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Biomedical subjects

H Sakuma

Publications and source records attributed to H Sakuma.

At least 109 records · Page 6Linked to original sources

[A study on the rhodopsin gene in Japanese retinitis pigmentosa--screening of mutation by restriction endonucreases and frequencies of DNA polymorphisms].

We analyzed 11 sites of the rhodopsin gene using polymerase chain reaction (PCR) amplification and restriction endonucleases in 30 unrelated Japanese patients with autosomal dominant retinitis pigmentosa (ADRP). No point mutation was found in any patient. The frequencies of the single nucleotide (nt) substitution at nt 269, nt 5145 and nt 5321 were examined in three groups, 38 unrelated patients with ADRP, 23 patients with autosomal recessive retinitis pigmentosa (ARRP), and 67 normal controls. There was no significant difference in the frequencies of substitution among these three groups. The frequencies of A269G, G5145A, and C5321A were 52%, 36%, and 5%, respectively. These values were different from those of the American population. The polymorphisms, A269G and G5145A, are useful as DNA makers for linkage analysis.

Asian People↗

Two cases of duodenal gangliocytic paraganglioma: immunocytochemical characteristics.

Two cases of duodenal gangliocytic paraganglioma were studied by means of immunocytochemical methods using 41 kinds of antibodies. The tumors consisted of three histological types; carcinoid, ganglioneuroma and paraganglioma. Tumors of both cases exhibited immunoreactivity to at least one or as many as three of the following: calcitonin, calcitonin-gene related peptide, endocrine granule constituent, Leu7, neuropeptide Y and basic fibroblast growth factor. In addition, these tumors were also immunopositive for neuron specific enolase, S-100 protein, neurofilament protein, pancreatic polypeptide, chromogranin A, somatostatin, leuenkephalin, substance P and vasoactive intestinal peptide, as has been described in previous reports. In one case, tumor cells were immunopositive for adrenocorticotropin, bombesin, gastrin releasing peptide, myelin basic protein, neuroendocrine marker and tyrosine hydroxylase. Moreover, paraganglioma cells of tumors showed both argyrophilia and argentaffinity. These results suggest that duodenal gangliocytic paraganglioma may originate from embryonic neuroinsular complex.

Duodenal Neoplasms↗

Quantification of mitral regurgitation by velocity-encoded cine nuclear magnetic resonance imaging.

OBJECTIVES: The feasibility of velocity-encoded cine nuclear magnetic resonance (NMR) imaging to measure regurgitant volume and regurgitant fraction in patients with mitral regurgitation was evaluated. BACKGROUND: Velocity-encoded cine NMR imaging has been reported to provide accurate measurement of the volume of blood flow in the ascending aorta and through the mitral annulus. Therefore, we hypothesized that the difference between mitral inflow and aortic systolic flow provides the regurgitant volume in the setting of mitral regurgitation. METHODS: Using velocity-encoded cine NMR imaging at a magnet field strength of 1.5 T and color Doppler echocardiography, 19 patients with isolated mitral regurgitation and 10 normal subjects were studied. Velocity-encoded cine NMR images were acquired in the short-axis plane of the ascending aorta and from the short-axis plane of the left ventricle at the level of the mitral annulus. Two independent observers measured the ascending aortic flow volume and left ventricular inflow volume to calculate the regurgitant volume as the difference between left ventricular inflow volume and aortic flow volume, and the regurgitant fraction was calculated. Using accepted criteria of color flow Doppler imaging and spectral analysis, the severity of mitral regurgitation was qualitatively graded as mild, moderate or severe and compared with regurgitant volume and regurgitant fraction, as determined by velocity-encoded cine NMR imaging. RESULTS: In normal subjects the regurgitant volume was -6 +/- 345 ml/min (mean +/- SD). In patients with mild, moderate and severe mitral regurgitation, the regurgitant volume was 156 +/- 203, 1,384 +/- 437 and 4,763 +/- 2,449 ml/min, respectively. In normal subjects the regurgitant fraction was 0.7 +/- 6.1%. In patients with mild, moderate and severe mitral regurgitation, the regurgitant fraction was 3.1 +/- 3.4%, 24.5 +/- 8.9% and 48.6 +/- 7.6%, respectively. The regurgitant fraction correlated well with the echocardiographic severity of mitral regurgitation (r = 0.87). Interobserver reproducibilities for regurgitant volume and regurgitant fraction were excellent (r = 0.99, SEE = 238 ml; r = 0.98, SEE = 4.1%, respectively). CONCLUSIONS: These findings suggest that velocity-encoded NMR imaging can be used to estimate regurgitant volume and regurgitant fraction in patients with mitral regurgitation and can discriminate patients with moderate or severe mitral regurgitation from normal subjects and patients with mild regurgitation. It may be useful for monitoring the effect of therapy intended to reduce the severity of mitral regurgitation.

Adult↗

A solid and cystic tumor of the pancreas in a 10-year-old girl: report of a case and review of the literature.

We report herein the unusual case of a 10-year-old girl in whom a neoplasm developed in the head of the pancreas. Complete extirpation of the tumor was performed, which was histologically classified as a "solid and cystic tumor of the pancreas." Postoperative DNA analysis revealed a diploid pattern. The patient remains well with no sign of tumor recurrence 2 years after her operation. Thus, complete tumor extirpation without pancreatectomy is recommended for pediatric patients when there is no direct invasion to the adjacent organs or distant tumor metastasis.

Carcinoma, Acinar Cell↗

Accuracy and performance of the Terumo ES-H51, a new portable blood pressure monitor.

A high performance portable automatic sphygmomanometer, the Terumo ES-H51 (104 g, 58 x 22 x 92 mm), was newly developed for clinical use as a substitute for auscultation using a mercury sphygmomanometer. This device usually displays blood pressure (BP) values obtained by the Korotkoff sound method (K-method). However, when the device judges that BP values obtained by the K-method are inaccurate or unreliable, it substitutes automatically BP values obtained by the cuffoscillometric method (O-method). The accuracy and reliability of the device was tested by comparing it to the auscultation with the standard mercury sphygmomanometer. The mean difference between BP values obtained by the standard method and those obtained by the K-method were -0.7 +/- 2.9 mm Hg systole (mean +/- SD) and -0.3 +/- 2.6 mm Hg diastole, whereas the difference between the former and those obtained by the O-method were 0.3 +/- 5.7 mm Hg systole and 0.3 +/- 4.3 mm Hg diastole (n = 170). The agreement between the BP values obtained according to each of the two methods using the device and the standard method was within 5 mm Hg for 72% to 93% of both systolic and diastolic readings. Therefore, BP values measured by the ES-H51 are accurate. The ES-H51 is sufficiently small and light to be carried easily anywhere. The objective and reproducible BP information obtained by the present device would be useful in clinical practice.

Adult↗

Acute retinal necrosis syndrome associated with herpes simplex keratitis.

BACKGROUND: Although acute retinal necrosis (ARN) syndrome is caused by a herpes group virus, association of herpetic keratitis with ARN syndrome is uncommon. A case of unilateral ARN syndrome with herpes simplex keratitis is discussed. METHODS: A 40-year-old man developed unilateral keratitis, necrotic retinitis, retinal vasculitis, vitritis, and iritis consistent with ARN syndrome 1 month after treatment for ipsilateral facial nerve palsy and auricular herpetic vesicles (Tolosa-Hunt syndrome). Impression cytologic examination of the corneal epithelial ulcer that developed concurrent with the intraocular findings and of the aqueous humor (obtained by paracentesis) was performed. RESULTS: Cells that reacted with anti-herpes simplex virus type 1 (HSV-1) antibody were detected on impression cytology, and DNA fragments corresponding to the HSV-1 DNA sequence were detected in the aqueous humor. CONCLUSION: This case shows that ARN syndrome may, on rare occasions, be associated with herpes keratitis secondary to HSV-1.

Adult↗

An immunohistochemical study of Warthin-Finkeldey cells in measles.

An autopsy case of an 18 month old male infant with measles infection is reported. An autopsy revealed generalized lymphadenopathy, splenomegaly and hyperplastic thymus. Histologically, there were many Warthin-Finkeldey cells (WFC) in hyperplastic lymphoid tissues. Although viral particles and inclusions were not detected electronmicroscopically, the infection of measles virus was detected in WFC by immunofluorescent technique using anti-measles antibody. Warthin-Finkeldey cells were morphologically and immunohistochemically divided into two groups. The first type was WFC appearing in the germinal centers of lymphoid tissue, revealing many large nuclei and B cell markers. The second type was WFC appearing in the interfollicular areas and thymus, showing many small hyperchromatic nuclei and T cell markers. The data indicate that there might be a morphologic and immunophenotypic heterogeneity in WFC.

Autopsy↗

Effect of magnetic susceptibility contrast medium on myocardial signal intensity with fast gradient-recalled echo and spin-echo MR imaging: initial experience in humans.

PURPOSE: To show the effect of dysprosium diethylenetriaminepentaacetic acid bis-methylamine injection on the images of normal human myocardium. MATERIALS AND METHODS: T2-sensitive fast gradient-recalled echo (GRE) (repetition time [TR], 10.8 msec; echo time [TE], 4.2 msec) and spin-echo (SE) (TR, three RR intervals; TE, 60 msec) magnetic resonance (MR) imaging with driven equilibrium-preparation pulse was used to produce T2 contrast material enhancement. The contrast agent was injected into 12 healthy subjects at doses of 0.05, 0.1, 0.2, 0.4, and 0.6 mmol/kg. RESULTS: Driven equilibrium-prepared GRE images showed a transient decrease of myocardial signal intensity at doses of 0.2-0.6 mmol/kg. Postcontrast T2-weighted SE images showed a myocardial signal attenuation (30%-45% decrease) at a dose of 0.4 mmol/kg or higher. CONCLUSION: Dynamic MR imaging with a magnetic susceptibility contrast medium can be used to monitor the first pass of contrast media through human myocardium with a conventional MR imager and a fast GRE sequence.

Adult↗

Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging.

BACKGROUND: Knowledge about the volume of collateral flow provides insight into the severity of coarctation of the aorta and may be critical in planning the operative approach. There is currently no method for the quantification of collateral flow in coarctation of the aorta. In this study, we applied velocity encoded cine magnetic resonance imaging (VENC-MR) to establish the flow pattern and volume of collateral flow in the descending thoracic aorta in normal subjects and patients with coarctation, introducing a new possibility to quantify the severity of the coarctation by determining the amount of collateral flow. METHODS AND RESULTS: VENC-MR was used to measure flow in the proximal and distal descending thoracic aorta in 10 normal subjects. In 23 patients with coarctation, flow was measured near the coarctation site and above the diaphragm. Patients were divided into a group with moderate to severe coarctation and a group with mild coarctation on the basis of clinical gradient between upper and lower extremities and the estimation of the gradient across the coarctation by Doppler echocardiography. The gradient across the coarctation and the degree of anatomic narrowing were also assessed by MR imaging. In normal volunteers, VENC-MR showed a 7 +/- 6% decrease in total flow, from proximal to distal aorta. The interobserver reproducibility was 3.9% to 4.9% (mean, 4.4%). In patients with moderate to severe coarctation, VENC-MR demonstrated an 83 +/- 50% increase in total flow from proximal to distal aorta, yielding a significant change compared with normal subjects (P < .01). Patients with mild coarctation showed a normal flow pattern and no significant change in total flow. There was a significant relation between the amount of flow increase in the distal aorta and the reduction in luminal diameter at the coarctation site (r = .94) as well as the clinical gradient (r = .84). CONCLUSIONS: This study shows the normal flow pattern in the descending thoracic aorta and its reversal in coarctation due to collateral flow. Thus, VENC-MR can measure collateral flow in coarctation and serves as a unique method for providing this important measurement of the severity of coarctation of the aorta.

Aorta, Thoracic↗

A high-salt diet alters circadian blood pressure rhythm in Dahl rats.

To determine whether salt loading and salt sensitivity are related to the circadian variation in blood pressure (BP), we studied the circadian rhythm of BP in Dahl rats. Thirteen Dahl salt-sensitive (Dahl-S) and 14 salt-resistant (Dahl-R) rats were fed a high- or low-salt diet after weaning. Mean arterial pressure (MAP) and heart rate (HR) were measured every 4 sec throughout 24 hr in freely moving rats, and the data obtained were analyzed quantitatively by the cosinor method. MAP mesor was significantly elevated in Dahl-S rats on a high-salt diet (SH), as compared with those on a low-salt diet (SL), but there was no difference in the MAP mesor between Dahl-R rats on a high-salt diet (RH) and those on a low-salt diet (RL). MAP amplitude was significantly greater and HR amplitude was smaller in SH rats than in SL rats; the amplitudes of MAP and HR in RH rats were similar to those in RL rats. MAP acrophase was significantly delayed in SH and RH rats as compared with SL and RL rats, respectively; the time delay in the MAP acrophase was not accompanied by a synchronized delay in HR acrophase. The time delay in MAP acrophase was greater in SH rats than in RH rats. These results indicate that salt loading influences the amplitude and acrophase of BP, and that the effect of salt loading on circadian BP rhythm is modulated by salt sensitivity.

Animals↗

Maxillary ameloblastoma with intracranial invasion--case report.

A 79-year-old male presented with recurrent maxillary ameloblastoma with intracranial invasion into the left orbit, previously histologically diagnosed as benign ameloblastoma. Skull x-ray films and computed tomography showed the multicystic mass had destroyed the skull base. The tumor was nearly completely removed. However, microscopic examination revealed residual tumor cells around the left optic nerve. Histological examination found no malignant transformation in the tumor specimen. Aggressive complete removal of maxillary ameloblastoma should be attempted even in cases of intracranial invasion.

Aged↗

Breath-hold MR cine angiography of coronary arteries in healthy volunteers: value of multiangle oblique imaging planes.

OBJECTIVE: Breath-hold MR cine angiography was used to depict the coronary arteries in healthy volunteers. Multiangle oblique imaging planes were evaluated for feasibility in showing continuous segments of the proximal and middle portions of the left anterior descending and right coronary arteries. SUBJECTS AND METHODS: Eighteen healthy subjects were examined with a 1.5-T MR imager. Fat-suppressed fast gradient-echo images (TR = 9.8 msec, TE = 3.5 msec) were acquired with a 13-cm receive surface coil. A segmented k-space data acquisition was used to obtain images of the coronary arteries at several phases of the cardiac cycle within a single breath-hold. Multiangle double oblique images that were tangential and sequential to the epicardial surface of the left ventricle were used to show the left anterior descending artery, and oblique coronal images were used to show the right coronary artery. Images of consecutive slice locations were shown in a cine format, and the length of each major coronary artery that was continuously visualized was measured. RESULTS: The left main coronary artery, proximal left anterior descending artery, and right coronary artery were demonstrated in all subjects. The mid and distal portions of the left anterior descending artery and diagonal branches were visualized best on multiangle oblique imaging planes. Continuous segments (> 6 cm) of the left anterior descending artery and right coronary artery were imaged in 14 subjects (78%) and 12 subjects (67%), respectively. Cine display was useful for showing the continuity of the coronary arterial segments and also for distinguishing arteries from veins. CONCLUSION: Double oblique imaging planes were useful in showing long segments of left anterior descending and right coronary arteries on coronary MR angiograms. Further work is necessary to improve detection of the left circumflex artery.

Adult↗

Compliance with long-term dietary salt restriction in hypertensive outpatients.

Eighty hypertensive outpatients were recruited for a dietary salt restriction program to examine long-term compliance. Twenty-four-hour urine samples were collected repeatedly (7.9 +/- 2.6 times, mean +/- s.d.) during a follow-up period of 6.4 +/- 1.7 years. After initial urine collection, nutritional education was carried out by dietitians to reduce dietary salt intake to 8 g/day or less. After every urine collection, the subjects were given advice by doctors on salt restriction, if necessary. The mean 24-hour urinary salt excretion (U-NaCl) and the mean urinary salt/creatinine ratio (U-NaCl/U-Cr) varied considerably both among and within individuals. U-NaCl/U-Cr, but not U-NaCl, in females was significantly higher than that in males, and in middle-aged subjects than in young subjects. U-NaCl and U-NaCl/U-Cr tended to decrease in the summer. In spite of the repeated educational effort, neither U-NaCl nor U-NaCl/U-Cr was different in the first control samples from that in the last samples. When 57 subjects were divided into three groups according to the urinary salt excretion level, U-NaCl was consistently higher during a follow-up period in the high-salt excretion group than in the mid-salt excretion group, while U-NaCl in the low-salt excretion group was initially lower than, but finally similar to, that in the mid-salt excretion group. These results suggest that: (1) multiple 24-hour urine samplings are required to assess urinary salt excretion in individuals; (2) the influence of age and sex should be taken into account in interpreting U-NaCl/U-Cr; and (3) it seems difficult to achieve long-term dietary salt restriction as a non-pharmacologic treatment of hypertension in an outpatient clinic.

Adult↗

A single clonal origin of neoplastic B cells in a patient with CD5+B-intermediate lymphocytic lymphoma terminating in plasmacytoid differentiation.

To investigate the clonal origin of a case of CD5+B-intermediate lymphocytic lymphoma terminating in plasmacytoid differentiation, we analyzed the immunophenotype and immunoglobulin gene rearrangements in the first and second lymph nodes from which biopsy specimens were taken. Immunohistochemical study revealed that both neoplasms have the same immunoglobulin light chain type (kappa-light chain). Immunoglobulin gene analysis using the Southern blot method revealed the identical immunoglobulin heavy chain and kappa-light chain gene rearrangements in both neoplasms. These findings suggest that both neoplasms are derived from a single clonal B cell. The present case may help a further understanding of CD5+B-lymphocyte differentiation pathway.

Aged↗