Biomedical subjects

Jun Yoshida

Publications and source records attributed to Jun Yoshida.

At least 37 records · Page 2Linked to original sources

PubMed2005

Pedicle fracture of the axis: report of two cases and a review of literature.

Clinical and neuroradiological features of two cases with unilateral pedicle fractures of C2 were presented and the literature of this rare traumatic fracture was reviewed. Both 37- and 57-year-old woman had traffic accident and were admitted in our institute. Both patients were neurologically free except for neck pain. Plain X-ray of cervical spine did not show abnormal findings. Computerized tomography (CT) with bone window showed the location and extension of the traumatic fracture in C2 pedicle. The fracture was located in the portion between the lateral border of the odontoid process and pars interarticularis. Fractures of the C2 pedicle are rarely seen in acute traumatic fractures. They can be overlooked because there is confusion in the describing of anatomical location of C2 pedicle in some medical literature. For proper diagnosis of pedicle fracture of the axis, understanding of the anatomy of C2 and CT findings with bone window are important.

Adult↗

PubMed2005

Pilomotor seizures in mesial temporal lobe epilepsy: a case confirmed by intracranial EEG.

We report the first case in which intracranial EEG was used to confirm pilomotor seizures of mesial temporal origin. A 41-year-old man who had pilomotor seizures in the left arm in addition to complex partial seizures was admitted for presurgical evaluation. Intracranial EEG revealed ictal discharges in the left mesial temporal area during left pilomotor seizures. Moreover, electrical stimulation of the left mesial temporal area induced a habitual pilomotor seizure. After anteromesial temporal lobectomy, the patient became seizure-free. The localizing and lateralizing value of pilomotor seizures are discussed.

Adult↗

PubMed2005

Contralateral meningeal artery supply of paramedian meningiomas.

BACKGROUND: When resecting at falcine or parasagittal portion of paramedian meningiomas, intraoperative hemostasis often is difficult despite effective management of ipsilateral meningeal arteries. We attribute such difficulties to meningeal artery blood supply from the contralateral side. We retrospectively studied feeding arteries from both sides in case of paramedian meningioma in terms of patient and tumor characteristics. METHODS: Forty-three patients with paramedian meningiomas underwent selective internal and external carotid angiography. We investigated how contralateral meningeal arterial feeders related to patient profiles and imaging, histopathologic, and immunohistochemical findings. RESULTS: Contralateral meningeal supply existed for 14 of 25 falcine meningiomas and 6 of 18 parasagittal meningiomas. Patients with contralateral feeders were 8.5 years younger than the others (P=.027) and were more likely to have larger tumors (P=.028). These were histopathologically malignant (P=.048), while showing more proliferation followed by monoclonal antibody against the Ki-67 antigen index (P=.012) and angiogenetic potential associated with vascular endothelial growth factor expression (P=.0085). CONCLUSIONS: Contralateral meningeal supply may reflect strong angiogenetic recruitment from rapid tumor growth followed by high expression of vascular endothelial growth factor. This angiographical feature may predict the aggressive growth of paramedian meningiomas.

Adult↗

PubMed2005

Management and survival of pineoblastoma: an analysis of 34 adults from the brain tumor registry of Japan.

Pineoblastoma is a rare tumor in adults, and factors influencing survival are poorly understood. Data from the Brain Tumor Registry of Japan (BTRJ) was analyzed to examine patient, tumor, and treatment characteristics associated with increased survival in adults with pineoblastomas. All pineoblastoma cases in adults aged 16 years or older were identified in the BTRJ. Data were extracted on demographics, presentation, tumor characteristics, treatments, and outcomes. Kaplan-Meier plots, the log rank method, and p value <0.15 was used to screen variables for inclusion in a multivariate Cox regression estimating survival. In the final Cox multivariate model, all variables with p values <0.05 were considered significant predictors of survival, and all variables with p values 0.05-0.099 were considered trends. The BTRJ contained 34 adults with pineoblastomas diagnosed from 1969-1998. The patients were predominantly male (22 patients), with a median age of 35 years (range 16-66 years). Median survival from diagnosis was 25.7 months, with a median follow up of 20.5 months. Median surgical resection was 75-94%, and five of the 34 patients had gross total resection. Twenty-nine of the 34 patients received cranial irradiation therapy with a median dose of 50 Gy (range 30-70 Gy). In the final multivariate model, cranial irradiation > or =40 Gy (p=0.014) and gross total resection (p=0.034) were associated with improved survival. There was a trend towards improved survival for women (p=0.099). Adult pineoblastoma patients have poor survival prognosis. Cranial irradiation therapy using at least 40 Gy and complete surgical resection are associated with improved survival.

Adolescent↗

PubMed2005

Long-term outcomes in patients with vestibular schwannomas treated using gamma knife surgery: 10-year follow up.

OBJECT: Gamma knife surgery (GKS) has been a safe and effective treatment for vestibular schwannomas in both the short and long term, although less is known about long-term outcomes in the past 10 years. The aim of this study was to clarify long-term outcomes in patients with vestibular schwannomas treated using GKS based on techniques in place in the early 1990s. METHODS: Eighty patients harboring a vestibular schwannoma (excluding neurofibromatosis Type 2) were treated using GKS between May 1991 and December 1993. Among these, 73 patients were assessed; seven were lost to follow up. The median duration of follow up was 135 months. The mean patient age at the time of GKS was 56 years old. The mean tumor volume was 6.3 cm3, and the mean maximal and marginal radiation doses applied to the tumor were 28.4 and 14.6 Gy, respectively. Follow-up magnetic resonance images were obtained in 71 patients. Forty-eight patients demonstrated partial tumor remission, 14 had tumors that remained stable, and nine demonstrated tumor enlargement or radiation-induced edema requiring resection. Patients with larger tumors did not fare as well as those with smaller lesions. The actuarial 10-year progression-free survival rate was 87% overall, and 93% in patients with tumor volumes less than 10 cm3. No patient experienced malignant transformation. CONCLUSIONS: Gamma knife surgery remained an effective treatment for vestibular schwannomas for longer than 10 years. Although treatment failures usually occurred within 3 years after GKS, it is necessary to continue follow up in patients to reveal delayed tumor recurrence.

Adolescent↗

PubMed2005

Intraventricular chordoid meningioma presenting with Castleman disease due to overproduction of interleukin-6. Case report.

A rare case of chordoid meningioma in the lateral ventricle observed in an adult is reported. The first clinical manifestation of the disease was a prolonged fever of unknown origin. Abnormalities in the patient's blood chemistry, principally polyclonal hypergammaglobulinemia (immunoglobulin [Ig]G, IgA, and markedly IgE) and an elevated serum level of C-reactive protein, were associated with the disease. The tumor was histologically confirmed to be a chordoid meningioma, and its surgical removal resulted in complete resolution of the patient's symptoms. By combining reverse transcription-polymerase chain reaction and immunohistochemical analysis, it may be shown that cytokine production, including that of interleukin (IL)-6, IL-1beta, and vascular endothelial growth factor, plays a role in the pathogenesis of chordoid meningioma associated with Castleman syndrome.

Adult↗

PubMed2005

Suppression of secondary generalization of limbic seizures by stimulation of subthalamic nucleus in rats.

OBJECT: Deep brain stimulation (DBS) of subcortical nuclei such as the subthalamic nucleus (STN) or the substantia nigra pars reticulata (SNR) may provide an alternative therapy for intractable epilepsy. The authors attempted to evaluate the antiepileptic effects of DBS to these structures in an experimental seizure model. METHODS: Three groups of rats were prepared. In the first two groups, the rats underwent unilateral implantation of stimulation electrodes in the STN (six rats) or the SNR (six rats). A control group received no electrodes (six rats). Kainic acid (KA) was systemically administered to induce limbic seizures, which started with focal seizures and became generalized secondarily. High-frequency electrical stimulation of the STN or SNR was begun immediately after KA administration, and changes on electroencephalography (EEG) and the magnitude of clinical seizures were evaluated. Results showed that STN stimulation significantly reduced the duration of generalized seizures on EEG, although the total duration of seizures (generalized plus focal seizures) was unchanged. The duration of focal seizures on EEG was prolonged by STN DBS, a result possibly due to the suppression of secondary generalization. In addition, STN DBS reduced the severity of clinical seizures. On the other hand, stimulation of the SNR demonstrated no effect. CONCLUSIONS: Unilateral STN DBS showed significant suppression of the secondary generalization of limbic seizures. Note, however, that SNR DBS was less effective, which implies that in addition to the nigral control of the epilepsy system, another antiepileptic mechanism such as antidromic stimulation of the corticosubthalamic pathway should be considered.

Animals↗

PubMed2005

Multicentric atypical teratoid/rhabdoid tumors occurring in the eye and fourth ventricle of an infant: case report.

Atypical teratoid/rhabdoid tumors (AT/RTs) are aggressive malignant tumors found in infants and young children. The tumor is characterized by the presence of a rhabdoid cell component in all cases, but the histological origin is still unclear. Recently, germline mutation of the hSNF5/INI1 gene has been reported in association with AT/RTs. The authors report a rare case of an intraocular AT/RT followed by a fourth ventricular tumor. The results of immunohistochemical studies of the surgical specimens revealed the presence of an AT/RT and from this finding the neural origin was inferred. A novel missense mutation of the hSNF5/INI1 gene was demonstrated by DNA analysis. High-dose chemotherapy with stem cell rescue was effective in treating this patient. The immunohistochemical relationship between rhabdoid cells and the neurogenic zone, which has not been described in AT/RTs, is of great interest in view of the nature of rhabdoid cells.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Growth inhibition of human pancreatic cancer cells by human interferon-beta gene combined with gemcitabine.

We examined the anti-tumor effect of cationic multilamellar liposome containing human IFN-beta (huIFN-beta) gene against cultured human pancreatic cancer cells. We also evaluated the combined effect of huIFN-beta gene entrapped in liposomes and gemcitabine. Furthermore, we examined the anti-tumor mechanisms of the therapy, with emphasis on the Ras-related signal pathway. Three human pancreatic cancer cell lines (AsPc-1, MIAPaCa-2, and PANC-1) were used in this study. The growth inhibition together with the therapy were evaluated by WST-1 assay; the production of huIFN-beta protein was measured by ELISA; the cell cycle and apoptosis were analyzed using a FACScan flow cytometer; the protein levels of Son of sevenless (SOS-1) and Ras-GAP were measured by Western blotting; and the activation of Ras-GTP was evaluated by the immunoprecipitation method. As a result, we found that huIFN-beta gene entrapped in liposomes demonstrated a strong anti-tumor effect against human pancreatic cancer cells. The treatment that combined huIFN-beta gene entrapped in liposomes and gemcitabine was more effective than each treatment alone. Although gemcitabine remarkably reduced the level of SOS-1, the above combined therapy reduced the level of SOS-1 even more significantly. Both huIFN-beta gene entrapped in liposomes and the com-bination of huIFN-beta gene entrapped in liposomes and gemcitabine increased the level of Ras-GAP, and decreased the activity of Ras-GTP. These results suggest that this combination therapy can induce strong anti-tumor activity against human pancreatic cancer cells through the regulation of the Ras-related signal pathway.

Annexin A5↗

PubMed2005

[Gene therapy for malignant glioma].

Life sciences and computer technologies have begun to create new medical fields such as pharmacogenomics, nutrinogenomics, and genetic medicines (genetic diagnosis and gene therapy). In gene therapies for malignant brain tumors, suicide gene therapies using herpes simplex virus-thymidine kinase gene and ganciclovir, and immuno-gene therapies using cytokine genes have been developed. Recently, we made a gene therapy protocol of our own, which used cationic multilamellar liposomes entrapped with interferon-beta (IFN-beta) gene as a vector and we started clinical trial of IFN-beta gene therapy for patients with malignant glioma in April 2000. Until now, five patients received the treatment and then they are under evaluation on safety and usefulness. Here the authors introduce present and prospect of gene therapy for malignant brain tumors.

Brain Neoplasms↗

PubMed2005

[Gene therapy using cationic multilamellar liposomes containing human interferon-beta gene against renal cell carcinoma].

The anticancer activity of cationic multilamellar liposomes containing human IFN-beta gene (IAB-1) against renal cell carcinoma (RCC) was examined. Concentrations of IFN-beta protein were measured by an enzyme-linked immunosorbent assay. The cytotoxic activity of IAB-1 against RCC cells and normal renal proximal tubule endothelial cells (RPTEC5899) was examined by the microculture tetrazolium dye assay. For the in vivo study, the NC65 RCC cell line was inoculated into severe combined immunodeficiency mouse. The RCC cells treated with IAB-1 secreted significant amounts of IFN-beta protein. Significant in vitro cytotoxic activity of IAB-1 against RCC cells was observed. In contrast, treatment of RCC cells with recombinant IFN-beta protein resulted in less cytotoxicity. No significant cytotoxicity was seen in RPTEC5899 cells. Apoptosis was observed in RCC cells treated with IAB-1. The size of NC65 RCC cancers transfected with IAB-1 in mice was significantly smaller than that receiving injection of empty liposomes or recombinant IFN-beta protein. These findings show that IAB-1 may have significant antitumor activity against RCC, and suggest its potential clinical application for gene therapy against RCC.

Animals↗

PubMed2005

[Gene therapy for brain tumors--present conditions and prospects].

Malignant brain tumors, particularly malignant gliomas, are one of the most difficult diseases to cure. Gene therapy for malignant gliomas has been clinically applied since 1992 as an advanced therapeutic strategy for a breakthrough. Suicide gene therapy with retroviral or adenoviral vectors was the mainstream at first. Now protocols of immune gene therapy and oncolytic therapy with replication competent virus only within tumor cells are increasing in number. So far, it would be difficult to hold that gene therapy for malignant brain tumors has shown a remarkable therapeutic effect. However, gene therapy would be a more powerful tool for exploration of therapeutic genes on the basis of molecule antitumor mechanisms, improvement of gene expression systems and amelioration of gene delivery methods. Besides in addition, cooperation among industry, administration and university is necessary for promotion of basic and clinical research as well as the development of gene therapy to overcome malignant brain tumors.

Adenoviridae↗

PubMed2005