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Biomedical subjects

H Murai

Publications and source records attributed to H Murai.

At least 127 records · Page 7Linked to original sources
PubMed1988

[The role of adjuvant endocrine therapy in the management of operable breast cancer].

UNLABELLED: Since June, 1982, a chemoendocrine adjuvant clinical trial has been conducted at the Aichi Cancer Center Hospital. Women with operable breast cancer were stratified on the basis of the number of positive axillary nodes. Node negative patients received tamoxifen (TAM) for 6 months (Trial I), patients with 1-7 positive nodes received either cyclophosphamide (CPA) for 4 weeks and TAM for one year (Trial II), and patients with 8 or more positive nodes received either CPA for 8 weeks and TAM for 3 years (Trial III). Numbers of evaluable cases are 449 for Trial I, 228 for Trial II and 84 for Trial III. This is an interim report, and the median follow-up time is 3 years and 5 months. This is a prospective non-randomized trial, and control groups (observation group and chemotherapy group) are historical. RESULTS: 1. Premenopausal patients in Trial I yielded intermediate outcome between those of observation and chemotherapy groups. Thus, for this subgroup, adjuvant chemotherapy can be considered as a standard, and addition of TAM is recommended. 2. The benefit of TAM is apparent for postmenopausal patients in Trial I. 3. TAM is effective for both pre- and postmenopausal patients in Trial II. Addition of more aggressive chemotherapy should be considered. 4. Premenopausal patients in Trial III had a better disease-free survival compared with those of control groups. More effective combined chemotherapy may yield longer overall survival. 5. Postmenopausal patients in Trial III had a better disease-free and overall survival rate. Adjuvant TAM and combined chemotherapy can be considered as standard care for this subgroup.

Adjuvants, Immunologic↗
PubMed1987

Mineralization and biodegradation of CSF shunting systems.

The mineralization and biodegradation of cerebrospinal fluid shunting systems were studied using material from 25 shunts that had been implanted for between 6 days and 10 years. New unused materials were also examined for comparison. Surface changes in six systems could be observed under an operating microscope. Substantial quantities of a white deposit had adhered to the tubing in four of the shunts. These changes were most advanced in the galeal penetrative portion of the shunts and are believed to have been caused by mechanical stress. Scanning electron microscopic analysis revealed surface wrinkles, microscopic holes, and tiny particles, suggesting deterioration of the material itself. An energy-dispersive analysis using x-rays demonstrated that the surface deposits were due to mineralization of calcium phosphate and that the tiny particle growth was aluminum. These changes may be a consequence of the degradation of silicone rubber. A discriminant analysis of the mineralization was carried out; thus, the age of the host and the duration of system implantation could be correlated with the incidence of mineralization (p less than 0.1). A measurement of the physical properties showed progressive change with a remarkable deterioration in systems implanted for more than 5 years.

Adult↗
PubMed1987

[An autopsy case of neurocutaneous melanosis associated with intracerebral malignant melanoma].

The authors reported the clinical course and the postmortem examination of a unique case of neurocutaneous melanosis with numerous anomalies and complications, which included congenital dislocation of lenses, hypogonadism, ectopia of prostatic duct, genuine phimose, retentio testis, psina bifida and neurogenic bladder. This 13-year-old boy with a large hairy nevus in a bathing trunk configulation and multiple small nevi over the whole body since his birth was admitted to our hospital for evaluation of headache and vomiting. Neurological examination showed bilateral papilledema and slight left hemiparesis. A CT scan revealed a large right frontal mass and craniotomy was performed with subtotal removal of this tumor which was confirmed as a malignant leptomeningeal melanoma. He initially made uneventful postoperative recovery, and two courses of chemotherapy with DTIC, ACNU and VCR were given; however, the currence of brain tumor ensued shortly thereafter, and he died in approximately six months after the onset of intracranial symptoms despite of the third course of chemotherapy. Thirty five cases of neurocutaneous melanosis associated with or without malignant melanoma have been reported in Japan. Twenty-eight cases were male and 7 female. Two cases showed the evidence of primary malignant melanoma outside of the central nervous system, whereas twenty eight leptomeningeal melanoma, in which 22 were solid and 6 diffuse, were shown intracranially. Other 5 cases had epileptic seizure and/or hydrocephalus caused by wide spreaded leptmeningeal melanosis. This high incidence of intracranial malignant melanoma in this disorder was remarkable compaired with the previous reports in other countries. Mean duration between deaths and the onset of symptoms of intracranial hypertension or focal neurological signs was 7 months, ranging from 1 to 24 months, showing the rapidly deteriorating course in this disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Two cases of cervical disc disease with intramedullary pathological changes, which are responsible for their neurological syndromes, on delayed CT myelography].

We report two cases of cervical disc disease with myelopathy classified as of motor system syndrome type showing small contrast accumulation within the spinal cord on delayed CT myelography. In our two cases, high density spots on delayed CT myelography were bilaterally localized within the spinal cord, and believed represent pathological changes of the spinal cord, such as collection of microcavities or cystic necrosis. In case 1, the high density areas seemed to be localized in the anterior horn and corticospinal tract, and in case 2, they seemed to be localized in the corticospinal tract. The patient in case 1 produced signs and symptoms resembling motor neurone disease and lesion could not be differentiated from the latter. Delayed CT myelography showed that the cause of the upper limb amyotrophy was attributed to an anterior horn disorder and that of pyramidal tract sign to a corticospinal tract disorder. Therefore, we could differentiate the lesion from motor neurone disease on delayed CT myelography in case 1. In conclusion, we emphasize that delayed CT myelography can demonstrate the intramedullary pathological changes in the cervical disc disease and is useful in distinguishing between cervical disc disease simulating motor neurone disease and the latter.

Cervical Vertebrae↗
PubMed1986

[Fundamental and clinical studies of imipenem/cilastatin sodium in the field of obstetrics and gynecology].

Seven patients with gynecologic infections were treated with the new carbapenem class of antibiotic, imipenem/cilastatin sodium (MK-0787/MK-0791) at a dose level of 500 mg/500 mg or 250 mg/250 mg administered intravenously every 12 hours for 5 days. The results obtained were as follows. Clinical effects of MK-0787/MK-0791 were analyzed in 7 patients, including 1 case with pelvic peritonitis, 2 cases with endometritis, adnexitis and pelvic peritonitis, abdominal abscess, vaginal cuff infection and parametritis, and pyometra. Excellent clinical response was seen in 3 cases and good response in 4 cases. No side effect nor abnormal finding in clinical laboratory values was seen in all patients.

Adult↗
PubMed1985

Paroxysmal tinnitus and nystagmus accompanied by facial spasm.

A case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, in which neurovascular decompression was performed, is reported. The paroxysmal tinnitus and nystagmus were synchronous with each other. Horizontal nystagmus with a rotary component was found to be counterclockwise during the brief attack of tinnitus, whereas its direction became clockwise while free of tinnitus. The patient has been postoperatively relieved not only of the facial spasm, but also of the tinnitus and nystagmus. The mechanism of the occurrence of the syndrome and the significance of the neurootologic examination are discussed.

Arteries↗
PubMed1985

Amino acid sequence of Streptomyces metallo-proteinase inhibitor from Streptomyces nigrescens TK-23.

Streptomyces Metallo-Proteinase Inhibitor (S-MPI) consists of 102 amino acid residues, including one methionine and two disulfide bridges. The complete amino acid sequence of S-MPI, including two disulfide bridges, was determined by sequencing of tryptic and chymotryptic peptides of two fragments obtained by cyanogen bromide cleavage followed by reduction and S-pyridylethylation of the protein. Incubation of the inhibitor with thermolysin slowly cleaved one peptide bond, Cys(64)-Val(65), which might be a reactive site of S-MPI.

Amino Acid Sequence↗
PubMed1985

Amino acid sequence of protein alpha-amylase inhibitor from Streptomyces griseosporeus YM-25.

The amino acid sequence of a protein alpha-amylase inhibitor from Streptomyces griseosporeus YM-25 (Haim II), which consists of 77 amino acid residues, including two disulfide bridges, was determined by conventional methods. One of the disulfide bridges was found to be located between Cys(6) and Cys(22), and the other between Cys(40) and Cys(67) from the results of structure analyses of the two cystine-containing peptides obtained from the thermolysin digest of the native inhibitor.

Amino Acid Sequence↗
PubMed1985

[Therapeutic effects of medroxyprogesterone acetate in recurrent or advanced breast cancer].

Medroxyprogesterone acetate (MPA) was given to 25 cases of recurrent or advanced breast cancer in consecutive oral doses of 1,200 mg/day to evaluate its efficacy. Results in 22 evaluable cases were: CR in 5, PR in 6, NC in 3 and PD in 8 cases, response rate being 50% (11/22). Pretreatment of 11 cases with pharmacological endocrine therapy was effective in 7 cases, 4 of which were led to remission by MPA treatment. In 4 cases which did not respond to the pretreatment, 2 showed response to MPA. This suggests the appearance of a new method of treatment in addition to conventional endocrine therapy. Response rate of MPA in ER-positive cases was 60% (6/10); for ER-negative cases, MPA had no effect in the 3 cases studied. Response rate in postmenopausal patients was 39% (7/18). It is noticeable that MPA was effective in all of 4 premenopausal patients (CR1, PR3). A striking increase in weight was controlled after a full explanation before the study by a diet consisting mainly of staple food.

Administration, Oral↗
PubMed1984

[A case of paroxysmal tinnitus and nystagmus accompanied by facial spasm].

Trigeminal neuralgia and facial spasm are usually caused by cross vascular compression of the trigeminal root entry zone and facial nerve exit zone. A similar mechanism is believed to affect the acoustic nerve as well, giving rise to tinnitus and nystagmus. We present one case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, and discuss the mechanism and the significance of the neurotological examination.

Arteries↗
PubMed1983

[Serum cortisol fractions in breast cancer].

Serum cortisol fractions were determined by isocolloidosmolar equilibrium dialysis in 93 women with breast cancer and 29 normal women. In breast cancer patients, the percentage of protein-unbound cortisol was increased at any concentration of total serum cortisol; this was accompanied by a relative decrease in the percentage of transcortin-bound cortisol. A significant increase in the unbound fraction is indicative of accelerated physiological activity of cortisol in breast cancer patients. In the breast cancer cases, there was a high incidence of obesity (61%) and impaired glucose tolerance (85%). In obese and/or diabetic patients, more remarkable increases of unbound cortisol were observed. We suggest that obesity and impaired glucose tolerance may increase the risk for breast cancer, and that the characteristic increase in the unbound cortisol fraction in women with breast cancer may reflect such risk factors.

Adult↗
PubMed1983

[Surgical management of trigeminal neuralgia, hemifacial spasm, paroxysmal tinnitus and nystagmus by neurovascular decompression].

Trigeminal neuralgia, facial spasm, tinnitus, vertigo, and glossopharyngeal neuralgia are believed to be the symptoms complex of hyperactive dysfunction of the cranial nerve caused by vascular cross compression at the root entry (exit) zone of the appropriate nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al (1975). From their experiences of surgery, they emphasized that these symptoms were relieved by surgery. In this report, we will discuss the etiology of the disease, the neurotological examination, the angiographic findings, the operative findings and results in a series of 10 patients who have undergone neurovascular decompression. The series consisted of 4 cases with trigeminal neuralgia, 5 cases with facial spasm, and 1 case with paroxysmal tinnitus accompanied by facial spasm. The postoperative progress in these all patients was excellent and relieved of the symptoms. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia and facial spasm, because the surgery can be performed easily and safely by the neurosurgeons. The indication of the neurovascular decompression for the acoustic nerve and glossopharyngeal nerve is still controversial. In our own case, tinnitus was paroxysmal and complicated with facial spasm, not synchronous with facial spasm, but with nystagmus. This selective synchronism between tinnitus and nystagmus is a particular feature of our clinical instance. This particular clinical experience may provide some highly significant suggestions in considering the applicability of neurovascular decompression to the acoustic nerve.

Aged↗
PubMed1982

The response to endocrine therapy in patients with advanced breast cancer in Great Britain and Japan.

A prospective study has been carried out to compare the response rates to endocrine therapy of Japanese and British women with breast cancer. Premenopausal women were treated by ovarian ablation, patients who were up to five years postmenopausal were prescribed androgen therapy and patients who were more than five years postmenopausal were treated with oestrogens. No differences in response rate, response time or survival could be detected in the three categories of patients. Significantly more Japanese patients presented with pulmonary metastases in the pre- and postmenopausal groups. In postmenopausal Japanese patients treated with oestrogens, those with pulmonary metastases survived significantly longer.

Adult↗
PubMed1982

[Not Available].

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History of Medicine↗