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Biomedical subjects

K Fukuda

Publications and source records attributed to K Fukuda.

1,077 records · Page 60Linked to original sources
PubMedDate not supplied

A protease inhibitor from human allergic nasal secretions.

Protease and antiprotease activities were estimated in nasal secretions from patients with chronic sinusitis and nasal allergy, using [3H]-casein as substrate. In the purulent nasal secretions, strong protease activity was measured, but there was less activity in the allergic nasal secretions. In contrast, trypsin inhibitory activity in allergic nasal secretions was much higher than in nasal secretions from the patients with chronic sinusitis. A protease inhibitor was partially isolated from nasal secretions of the nasal allergic patients by Sephadex G-150 gel chromatography and characterized. This protease inhibitor has an apparent molecular weight of 10,000 D, determined by SDS-polyacrylamidegel electrophoresis. It depresses the activities of bovine pancreatic trypsin, bovine pancreatic chymotrypsin and proteases in nasal purulent secretions, whereas it does not inhibit porcine pancreatic elastase, papain, or human plasmin.

Chronic Disease↗
PubMedDate not supplied

The economic impact of pandemic influenza in the United States: priorities for intervention.

We estimated the possible effects of the next influenza pandemic in the United States and analyzed the economic impact of vaccine-based interventions. Using death rates, hospitalization data, and outpatient visits, we estimated 89,000 to 207,000 deaths; 314,000 to 734,000 hospitalizations; 18 to 42 million outpatient visits; and 20 to 47 million additional illnesses. Patients at high risk (15% of the population) would account for approximately 84% of all deaths. The estimated economic impact would be US$71.3 to $166.5 billion, excluding disruptions to commerce and society. At $21 per vaccinee, we project a net savings to society if persons in all age groups are vaccinated. At $62 per vaccinee and at gross attack rates of 25%, we project net losses if persons not at high risk for complications are vaccinated. Vaccinating 60% of the population would generate the highest economic returns but may not be possible within the time required for vaccine effectiveness, especially if two doses of vaccine are required.

Adolescent↗
PubMedDate not supplied

A case of deep soft tissue leiomyoma: CT and MRI findings.

A 25-year-old man presented with a firm tissue mass of the right elbow and intermittent pain. CT showed a dumbbell-shaped soft tissue mass with foci of dense calcification in the muscular layer of the triceps brachii muscle and subcutaneous tissue. The tumor showed slightly higher signal intensity on T1-weighted images and markedly higher intensity on T2-weighted images compared with the surrounding muscle. Prominent enhancement was present after the intravenous injection of Gd-DTPA. Histopathological examination of the resected specimen revealed a deep soft tissue leiomyoma.

Adult↗
PubMedDate not supplied

Pharmacokinetics of intraoperative intrapleural cisplatin chemotherapy of various osmolarities in cases of esophageal cancer.

Intraoperative intrapleural (i.pl.) cisplatin (CDDP) treatment during thoracotomy was performed for esophageal cancers. Three patients underwent isotonic (308 mOsm/l) CDDP treatment. Hypotonic CDDP treatments with a 154 mOsm/l solution and a 62 mOsm/l solution were administered to 4 and 9 patients, respectively. The maximum concentrations (Cmax) of both total and filterable platinum in the plasma after injection of the hypotonic solution were significantly higher than those after injection of the isotonic solution. The area under the curve of concentration versus time (AUC) of the plasma of the 62 mOsm/l solution was significantly higher than that of the 154 mOsm/l and isotonic solution. Although higher levels of the Cmax may increase side-effects, the hypotonic condition of the i.pl. fluid and increased AUC in the plasma may escalate the accumulation of platinum in i.pl. cancer cells. These results suggest that hypotonic i.pl. CDDP is tolerable and may be useful for treatment of the incipient phase of pleural carcinomatosis and for prophylaxis of postoperative recurrence.

Aged↗
PubMedDate not supplied

Fluid-attenuated inversion recovery intraarterial signal: an early sign of hyperacute cerebral ischemia.

BACKGROUND AND PURPOSE: Early detection of arterial occlusion and perfusion abnormality is necessary for effective therapy of hyperacute cerebral ischemia. We attempted to assess the utility of the fast fluid-attenuated inversion recovery (fast-FLAIR) sequence in detecting occluded arteries as high signal (referred to as intraarterial signal) and to establish the role of fast-FLAIR in detecting ischemic penumbra of hyperacute stroke within 24 hours after ictus. METHODS: We studied 60 patients with hyperacute cerebral ischemia caused by occlusion of intracranial major arteries. We compared intraarterial signal on FLAIR images with time of flight (TOF) on MR angiograms, flow voids on T2-weighted images, hyperintense lesions on diffusion-weighted images, and results of follow-up CT or MR scans. RESULTS: In 58 (96.7%) patients, FLAIR detected intraarterial signals as early as 35 minutes after stroke onset. In 48 (80.0%) patients, intraarterial signal on FLAIR images coincided with lack of TOF on MR angiograms. In 41 (74.5%) of 55 patients, the intraarterial signals of fast T2-weighted imaging depicted occlusion better than did deficient flow void on T2-weighted images. In 25 (41.7%) of 60 patients, the area of intraarterial signal distribution was larger than the hyperintense lesion measured on diffusion-weighted images. Areas of final infarction had sizes between those of intraarterial signal distribution on FLAIR images and lesions measured on diffusion-weighted images. In 35 (87.5%) of 40 patients, areas of intraarterial signal distribution were equal to regions of abnormal perfusion. CONCLUSION: Intraarterial signal on FLAIR images is an early sign of occlusion of major arteries. FLAIR combined with diffusion-weighted imaging can be helpful to predict an area at risk for infarction (ischemic penumbra). FLAIR plays an important role for determining whether a patient should undergo perfusion study.

Acute Disease↗
PubMedDate not supplied

Dynamic multislice helical CT of maxillomandibular lesions: distinction of ameloblastomas from other cystic lesions.

PURPOSE: To evaluate the clinical usefulness of dynamic multislice helical CT in differentiating ameloblastoma from other cystic lesions in cases of maxillomandibular cystic lesions. MATERIALS AND METHODS: The study included 32 patients with maxillomandibular cystic lesions (ameloblastoma [n=6], myxofibroma [n=1], odontogenic keratocyst [n=3], dentigerous cyst [n=11], radicular cyst [n=11], and paradental cyst [n=2]). Dynamic study was performed before and 30 sec, and 90 sec after intravenous contrast medium administration. CT density values and percentage of density increase were calculated at 30 and 90 sec. RESULTS: In five cases of ameloblastoma, a rapidly enhancing area was detected within the cystic lesions at 30 sec, while no apparent rapid enhancement was seen in the other cystic lesions. Three cysts showed gradual enhancement in the marginal area at 90 sec. Comparing ameloblastoma and other kinds of cysts, we found significant differences in the percentage of density increase at 30 sec (p<0.01) and 90 sec (p<0.05). CONCLUSION: Dynamic multislice helical CT is useful in the diagnosis of cystic lesions of the maxillomandibular region, especially in the detection of neovascularities in ameloblastoma.

Adult↗
PubMedDate not supplied

CT-guided percutaneous laser disk decompression (PLDD) for cervical disk hernia.

OBJECTIVE: Percutaneous laser disk decompression (PLDD) is an effective treatment for bulging or protruding disk. The aim of this study was to present a method of PLDD for cervical disk hernia under CT guidance and to evaluate the efficacy and safety of this procedure. MATERIALS AND METHODS: Seven patients with radiculalgia caused by cervical disk hernia were treated overnight by PLDD. A laser fiber was inserted through an 18 G needle into the target disk under CT guidance. A Nd-Yag laser (1,064 nm) was used for ablation. A CT scan was obtained every 60 joule (J) at the slice of the target disk to visualize the vaporized area during the procedure. The Japan Orthopedic Association (JOA) score of cervical radiculopathy (full score 15) and MacNab criteria were used for assessment of treatment response. RESULTS: Puncture of the needle to the target disk was safely performed under CT guidance. The total dosage of laser ablation ranged from 120 to 500 J (average, 266 J). The overall success rate according to MacNab criteria was good in all cases. No complications were observed in our series. CONCLUSION: The CT-guided technique provides safe, accurate PLDD for cervical disk hernia. PLDD for cervical disk hernia shows promise in the management of radiculalgia.

Cervical Vertebrae↗
PubMedDate not supplied

Initial experience of percutaneous renal cryosurgery under the guidance of a horizontal open MRI system.

OBJECTIVE: The aim of this study was to obtain preliminary results of cryoablation of renal tumors by using a percutaneous approach guided by a horizontal open MRI system, and to assess the safety and efficacy of this procedure. MATERIALS AND METHODS: Four patients with renal tumors underwent percutaneous cryosurgery with local anesthesia using a horizontal open MRI system (AIRIS II, Hitachi Medical Corp., Tokyo, Japan). The size of the mass was radiographically documented as 4 cm or less in diameter. A 2- or 3-mm cryoprobe was advanced into the renal mass under real-time MR monitoring. Growth of the iceball during cryoablation was monitored by two-dimensional MR images. Follow-up dynamic CT and physical examination were done after two weeks and six weeks. RESULT: MR imaging demonstrated the iceballs as sharply marginated regions of signal loss that expanded and engulfed the renal mass with clear contrast between the iceball and surrounding tissue. Cryoablated tumors resolved, and there were no serious complications and no clinically significant changes during the procedures and follow-up study. CONCLUSION: In this limited clinical trial of percutaneous renal tumor surgery, cryoablation demonstrated its feasibility with minimal morbidity. Intraprocedual MR-guided cryosurgery can be used as a safe modality, although further studies are necessary to determine the long-term efficacy of this procedure.

Aged↗
PubMedDate not supplied

Expression of the multidrug-resistant gene in human musculoskeletal tumors.

We measured the levels of messenger RNA of the human multidrug-resistant (MDR) gene in 15 human musculoskeletal tumors. In metastatic tumors and those which did not respond to combination chemotherapy, there was an increased expression of this gene. No evidence of expressions of the MDR gene was found in the benign tumors. The high expression of the MDR gene from musculoskeletal tumors apparently induced a multidrug resistance, and this acquired resistance may be due to outgrowth of the P-glycoprotein-expressing MDR tumor. Elucidation of expression of the MDR gene is an important step in malignant musculoskeletal tumors research.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Papillary carcinoma of the thyroid occurring during pregnancy. Report of a case diagnosed by fine needle aspiration cytology.

A case of papillary carcinoma of the thyroid gland occurring during pregnancy in a 29-year-old woman is described. The enlarged thyroid nodule was first detected at 10 weeks of gestation; fine needle aspiration (FNA) of the nodule showed no cytologic evidence of malignancy. Repeat FNA at 30 weeks of gestation produced inadequate material for diagnosis. A final FNA at 38 weeks of gestation showed classic cytologic features of papillary carcinoma, including papillary structures, grooved nuclei and intranuclear cytoplasmic inclusions. After delivery, the patient was treated with total thyroidectomy and cervical lymph node dissection. The enlargement of the nodule in this case during the course of the pregnancy suggests a relationship between pregnancy and the malignant development of thyroid nodules; this is discussed along with the utility of FNA cytology for diagnosing thyroid cancers during pregnancy.

Adult↗
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Thoracic tissue core biopsy by Surecut: a preliminary report of 42 cases.

Percutaneous thoracic tissue core biopsy was performed in forty-two cases using modified Menghini needle with a 1-mm outer diameter (19-gauge Surecut). The tissue core for histological analysis was obtained in 32 out of 42 cases (76%). No serious complication was encountered. It is suggested that the Surecut is a desirable thin needle for obtaining histological material with minimal risk to the patient.

Aged↗
PubMedDate not supplied

Psammoma bodies found in cervicovaginal and/or endometrial smears.

Eight cases of the unusual occurrence of psammoma bodies associated with adenocarcinoma cells in cervicovaginal and/or endometrial smears are presented. Three of the eight cases were advanced ovarian cancers, four were primary endometrial adenocarcinomas, and one was a metastasis of breast cancer to the pouch of Douglas. From our histologic and histochemical observations, psammoma bodies seem to be secretory rather than degenerative in origin.

Adult↗
PubMedDate not supplied

[Detection of right-to-left shunt flow in atrial septal defect using transesophageal color and pulsed Doppler echocardiography].

The clinical significance of right-to-left (R-L) shunt flow dynamics in atrial septal defects (ASD) were investigated using transesophageal color and pulsed Doppler echocardiography in 30 patients with ASD of the ostium secundum type, including 20 with systolic pulmonary artery pressures (sPA) less than 40 mmHg, 4 with sPA of 40 to 60 mmHg, 3 with sPA of 90 mmHg or greater, 2 with pulmonic stenosis and 1 with Ebstein's anomaly. R-L shunting was detected by a shunt flow signal across the defect during a cardiac cycle. The timing of the R-L shunt was compared with various parameters obtained by echocardiography or cardiac catheterization. R-L shunt flow at the onset of ventricular contraction or closing phase of the tricuspid valve was detected in five patients with isolated ASD associated with increased mean right atrial pressure, but no severe pulmonary hypertension. R-L shunt flow during systole was detected in five of 26 patients with isolated ASD and tricuspid regurgitation and in one patient with Ebstein's anomaly. The tricuspid regurgitation signals in three of the five patients were directed toward the defect, while the other two had massive tricuspid regurgitation. R-L shunt flow during mid-diastole was detected in three patients without pulmonary hypertension. Massive left-to-right shunt flows occurred during the phase from end-systole to early diastole. R-L shunt flow during atrial systole was detected in three patients with severe pulmonary hypertension and two with pulmonic stenosis. The severe pulmonary hypertension patients, in particular, showed the aliasing signal as a high speed shunt flow, and in two of these, R-L shunt flow continued from atrial systole to early ventricular systole, and was also observed in early diastole. R-L shunt flow was detected in ASD patients with and without pulmonary hypertension, and was influenced by right atrial pressure at the phase of tricuspid valve closing, volume or direction of tricuspid regurgitation, rebound flow due to massive left-to-right shunt flow, grade of right ventricular distensibility or pulmonary hypertension, and other cardiac complications.

Adolescent↗
PubMedDate not supplied

Case report: breast hamartoma: MR findings.

We report a case of breast hamartoma which was diagnosed by magnetic resonance (MR) imaging and describe the MR features of this lesion. There was a perfect correlation between the findings at MR imaging and the macroscopic appearance of the tumor.

Adult↗