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Biomedical subjects

J Murakami

Publications and source records attributed to J Murakami.

At least 91 records · Page 5Linked to original sources

[A case of cytomegalovirus pneumonia and Pneumocystis carinii pneumonia with lung cancer--diagnosis by the polymerase chain reaction].

A 64-year-old male was admitted to Oita Medical University Hospital because of primary lung cancer. After the anticancer chemotherapy, the patient developed a high fever. His chest X-ray showed diffuse reticular shadows bilaterally, which were considered to be a drug induced pneumonia, then pulse therapy with corticosteroid was performed. With this treatment, the diffuse reticular shadows disappeared. One month later, however, a severe interstitial pneumonia developed, and the patient died of respiratory failure. Autopsy findings demonstrated cytomegalovirus (CMV) and Pneumocystis carinni pneumonia. The polymerase chain reaction (PCR) for CMV in mononuclear cells in the blood was positive through out his hospitalization. In the sera, however, it was negative at the time of admission, then became positive 10 days before the onset of pneumonia. In addition, the PCR for P. carinni on the swab became positive as well. These results imply that PCR can be used for diagnosis of CMV and P. carinii infections from sera or swabs.

Cytomegalovirus Infections↗

Reduction of increased signal intensity in the basal ganglia on T1-weighted MR images during treatment of hepatic encephalopathy.

A 61-year-old man with liver cirrhosis showed a symmetrical increase in the signal intensity of the basal ganglia on T1-weighted magnetic resonance (MR) images, which was diminished after 3 months of treatment for hepatic encephalopathy. He recovered from encephalopathy with treatment, and liver dysfunction (hyperammonemia and abnormal blood coagulation) as well as the results of quantitative psychometric tests showed a marked improvement. The cause of these high signal intensity changes on T1-weighted images and the reason for their partial reversibility are not known, but hyperammonemia due to portal-systemic shunting might be closely related to these clinical observations.

Ammonia↗

[Acute mixed lineage leukemia showing resistance to AML and ALL therapy].

A 51-year-old female was who admitted complaining of cough and slight fever and lower limb petechia. The laboratory examinations revealed leukocytosis (49,400/microliters) with blasts (71%) in the peripheral blood. The NCC was 30 x 10(4)/microliters with 84.8% blasts in the bone marrow. Myeloperoxidase staining was positive for 6% of blasts. Auer rods were not seen in some blasts. Thus, acute myeloblastic leukemia (M1) was diagnosed according to FAB classification. In the peripheral blood, 43.3% of blasts expressed CD19, 10.3% of blasts expressed CD20 and 55.6% of blasts expressed CD33 on admission. Though she received two courses of DCMP according to the DCMP-85 protocol, and one combined course of mitoxantrone, etoposide, and Ara-C. The NCC was 20.0 x 10(4)/microliters with 70% blasts in the bone marrow. CD19 was expressed by 72.4% of blasts and 35.0% expressed CD20. The ALL-90 protocol was started, but remission was not achieved. Thus this case was considered to be acute mixed lineage leukemia.

Antigens, CD↗

Forecasting survival in the medical intensive care unit: a comparison of clinical prognoses with formal estimates.

Physicians often need to make prognostic judgments. In the present study, the accuracy was explored of survival estimates for patients in the Medical Intensive Care Unit (MICU). Estimates were made by physicians and nurses several times during each patient's stay in the MICU and were compared to those of the APACHE II scale, a widely used quantitative index for critically ill patients. ROC curve and calibration curve analyses were performed to assess the accuracy of these estimates. Results revealed that MICU personnel were fairly accurate discriminators of patients who survived vs. who died, although there was a consistent tendency to underestimate survival. In addition, there was some relationship between the level of physician training and forecasting accuracy, but only within the patient's first 24 hours in the MICU. Finally, the estimates of physicians did not differ significantly from those of the APACHE II scale. Physicians tended to be better calibrated in their predictions, while the APACHE II scale was slightly superior in terms of discrimination.

Forecasting↗

Characteristic findings of hepatocellular carcinoma: an evaluation with comparative study of US, CT, and MRI.

The sensitivity, specificity, and accuracy of ultrasonography (US), dynamic incremented computed tomography (CT) with delayed phase imaging, and magnetic resonance imaging (MRI) with or without Gd-DTPA were studied for detecting the characteristic appearances of hepatocellular carcinomas (HCC): fibrous capsules, fibrous septa, and mosaic appearances. Results were prospectively evaluated in 30 patients who subsequently underwent hepatic lobectomies or segmentectomies. Pathologic evaluations of the resected liver specimens demonstrated fibrous capsules in 20 tumors (66.7%), fibrous septa in 13 tumors (43.3%), and mosaic appearances in 19 tumors (63.3%). The accuracies for fibrous capsules were 71.4% (20 of 28) for US, 81.5% (22 of 27) for CT, and 92.3% (24 of 26) for MRI. The accuracies for fibrous septa were 57.1% (16 of 28) for US, 59.3% (16 of 27) for CT, and 73.1% (19 of 26) for MRI. The accuracies for mosaic appearances were 71.4% (20 of 28) for US, 51.9% (14 of 27) for CT, and 69.2% (18 of 26) for MRI. Gd-DTPA administered MRI showed higher accuracies than did conventional MRI for all manifestations. In conclusion, the fibrous capsules of HCCs were readily detected by CT and MRI. Gd-DTPA administration demonstrated an advantage in clarifying fibrous capsules, as well as fibrous septa and mosaic appearances.

Aged↗

Fetal development of mice following intrauterine exposure to a static magnetic field of 6.3 T.

The study was undertaken to investigate possible teratogenic effects of a high magnetic field on fetal development in mice. Eighty-four pregnant CD-1 mice (ICR) were exposed to a static magnetic field of 6.3 T for 1 hr a day from day 7 through day 14 of gestation, a period corresponding to major organogenesis. Fifty mice served as controls. Dams were sacrificed on day 18 of gestation. Fetuses were examined for both external and skeletal abnormalities. No significant differences between exposed and control groups were observed regarding litter size, fetal weight, intrauterine mortality rate, or external and skeletal anomalies. The effects of static magnetic field of 6.3 T on the parameters studied appear negligible.

Animals↗

Differential diagnosis of hepatic tumors (hepatoma, hemangioma, and metastasis) with CT: value of two-phase incremental imaging.

Two-phase dynamic incremental CT is a technique in which CT scans are obtained 45 sec and 6 min after commencing the rapid bolus injection of contrast medium. We analyzed the contrast enhancement patterns of three types of hepatic tumors (72 hepatomas, 39 hemangiomas, and 28 metastases) in 139 patients to determine if any differences in the patterns are useful in the differential diagnosis of these lesions. Dynamic incremental CT scanning was performed after 100 ml of iodinated contrast material was administered i.v. with a power injector at a rate of 2 ml/sec. A 1-sec scanning time was used with a 1.6-sec inter-scan delay, which allowed table motion between scans. CT scans (eight to 16 sections) were obtained 45-110 sec (early phase) and 6-7 min (delayed phase) after commencing the injection of contrast medium. The enhancement patterns of hepatomas were as follows: 32% were totally hyperdense in the early phase and totally hypodense in the delayed phase, while 24% were totally hypodense in both phases. Most of the hepatomas (88%) appeared as totally hypodense lesions in the delayed phase. In the case of hemangiomas, 56% were peripherally hyperdense in the early phase; in the delayed phase, 36% were isodense and 31% were totally hyperdense. Most hemangiomas (85%) were not totally hypodense in the early phase, and no hemangioma was totally hypodense in both phases. In the early phase, 61% of metastases were hypodense. In the delayed phase, 57% were hypodense. Metastases most commonly were totally hypodense in both phases (43%). We conclude that contrast enhancement patterns of hepatomas, hemangiomas, and metastases seen on two-phase dynamic incremental CT scans are useful in the differential diagnosis of these tumors.

Carcinoma, Hepatocellular↗

Transforming growth factor-beta modulates effects of epidermal growth factor on corneal epithelial cells.

In order to understand the mechanisms that bring about maintenance and restoration of the integrity of corneal epithelium, we investigated independent and combined effects of transforming growth factor-beta (TGF-beta) and epidermal growth factor (EGF) on rabbit corneal epithelial cells in cell and organ culture. Specifically, we determined whether incubation with these factors influenced 1) cellular proliferation, 2) ability of cells to attach to a fibronectin matrix, and 3) the rate of epithelial migration over corneal stroma. Incubation with TGF-beta caused a dose-related decrease in the incorporation of 3H-thymidine by the epithelial cells. EGF increased 3H-thymidine incorporation, but this effect was antagonized by the addition of TGF-beta into the incubation medium. Incubation with EGF increased the numbers of cells that attached to a fibronectin matrix. TGF-beta itself did not affect the number of attached cells but, again, it antagonized the stimulatory effect of EGF. Similarly, when corneal blocks were cultured with EGF, epithelial migration increased in a dose-related manner. TGF-beta itself did not affect epithelial migration at any of the concentrations tested (0.1-10 ng/ml), but it antagonized EGF-stimulated epithelial migration. These findings suggest that the proliferation and the migration of corneal epithelial cells are regulated by different mechanisms, and that TGF-beta serves as a modulator of the effects of EGF.

Animals↗

Detection of free radicals in UV-irradiated lens by spin trapping ESR.

We have made an ESR study on the UV-photolysis of lens and identified the origins of free radicals involved in the initial photochemical process by spin trapping technique. Two spin adducts were detected on irradiation of canine lens in the presence of a spin trapping reagent (DMPO); a spin adduct of sulfur centered radical derived from glutathione and the protonated adduct of hydrated electron. A free radical mechanism of initial photochemical injury in UV-irradiated lens was discussed, comparing with a photolysis of tryptophan plus cysteine solution.

Animals↗

Coordinated appearance of beta 1 integrins and fibronectin during corneal wound healing.

Fibronectin, which appears at wound sites, serves as a temporary matrix for the epithelial migration involved in healing. Cellular responses to fibronectin have not yet been elucidated. We visualized beta 1 integrins, fibronectin, laminin, and collagen type IV by immunofluorescence techniques at various intervals after single, nonpenetrating incision in the corneas of rats to investigate the chronologic changes in the localization of these proteins during corneal epithelial wound healing. In unwounded corneas beta 1 integrins were found on basal cells of the corneal epithelium and fibronectin was found in the corneal subepithelial region, at Descemet's membrane, and in streaks between collagen fibers of the stroma. Both laminin and collagen type IV were found in the subepithelial region and Descemet's membrane. Immediately after the incision, fibronectin was visible on the surface of the V-shaped defect of the stroma; epithelial cell expressed beta 1 integrins began to migrate over the defect and to fill it. When healing was almost completed, beta 1 integrin staining of epithelial cells diminished, except for in basal cells. Staining of fibronectin diminished at the interface between the new epithelium and the stroma. Laminin and collagen type IV were not seen between the migrating epithelial cells and the underlying stroma until epithelial cells completely covered the defect. Appearance and disappearance of beta 1 integrins and fibronectin are thus well coordinated during corneal epithelial wound healing process, suggesting an active involvement of beta 1 integrins and fibronectin.

Animals↗

Epidermal growth factor stimulates corneal epithelial cell attachment to fibronectin through a fibronectin receptor system.

Epidermal growth factor (EGF) stimulates corneal epithelial migration in vivo and in vitro. Antibody against fibronectin inhibits this effect in vitro, suggesting that a fibronectin-dependent mechanism in involved. To elucidate the action of EGF, we placed rabbit corneal epithelial cells, preincubated in the absence or presence of EGF (10 ng/ml), into wells coated with fibronectin. After 45 minutes of incubation, the numbers of cells attached to the wells were counted. Preincubation with EGF for 6 hr was not effective, but preincubation for 9 hr significantly increased the numbers of cells attached to the wells. These numbers were not increased further by additional preincubation. When concentrations of EGF were reduced, numbers of attached cells decreased proportionally, but remained significantly higher than the numbers obtained with cells not exposed to EGF. The EGF-stimulated attachment to the fibronectin matrix was inhibited in a dose-dependent fashion by antifibronectin IgG and by GRGDSP, a synthetic peptide that mimics the amino acid sequence of the cell-binding domain of fibronectin. The authors conclude that a fibronectin/fibronectin receptor system mediates EGF-induced stimulation of cellular attachment. These findings suggest that EGF may increase the expression of fibronectin receptors.

Amino Acid Sequence↗

[Role of MRI in diagnosis of adrenal tumors].

The authors evaluated the ability of magnetic resonance imaging (MRI) at 1.5 T to characterize 33 adrenal masses, using visual analysis and the following quantitative variables: signal intensity ratios of tumor/liver, tumor/muscle, and (tumor--muscle)/(fat--muscle) on T2- and T1-weighted images, and the calculated T2 relaxation time of the adrenal masses. All 15 tumors of less than 3 cm in diameter were visually homogeneous on all pulse sequences, whereas the other 18 tumors of over 3 cm appeared to be inhomogeneous. The signal intensity ratios of tumor/liver and tumor/muscle and the calculated T2 relaxation time were not helpful in distinguishing tumors from one another. The ratios of tumor/fat and (tumor--muscle)/(fat--muscle) were useful in distinguishing pheochromocytoma and myelolipoma from other tumors on T2- and T1-weighted images, respectively. However, differentiation among other adrenal tumors appeared to be difficult. The authors concluded that, although MRI might have considerable potential in characterizing adrenal masses, the use of conventional MRI in such analysis is still quite limited.

Adenoma↗

Expression of fibronectin receptor (integrin) in the uterus of rats in relation to the estrous cycle.

The expression and localization of fibronectin receptor (integrin), fibronectin, laminin and collagen type IV in the endometrium of the rat uterus during each period of the estrous cycle were investigated by immunofluorescent microscopy. Fibronectin receptor was observed at the epithelial cells of the endometrium and at vascular endothelial cells. At proestrus, when epithelial cells actively migrate, fibronectin receptor was observed at the basal and lateral epithelial cell surfaces. During estrus, fibronectin receptor had begun to disappear, little fibronectin receptor was observed at metestrus or diestrus. No prominent changes in the localization of fibronectin (seen at the vascular endothelial cells and in the stroma) or of laminin and collagen type IV (seen at the muscles and at the basement membranes of the epithelial and vascular endothelial cells) were observed in relation to the estrous cycle. Thus, uterine epithelial cells, like epithelial cells of the healing cornea, increase their expression of fibronectin receptor during active migration, probably facilitating their attachment to stromal fibronectin. This fibronectin-fibronectin receptor mechanism may underlie epithelial repair, whether the defect results from physiological processes or from an insult.

Animals↗

Effects of oleic, arachidonic and 5,8,11,14-nonadecatetraenoic acids on lipid secretion and ketogenesis in perfused rat liver.

The effects of perfused oleic (18:1n-9), arachidonic (20:4n-6) and 5,8,11,14-nonadecatetraenoic (19:4n-5) acids on triglyceride and cholesterol secretion and ketone body production were studied in isolated rat liver. As compared to oleic and 19:4n-5 acids, both ketone body production and triglyceride secretion were significantly lowered when arachidonic acid was perfused. The concentration of triglyceride in the post-perfused liver was lower upon perfusion with arachidonic acid than upon perfusion with oleic acid or 19:4n-5 acid. Cholesterol secretion in the liver perfused with arachidonic acid or 19:4n-5 acid was significantly higher than with oleic acid. The concentration of cholesterol in the post-perfused liver was slightly but significantly higher with 19:4n-5 acid than with the other fatty acids. The results suggest that 19:4n-5 acid when compared with arachidonic acid affects lipid metabolism in liver differently.

Animals↗

Differentiation of central lung tumor from postobstructive lobar collapse by rapid sequence computed tomography.

When central lung tumor is associated with lobar collapse, discrimination of tumor from atelectasis is important for determining operability or for field planning should radiation therapy be utilized. Because tumor and collapsed lung have similar attenuation values, they cannot always be distinguished with usual contrast-enhanced CT. The article describes separation of tumor from collapsed lung by means of RSCT with bolus injection of nonionic contrast medium. With this technique collapsed lung is appreciably enhanced, but tumor enhancement is slow and minimal. The difference is most marked from 40 seconds to 2 minutes after scanning begins. This phenomenon is probably related to the marked increase in blood flow per unit area of collapsed lung due to crowding of relatively large pulmonary arteries compared to tumor blood supply through small bronchial arteries. Tumor can also be delineated from atelectasis by differences in internal structure with this technique.

Aged↗

Ultrasonographic anatomy of veins draining the left lobe of the liver. Feasibility of live related transplantation.

The anatomic variations of the left hepatic vein (LHV) in 182 patients with normal liver functions were analyzed using ultrasonography in order to clarify the feasibility of live related hepatic transplantation (LRHT). LHV was demonstrated in 151 patients (83%). Based on the location of the confluence of the middle hepatic vein (MHV) and LHV and the ramifications of the left medial vein (LMV) and the left superior vein (LSV), the livers were classified into 3 types: a) intrahepatic confluence (42/151 livers, 27.8%); b) extrahepatic confluence (69/151 livers, 45.7%); c) separate insertion (40/151 livers, 26.5%); and 23 subtypes. The length of the common trunk and the intrahepatic common trunk of MHV and LHV and the distance from LMV or LSV to the confluence of MHV and LHV were measured. Overall, the control of LHV in situ for LRHT appeared easy in 34/151 patients (22.5%), while in 44/151 patients (29.1%), the length of free LHV and the common trunk was less than optimal for procurement of a left hepatic lobe graft with complete venous outflow and sufficient extraparenchymal length of LHV.

Adult↗

[The CT diagnosis of emphysema and correlation with pathologic findings].

It is difficult to diagnose clinically silent or mild emphysema. The efficacy of CT scans for the diagnosis of emphysema has attracted attention and comparisons have been made between CT images and the pathological grade of emphysema in resected lungs. With a view to determine to what extent high resolution CT images are accurate concerning the diagnosis of mild emphysema, we conducted an extensive comparative study on CT scores of emphysema, based on high resolution CT, the pathology score derived from the cut surface of the lung identical in its plane with that of the CT and destructive index (DI) which is said to be instrumental in representing the degree of deterioration of alveolar walls in the same regions of the lungs. In this study, 42 patients who underwent thoracotomy and their lung specimens including a solitary nodule of considerable size have been employed. The CT scores and pathology scores depend on the picture grading system developed by Thurlbeck and coworkers for the basis of counting. The findings were such that with 1 mm collimation, the CT scores ranged between 12 and 57 with a mean +/- SD of 22.1 +/- 9.6 (n = 35) while with 5 mm collimation, the CT scores ranged between 7 and 46 with a mean +/- SD of 16.5 +/- 8.3 (n = 33). The pathology scores stood at 10 to 57 with a mean +/- SD of 23.2 +/- 9.8 (n = 42).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗