocardiogram were measured before, 30 min after, and 3 h after the naps. Each measurement was followed by an English transcription task lasting 90 min. The P300 latency was significantly shorter after the 15-min than after the 45-min nap, or after no nap had been taken, while its amplitude was not affected by the length of nap. Subjective sleepiness was lower after both naps than after no nap. The task performance was significantly better during the second half of the last task session after the 15-min nap than after no nap. The high-frequency component of the R-R interval spectrum increased significantly during the 45-min nap, showing a temporary shift to a predominance of the parasympathetic nervous system. Mean total sleep times during the 15- and 45-min naps were 7.3 and 30.1 min, respectively. These results would indicate that the 15-min nap may serve to shorten the stimulus evaluation time, reducing subjective sleepiness, and slightly improving task performance. Our data demonstrated that in our subjects a brief nap after lunch was effective for enhancing subsequent alertness and performance after normal sleep the previous night.

Adult↗

Detection and assessment of pyelectasis in the fetus: relationship to postnatal renal function.

OBJECTIVE: To assess the relationship between fetal pyelectasis determined by ultrasonography and postnatal renal function. METHODS: We first established normal values for anteroposterior, transverse, and longitudinal diameters of the renal pelvis sonographically in 68 normal fetuses at 30-40 weeks' gestation. We also evaluated prospectively the relationship between the severity of pyelectasis (diameter at least two standard deviations above the normal mean) in 36 fetuses at 30-40 weeks' gestation and postnatal renal function. Fetal renal function also was evaluated through measurement of the hourly urine production rate, whereas postnatal renal function was assessed by technetium 99m-diethylenetriamine penta-acetic acid renography and excretory urography. RESULTS: Fetal pyelectasis was diagnosed when renal pelvic diameters were at least 8 mm (anteroposterior), 11 mm (transverse), and 14 mm (longitudinal), all upper limits of normal diameters of 68 normal fetuses as determined in the first part of the study. Pyelectasis was associated with a normal urine production rate in all fetuses, but in six fetuses it was associated with a normal urine production rate in all fetuses, but in six fetuses it was associated with a progressive deterioration of renal function within the 1st month of life, requiring neonatal surgery. In the other 30 fetuses with pyelectasis, who did not require neonatal surgery, pyelectasis decreased gradually or totally disappeared within 2 years. Renal pelvic anteroposterior, transverse, and longitudinal pelvic diameters were at least 20, 25, and 26 mm, respectively, during late fetal life in those neonates at the time of corrective surgery. The mean anteroposterior diameter in those fetuses who did not require surgery at infancy (11 +/- 6 mm) was significantly less than in those requiring surgery (33 +/- 14 mm, P < .01). Likewise, the transverse diameters were 17 +/- 10 mm and 38 +/- 16 mm (P < .01) and the longitudinal diameters were 20 +/- 10 mm and 48 +/- 22 mm (P < .01). CONCLUSION: Neonatal surgery is recommended when the anteroposterior, transverse, and longitudinal renal pelvic diameters during the prenatal period are at least 20, 25, and 26 mm, respectively. Surgery is not necessary when the diameters are less than 20 mm.

Dilatation, Pathologic↗

Induction chemoradiotherapy for advanced stage III non-small cell lung cancer: long-term follow-up in 42 patients.

This multi-institutional phase II study was designed to assess the feasibility, efficacy, toxicity, and long-term survival of induction chemoradiotherapy followed by surgery in previously untreated patients with advanced stage III non-small cell lung cancer. Chemotherapy regimen included cisplatin 20 mg/m2 on days 1-5 and 29-33, and VP-16 40 mg/m2 on days 1-5 and 29-33. Radiotherapy (50 Gy in 25 fractions) began on day 1. Clinically downstaged patients underwent thoracotomy 3-5 weeks after the completion of radiotherapy. Forty-two eligible patients (ten stage IIIA and 32 IIIB) were followed for a median period of 64 months. The response rate was 81%, and 20 patients had a clinically good response. Twenty-one patients underwent thoracotomy. Nineteen patients had complete resections and there were seven pathologic complete responses. There were four treatment related deaths (all stage IIIBs). There were significant survival differences between stage IIIA versus IIIB patients (P = 0.028; median survivals, 24.9 vs. 11.1 months; 5-year survival rates, 20% vs. 8.3%), and patients that achieved pathologic complete response (CR) versus those that did not (P = 0.045; median survivals 30.1 vs. 11.1 months; 5-year survival rates, 28.6% vs. 8.3%). Although the induction chemoradiotherapy employed in this study was not appropriate for stage IIIB patients, it proved feasible in stage IIIA patients in whom it resulted in good 5-year survival rates. It also provided good survival rates in patients achieving pathologic CR.

Adult↗

Flow cytometric analysis of cell cycle fractions in oral leukoplakia.

Flow cytometric analysis of cell cycle fractions and DNA ploidy was performed on 39 biopsy specimens of oral leukoplakia. The aneuploidy rate of these leukoplakias was 9/39 (23.1%) and the mean DNA index of the aneuploid lesions was 1.34. The aneuploidy rate was significantly higher in severely dysplastic lesions (8/17) than in mildly dysplastic (1/15, P<0.02) and nondysplastic (0/7, P<0.05) lesions. No significant differences in the percentages of each cell cycle fraction were seen between the diploid and the aneuploid leukoplakias. However, the S-phase fraction of the severely dysplastic lesions (23.0%) among the diploid leukoplakias was higher than those of the mildly dysplastic (12.4%) and nondysplastic (15.5%) lesions, and the difference between the severely dysplastic and the mildly dysplastic lesions was statistically significant (P<0.001). These results suggest that flow cytometric analysis of cell cycle fractions and DNA ploidy might offer additional information for assessing the malignant potential of oral leukoplakias.

Aneuploidy↗

Multidirectional observations of the larynx using transurethral rigid endoscopes during direct laryngoscopy.

Microscopic direct laryngoscopy (microlaryngoscopy) under general anaesthesia is the optimal method of observing the larynx. However, as microlaryngoscopy does not allow precise observations of the ventricle, inferior surface of the vocal fold and subglottis, multidirectional observations of the larynx using transurethral rigid endoscopes were performed during direct laryngoscopy. This endoscopic technique has been shown to be clinically useful in the diagnosis and treatment of laryngeal lesions. The equipment and methods are introduced herein, and a representative care is presented.

Anesthesia, Inhalation↗

Expression of the Zinnia TED3 promoter in developing tracheary elements of transgenic Arabidopsis.

To determine the regulatory mechanism of gene expression in the early stages of tracheary element (TE) differentiation, we isolated and characterized a genomic fragment of TED3 whose mRNA is expressed preferentially in differentiating TEs 12-24 h before morphological changes in the in vitro Zinnia system. Transgenic Arabidopsis plants with a chimeric gene of the 537 bp TED3 promoter and the beta-glucuronidase (GUS) reporter gene indicated the strong expression of the GUS gene by the TED3 promoter in TEs, in particular in immature TEs as well as stipules and trichomes. GUS expression driven by the promoter was also induced in callus, in which GUS activity was localized in immature TEs and slender cells around TEs that may be TE precursor cells. The TED3 promoter was not significantly activated by wounding. This pattern of expression differed clearly from that of other vascular tissue-related genes such as PAL, 4CL, and GRP1.8. The nature of TED3 promoter enables us to use it to monitor TE differentiation in tissue and to introduce foreign genes preferentially into immature TE.

Amino Acid Sequence↗

A clinical and radiographic study of 25 autotransplanted third molars.

This paper is a report on 25 autotransplantations of third molars with complete root formations. The study consists of 23 patients in whom 25 third molars were transplanted. The mean age was 29.6 years (range 20-54). In nine cases third molars were directly transplanted into the new socket. In 11 cases the sockets were widened and made deeper with a bur. In five cases the recipient beds were made by splitting osteotomy of the alveolar region. The transplanted third molars were stabilized with silk sutures, resin, wire splint or circumferential wiring for 1-6 weeks. Two-three weeks after transplantation, the root canals were treated and filled. After operation, the marginal and the periapical conditions were examined clinically and radiographically. The transplanted teeth clinically appeared to become firmer with the passage of time. Progressive root resorption was not found and good results were obtained. This study shows that autotransplantation of third molars with complete root formation produces an acceptable result using the procedures outlined.

Adult↗

Regional cerebral blood flow changes in human brain related to ipsilateral and contralateral complex hand movements--a PET study.

The purpose of this study was to investigate the cortical motor areas activated in relation to unilateral complex hand movements of either hand, and the motor area related to motor skill learning. Regional cerebral blood flow (rCBF) was measured in eight right-handed healthy male volunteers using positron emission tomography during a two-ball-rotation task using the right hand, the same task using the left hand and two control tasks. In the two-ball-rotation tasks, subjects were required to rotate the same two iron balls either with the right or left hand. In the control task, they were required to hold two balls in each hand without movement. The primary motor area, premotor area and cerebellum were activated bilaterally with each unilateral hand movement. In contrast, the supplementary motor area proper was activated only by contralateral hand movements. In addition, we found a positive correlation between the rCBF to the premotor area and the degree of improvement in skill during motor task training. The results indicate that complex hand movements are organized bilaterally in the primary motor areas, premotor areas and cerebellum, that functional asymmetry in the motor cortices is not evident during complex finger movements, and that the premotor area may play an important role in motor skill learning.

Adult↗

Thoracic and lumbar extradural structure examined by extraduroscope.

We examined the extradural space using a flexible extraduroscope in 113 patients undergoing extradural anaesthesia. Patients were classified into two groups to receive either thoracic or lumbar extradural anaesthesia as needed for perioperative analgesia. The extraduroscopy showed that the thoracic extradural space becomes widely patent after injecting a given amount of air and that the amount of fatty and fibrous connective tissue is less in the thoracic extradural space compared with the lumbar extradural space. We suggest that differences between the structure of these two vertebral regions may affect the spread of local anaesthetics in the extradural space.

Adipose Tissue↗

Effects of lightwand (Trachlight) compared with direct laryngoscopy on circulatory responses to tracheal intubation.

We compared the effects of the lightwand technique on circulatory responses to tracheal intubation with those of direct-vision laryngoscopy. Forty adult patients received propofol and vecuronium, and their lungs were ventilated for 2 min via a mask with 5% sevoflurane in oxygen, after which the trachea was intubated orally using either the lightwand (Trachlight, n = 20) or the Macintosh laryngoscope (n = 20). Maximum mean arterial pressure changes did not differ between groups during (lightwand group, 25 (SD 21) mm Hg vs laryngoscopy group, 23 (19) mm Hg) and after (21 (24) mm Hg vs 21 (16) mm Hg) tracheal intubation. Maximum heart rate changes were similar for groups during (16 (14) beat min-1 vs 16 (15) beat min-1) and after (2 (11) beat min-1 vs 7 (19) beat min-1) tracheal intubation. There were no differences between the lightwand technique and direct-vision laryngoscopy in changes in mean arterial pressure and heart rate during and after tracheal intubation. We conclude that the effects of the lightwand technique on circulatory responses to tracheal intubation were similar to those of direct-vision laryngoscopy.

Adult↗

Japan Clinical Oncology Group (JCOG).

The Japan Clinical Oncology Group (JCOG) is a cooperative oncology group with the aims of conducting, developing, coordinating and stimulating clinical research in Japan on the treatment of cancer and related problems. The purpose of JCOG is to establish and improve the standard of cancer treatment, mainly in solid cancer, through the testing of new therapeutic regimens or combined modalities, using drugs that are newly-approved or already commercially available. Research sponsored by JCOG is accomplished mainly through the execution of large, prospective, randomized, multicenter, clinical trials. In this way, JCOG facilitates the passage of new clinical trial discoveries into state-of-the-art treatment.

Clinical Trials as Topic↗

Cancer chemotherapy in the elderly.

As the geriatric population is growing, it is increasingly important to be familiar with chemotherapy for the elderly. Age-related changes in pharmacokinetics are documented for doxorubicin, etoposide, ifosfamide, daunorubicin, mitomycin, cisplatin and methotrexate. The hematological toxicity of most standard-dose chemotherapy is not affected by age in patients with normal organic functions and good performance status, although increased toxicity with aging is suggested in the use of actinomycin-D, etoposide, vinblastin, methotrexate, methyl-CCNU, doxorubicin and mitomycin, and in dose-intensive chemotherapy. Among non-hematological toxicities, only doxorubicin-induced cardiomyopathy and bleomycin-induced pulmonary toxicity are demonstrated to be accelerated in the elderly. There is no evidence that advanced age decreases the efficacy of chemotherapy for tumors, except for Hodgkin's disease and acute leukemia. These results suggest that advanced chronological age alone is not always associated with severe toxicity and poor prognosis, and that many elderly patients with cancer will benefit from chemotherapy. To answer questions regarding the optimal chemotherapy regimen, dose and intensity in this population, the influence of age should be analyzed in a multivariate approach in future studies.

Adolescent↗

Lipogenic enzyme gene expression is quickly suppressed in rats by a small amount of exogenous polyunsaturated fatty acids.

An examination was conducted of the time courses of incorporation of polyunsaturated fatty acids (PUFA) into lipids of plasma, liver and its nuclei, and the time courses of hepatic lipogenic enzyme gene expression after oral administration of perilla oil by a stomach tube to rats fed a fat-free diet. Linolenic acid, 18:3(n-3), and eicosapentaenoic acid, 20:5(n-3), were considered indices of exogenous fatty acids. In total lipids of liver and its nuclei, linolenic acid was detected 1 h after the intubation, continued to increase during the first 4 h, then decreased and almost disappeared by 48 h. Eicosapentaenoic acid also increased within only 1 h of intubation, reached a maximum after 8 h and then gradually decreased. In contrast with the increase of exogenous PUFA, the mRNA concentrations of hepatic lipogenic enzymes began to decrease 2 h after the perilla oil intubation, were at a minimum at 8 h, and then increased. In another experiment to examine the effects of dietary perilla oil concentration on PUFA incorporation and gene expression, rats were given diets containing 0-10% perilla oil (supplemented with hydrogenated fat to 10% fat) for 3 d. Only 1% perilla oil elevated the exogenous PUFA concentrations in liver and its nuclei in comparison with concentrations in rats fed a hydrogenated fat diet. Perilla oil at 2% of the diet was sufficient to suppress lipogenic enzyme gene expressions, which were suppressed to the minimum level by 5% perilla oil in the diet. Thus, lipogenic enzyme gene expression was quickly suppressed by a small amount of exogenous PUFA, in contrast with the increase of PUFA incorporation into liver and its nuclei. Newly incorporated exogenous PUFA appear to be involved in suppression of lipogenic enzyme gene expression.

Animals↗

A crossover study of oral administration of UFT in chronic liver disease: comparison of continuous and intermittent schedules.

This study was aimed at evaluating the tolerance to an intermittently administered oral UFT for hepatocellular carcinoma (HCC) with chronic liver disease (CLD). Ten patients who had received curative therapy for HCC with CLD (Child's classification A or B) were randomly assigned either an intermittent schedule (IS), oral administration of UFT (130 mg/m2/b.i.d.) with 2 days rest a week, or a continuous schedule (CS), consecutive administration of UFT with the same dose. On day 12, the serum concentration of 5-fluorouracil (5-FU) was measured. After 2 weeks rest, the patients were switched to the other schedule for 10 weeks and the concentration of 5-FU was measured on day 12. The median values of the area under the curve (AUC) and maximum concentration (Cmax) of 5-FU in IS and CS were 187.7 and 263.2 ng/ml/h, 57.1 and 93.0 ng/ml, respectively. Both the AUC and Cmax for IS were significantly lower than those for CS. One IS patient had tolerable diarrhea, while three of the CS patients had intolerable nausea and one had hemorrhagic gastritis. IS seemed to be a suitable measure for CLD.

Administration, Oral↗

Follow-up of improvement in regional cerebral blood flow and mental status in Alzheimer's disease: a case report.

Cerebral SPECT imaging has the potential to make important contributions in the follow-up care of patients with Alzheimer's disease. An unusual case of a patient who showed a follow-up cerebral blood flow pattern different from that routinely seen in Alzheimer's disease patients is reported here. Qualitative and voxel-based objective evaluation of follow-up scans revealed improvement in parietotemporal deficits that had been observed on a baseline study. This change was observed without significant further deterioration in ratings by dementia batteries. This case shows that a baseline regional cerebral blood flow study might be necessary for reference and comparison in the proper follow-up care of Alzheimer's disease patients.

Aged↗