Biomedical subjects

K Masuda

Publications and source records attributed to K Masuda.

At least 253 records · Page 14Linked to original sources

PubMed1997

Small hepatocellular carcinoma on magnetic resonance imaging. Relation of signal intensity to angiographic and clinicopathologic findings.

RATIONALE AND OBJECTIVES: The authors discuss the clinicopathologic features and angiographic vascularity of various signal intensity patterns on magnetic resonance (MR) imaging of small hepatocellular carcinomas (HCCs). METHODS: Magnetic resonance images of 88 resected HCCs (< or = 3 cm) were obtained using T1- and T2-weighted spin-echo images and T1-weighted images after gadolinium (Gd)-DTPA administration. Images were compared with angiographic and histopathologic findings. RESULTS: Forty HCCs (45%) were depicted on T1-weighted images, 51 (58%) on T2-weighted images, and 41 (49%) on T1-weighted images after Gd-DTPA administration. Overall, 64 (76%) were found on at least one image. On T1-weighted images, hyperintense HCCs histologically showed fatty metamorphosis and portal tracts within the tumor. On T2-weighted images, HCC hyperintensity correlated with expansive growth, peliotic change, and hypervascularity. By contrast, HCCs that were undetected or hypointense on T2-weighted images were well differentiated with replacing growth and portal tracts. On T1-weighted images after Gd-DTPA, hyperintense HCCs had peliotic change; undetected HCCs were well differentiated and hypovascular. CONCLUSIONS: Histologic grade, vascularity, portal tracts and peliotic change correlate with MR signal intensity. For hyperintense HCCs on T1-weighted images and hypo- or isointense HCCs on T2-weighted images, treatment methods must be assigned with the consideration that HCCs may be receiving transsinusoidal and portal blood supplies.

Adult↗

PubMed1997

Evaluation of complications of kidney transplantation using artificial neural networks.

The aim of this study was to develop an artificial neural network (ANN) to differentiate between rejection, acute tubular necrosis (ATN) and normally functioning kidneys in a group of patients with renal transplants. The performance of ANN was compared with that of an experienced observer using a database of 35 patients' records, each of which included 12 quantitative parameters derived from renograms and clinical data as well as a clinical evaluation. These findings were encoded as features for a three-layered neural network to predict the outcome of biopsy or clinical diagnosis. The network was trained and tested using the jackknife method and its performance was then compared to that of a radiologist. The network was able to correctly classify 31 of the 35 original cases and gave a better diagnostic accuracy (88%) than the radiologist (83%), by showing an association between the quantitative data and the corresponding pathological results (r = 0.78, P < 0.001). We conclude that an ANN can be trained to differentiate rejection from acute tubular necrosis, as well as normally functioning transplants, with a reasonable degree of accuracy.

Adult↗

PubMed1997

An evaluation of FDG-PET in the detection and differentiation of thyroid tumours.

We evaluated the usefulness of FDG-PET for the detection of thyroid tumours and the differentiation between benign and malignant tumours. The subjects consisted of 5 normal volunteers and 22 patients, including 3 with follicular adenoma, 16 with papillary carcinoma and 3 with follicular carcinoma. The results were then evaluated both visually and semi-quantitatively using the standardized uptake value (SUV). All 22 tumours were seen as areas of high FDG uptake. FDG uptake in the normal thyroid gland, follicular adenoma, papillary carcinoma and follicular carcinoma was 1.0 +/- 0.2, 2.1 +/- 0.4, 4.7 +/- 3.2 and 4.6 +/- 2.9, respectively. Significant differences were observed between papillary carcinoma and both follicular adenoma (P < 0.05) and the normal thyroid gland (P < 0.001), and between follicular adenoma and the normal thyroid gland (P < 0.001). For the diagnosis of carcinoma, 58% sensitivity, 100% specificity and 73% accuracy were obtained when the highest FDG uptake value in adenoma was taken as the threshold. Our results thus indicate that high FDG uptake in a thyroid tumour suggests malignancy even though low levels of FDG uptake cannot completely rule out malignancy.

Adenoma↗

PubMed1997

Primary non-Hodgkin lymphoma of the sinonasal cavities: correlation of CT evaluation with clinical outcome.

PURPOSE: To determine retrospectively the primary site of origin of sinonasal lymphomas with computed tomography (CT) and correlate the CT findings with histologic phenotype and clinical outcome. MATERIALS AND METHODS: In 24 patients with stage I and II non-Hodgkin lymphomas of the sinonasal cavities, the CT appearances and clinical data were reviewed retrospectively. RESULTS: The sites of primary tumor determined at CT were the nasal cavity in 13 patients, the ethmoidal sinus in three patients, and the maxillary sinus in eight patients. B-cell lymphomas were found mainly in the maxillary sinus, while T-cell lymphomas were found in the nasal cavity and ethmoidal sinus (P < .005). The 5-year survival rates in relation to the primary site of the tumor were 64% for the nasal cavity, 50% for the ethmoidal sinus, and 100% for the maxillary sinus (P = .26). CONCLUSION: Patients with B-cell primary lymphoma of the maxillary sinus tended to have a good prognosis in contrast to those with T-cell lymphomas that originated from midline structures. The primary site determined at CT appears to be correlated with the histologic phenotype and clinical outcome.

Ethmoid Sinus↗

PubMed1997

Gastrointestinal submucosal tumors: evaluation with endoscopic US.

PURPOSE: To describe the endoscopic ultrasound (US) features of benign versus malignant submucosal tumors throughout the gastrointestinal tract. MATERIALS AND METHODS: One hundred nine patients aged 24-81 years suspected to have submucosal tumors (11 esophageal, 41 stomach, 24 duodenal, and 33 colorectal tumors) at barium studies or endoscopy underwent endoscopic US. The layer of origin, internal echo pattern, and lesion margin were analyzed by means of consensus and independent interpretation by three radiologists. RESULTS: Endoscopic US findings revealed several distinct patterns among various submucosal tumors. Sixteen (94%) of the 17 homogeneous lesions with histopathologic findings of malignancy were hypoechoic, although 29 (43%) of the 68 homogeneous lesions with histopathologic findings of benignity were similarly hypoechoic. Homogeneous lesions that were anechoic, of intermediate echogenicity, or hyperechoic were almost exclusively benign (39 [98%] of 40). In contrast, 23 (96%) of the 24 malignant lesions were heterogeneous (n = 7) or homogeneously hypoechoic (n = 16). The sizes of benign and malignant lesions were significantly different (P < .05). There was no significant difference in the echo pattern (i.e., homogeneous versus heterogeneous), but there was a significant difference in the proportion of hypoechoic versus nonhypoechoic lesions (anechoic, hyperechoic, or of intermediate echogenicity; P < .001). CONCLUSION: The differential diagnosis of gastrointestinal submucosal tumors is assisted with endoscopic US.

Diagnosis, Differential↗

PubMed1997

Response to hypercapnia in moyamoya disease. Cerebrovascular response to hypercapnia in pediatric and adult patients with moyamoya disease.

BACKGROUND AND PURPOSE: We have previously reported that cerebral blood flow decreased and oxygen extraction fraction and cerebral blood volume increased in pediatric patients with moyamoya disease, whereas these values did not change significantly in adult patients. In this study, we measured the cerebrovascular response to hypercapnia using 15O H2O positron emission tomography (PET) in each group of patients. These data were also compared with the oxygen extraction fraction and transit time (cerebral blood volume/cerebral blood flow) measured by 15O PET. METHODS: The subjects consisted of 20 patients with moyamoya disease (7 pediatric and 13 adult patients). Cerebral blood flow was measured by the 15O H2O bolus injection method at the resting state and during the inhalation of 5% CO2. Cerebrovascular CO2 response was estimated as the percentage change of cerebral blood flow per 1 mm Hg change of PaCO2. Oxygen extraction fraction and transit time were measured by the 15O steady-state method. RESULTS: Cerebrovascular response to hypercapnia severely decreased over the cerebral cortices in both pediatric and adult patients with moyamoya disease when compared with those of normal control subjects, and there was no significant difference between pediatric and adult patients. A significant correlation was observed between the CO2 response and transit time, whereas no significant correlation was seen between the CO2 response and oxygen extraction fraction. CONCLUSIONS: Our study revealed that the cerebral hemodynamic reserve capacity decreased to an equal degree in both pediatric and adult patients with moyamoya disease. This finding may thus help to explain the occurrence of transient ischemic attack in adult patients.

Administration, Inhalation↗

PubMed1997

Purification, characterization, and localization of a novel trypsin-like protease found in the human airway.

A novel trypsin-like protease was purified to homogeneity from the sputum of patients with chronic airway diseases, by sequential chromatographic procedures. The enzyme migrated on SDS-polyacrylamide gel electrophoresis to a position corresponding to a molecular weight of 28 kDa under both reducing and non-reducing conditions, and showed an apparent molecular weight of 27 kDa by gel filtration, indicating that it exists as a monomer. It had an NH2-terminal sequence of Ile-Leu-Gly-Gly-Thr-Glu-Ala-Glu-Glu-Gly-Ser-Trp-Pro-Trp-Gln-Val-Ser-Leu- Arg-Leu, which differed from that of any known protease. Studies with model peptide substrates showed that the enzyme preferentially cleaves the COOH-terminal side of arginine residues at the P1 position of certain peptides, cleaving Boc-Phe-Ser-Arg-4-methylcoumaryl-7-amide most efficiently and having an optimum pH of 8.6 with this substrate. The enzyme was strongly inhibited by diisopropyl fluorophosphate, leupeptin, antipain, aprotinin, and soybean trypsin inhibitor, but hardly inhibited by secretory leukocyte protease inhibitor at 10 microM. An immunohistochemical study indicated that the enzyme is located in the cells of the submucosal serous glands of the bronchi and trachea. These results suggest that the enzyme is secreted from submucosal serous glands onto the mucous membrane in patients with chronic airway diseases.

Amino Acid Sequence↗

PubMed1997

Interferon alpha-2a therapy for disseminated intravascular coagulation in a patient with blue rubber bleb nevus syndrome. A case report.

The authors present a sixteen-year-old girl with blue rubber bleb nevus syndrome (BRBNS) associated with disseminated hemangiomas involving the skin, oral cavity, skeletal muscle, and cerebrum. Although she denied neurologic symptoms, magnetic resonance imaging of the brain demonstrated dilatated cerebral veins and the Chiari I malformation. Examination of hemostasis revealed disseminated intravascular coagulation (DIC) manifesting as Kasabach-Merritt syndrome, with the potential for life-threatening bleeding or thrombosis in the central nervous system. Since successful management of life-threatening hemangiomas with interferon alpha-2a (IFN alpha-2a) has been reported, the authors administered IFN alpha-2a with an improvement in hemostasis. These findings suggest that IFN alpha-2a therapy is beneficial for relieving the life-threatening consumptive coagulopathy associated with BRBNS.

Adolescent↗

PubMed1997

Using endosonography to assess the effects of neoadjuvant therapy in patients with advanced esophageal cancer.

OBJECTIVE: The aim of this study was to determine the usefulness of endosonography for evaluating the effect of neoadjuvant therapy for advanced esophageal carcinoma. MATERIALS AND METHODS: Thirty-four patients with esophageal carcinoma (stage II, 16 patients; stage III, 18 patients) underwent various preoperative treatment. In all patients, endosonography was performed before and after treatment, and the percentage reduction in tumor size was calculated from the maximum area of the tumor. In the 27 patients who underwent surgery, the percentage reduction was compared with the pathologic response. Also, the overall survival rates were compared with the percentage reduction in tumor area. RESULTS: Reduction in tumor area ranged from 0% to 47%. The patients were divided into three groups according to the percentage reduction in tumor area. Pathologic response was graded according to the number of viable cells in the entire lesion. Correlation between pathologic response and percentage reduction in tumor area was strong. We found a significant difference in survival rates among the three groups. CONCLUSION: The percentage reduction in tumor area estimated by means of endosonography reflects the histologic effectiveness of neoadjuvant therapy in patients with advanced esophageal carcinoma and may enable clinicians to predict the prognosis of the disease.

Aged↗

PubMed1997

Anatomy and clinical importance of cholecystic venous drainage: helical CT observations during injection of contrast medium into the cholecystic artery.

OBJECTIVE: The purpose of this study was to use helical CT to elucidate the anatomy and clinical importance of cholecystic venous drainage. SUBJECTS AND METHODS: We performed helical CT of the upper abdomen during injection of contrast medium through a superselectively catheterized cholecystic artery (cholecystic artery CT) in 28 patients, all of whom were surgical candidates for suspected hepatobiliary abnormality. In nine of these patients, CT during arterial portography (CTAP) was also performed. RESULTS: Cholecystic venous blood most frequently entered peripheral portal branches of hepatic segment V (27 of 28 patients, 96%) and segment IV (26 of 28, 93%). In order of decreasing frequency, cholecystic venous blood also drained to segments I, VI, VIII, III, and VII. Cholecystic venous blood subsequently drained into the middle hepatic vein (21 of 28, 75%) or right hepatic vein (20 of 28, 71%). In two patients with adenocarcinoma involving the gallbladder associated with multiple liver metastases, cholecystic venous drainage was seen around each metastatic focus. In the nine patients in whom both cholecystic artery CT and CTAP were performed, nontumorous portal perfusion defects were attributable to cholecystic venous drainage. CONCLUSION: Recognition of cholecystic venous drainage as a possible pathway for spread of disease from the gallbladder to the liver and also as one of the causes of non-tumorous portal perfusion defects seen on CTAP is important.

Aged↗

PubMed1997

[Anterior chamber inflammation after the injection of endothelin-1 into the vitreous and the effect of an anti-prostaglandin agent].

We measured the time course of aqueous protein concentration (APC) with a laser flare-cell meter after the injection of endothelin-1 (ET-1) into the vitreous cavity of pigmented rabbits and investigated the influence of pre- or post-treatment with an anti-prostaglandin agent on these effects of ET-1. Injection of ET-1 significantly increased APC in a dose-dependent fashion. After 10(-5)M ET-1 injection, APC reached maximum at 4 hours after treatment and returned to the normal level 24 hours after the injection. On the other hand, the 10(-4)M ET-1 model displayed a bi-phase time course, with a peak value observed at 4 approximately 8 hours and 48 hours post-treatment, and APC did not return to normal even 7 days after treatment. Treatment with anti-prostaglandin agents before and after the injection blocked APC increase completely in the 10(-5)M ET-1 model, and partially in the 10(-4)M ET-1 model. These results indicate that ET-1 effects on APC are at least partially mediated by the cyclooxygenase pathway of the arachidonic acid cascade.

Animals↗

PubMed1997

[Human leukocyte antigens and episcleritis in leprosy (Hansen's disease)].

Human leukocyte antigens (HLA) were analyzed in Japanese leprosy patients to ascertain whether immunogenetic differences exist between leprosy patients with episcleritis (ES) and those without it. The subjects were 79 Japanese leprosy patients, including 33 patients with a past history of ES, and 49 patients without ES. Controls were 114 healthy subjects. A standard microcytotoxicity test was used for typing HLA-A, -B, -C, -DR and -DQ antigens. HLA-DRB1 and DQB1 genotypings were performed by using the polymerase chain reaction (PCR)-single strand conformation polymorphism and PCR-restriction fragment length polymorphism methods. The occurrence of HLA-Cw3 was significantly greater in the patients with ES (66.7%) than in those without ES (43.5%; odds ratio = 2.6, p < 0.05). The occurrence of HLA-DR4 was significantly lesser in the patients with ES (15.2%) than in those without ES (39.1%; odds ratio = 0.28, p < 0.05) and the controls (46.5%; odds ratio = 0.21, p < 0.005). At the genomic level, the occurrence of HLA-DRB1*0405, DQB1*0401, and DQB1*0302 was significantly lesser in the patients with ES (0%, 0% and 6.1%, respectively) than in those without ES (15.2%, 13.0%, and 26.1%, respectively; odds ratio = 0.07, 0.09 and 0.18, p < 0.05). HLA-DRB1*0405 and DQB1*0401 were also significantly lesser in the patients with ES than in the controls (29.8% and 29.8%; odds ratio = 0.04, p < 0.0001). Our results suggest that HLA-Cw3 causes susceptibility to episcleritis in Japanese patients with leprosy, whereas DR4 (DRB1*0405), DQB1*0401, and DQB1*0302 provide some protection against leprous episcleritis.

Adolescent↗

PubMed1997

[Anterior chamber inflammation after the injection of endothelin-1 into the vitreous and the effect of ETA receptor antagonist].

To assess the receptors which mediate the inflammatory reaction induced by endothelin-1 (ET-1), we investigated the influence of pre-treatment with an ETA receptor antagonist (97-139) on the increase of aqueous protein concentration (APC) after the injection of ET-1 (10(-4), 10(-5)M) into the vitreous cavity of pigmented rabbits. The concentration of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) in the aqueous humor after the injection of 10(-4)M ET-1 with or without pre-treatment with 97-139 (10(-1), 10(-2), 10(-3)M) was also studied. Pre-treatment with 10(-2)M and 10(-1)M 97-139 completely prevented the APC increase induced by 10(-5)M and 10(-4)M ET-1, respectively. Increases in aqueous PGE2 concentration were observed after the injection of ET-1, which was inhibited by pre-treatment with 97-139. Aqueous LTB4 concentration was not changed significantly by ET-1. These results indicate that the effects of ET-1 on APC are at least partially mediated by the cyclooxygenase pathway of arachidonic acid cascade, and that ETA receptors play an important role in these reactions.

Animals↗

PubMed1997

Increased activity of the ipsilateral motor cortex during a hand motor task in patients with brain tumor and paresis.

PURPOSE: To look for changes in the motor cortex in patients with brain tumors. METHODS: Both cerebral hemispheres in seven patients with brain tumors were examined with functional MR imaging during a motor task performed by the hand opposite the site of tumor. The ratio of the activated area in the motor cortex ipsilateral/contralateral to the tested hand was calculated for each subject. Twenty healthy subjects were also examined in the same manner for comparison. RESULTS: The ratio of the ipsilateral/contralateral activated area was abnormally high in three patients with tumor-related paresis of the tested hand. The ratio was significantly greater in patients with paresis than in healthy subjects. CONCLUSION: This study demonstrated increased activity in the ipsilateral (unaffected) motor area during a hand motor task in patients with brain tumor and paresis, which was thought to reflect compensatory reorganization induced by the functional damage.

Adult↗

PubMed1997

Potency of truncated secretory leukoprotease inhibitor assessed in acute lung injury models in hamsters.

We evaluated the potency of truncated secretory leukoprotease inhibitor (truncated SLPI) in a human sputum elastase (HSE)-induced lung injury model and in a specific neutrophil-mediated acute lung injury model in hamsters. Intratracheal administration of HSE induced acute lung hemorrhage that could be measured by determination of the hemoglobin content in the bronchoalveolar lavage fluid. Intratracheal administration of truncated SLPI 1 hr before HSE administration inhibited acute lung hemorrhage in a dose-dependent manner (ED50 = 46.8 microg/kg), as did i.v. injection of the inhibitor given 2 min before HSE administration (ED50 = 14.7 mg/kg). Intratracheal administration of endotoxin (lipopolysaccharide) induced pulmonary neutrophilia. Twenty-four hours after lipopolysaccharide administration, the addition of formyl-methionyl-leucyl-phenylalanine resulted in a neutrophil-dependent acute lung injury that expressed an increase in hemoglobin content and in elastase-like activity in bronchoalveolar lavage fluids. In this model, lung injury was significantly attenuated by i.v. and intratracheal administration of truncated SLPI. These results suggest that truncated SLPI appears to be a good candidate inhibitor for the treatment of destructive lung diseases due to neutrophils.

Animals↗

PubMed1997

[Evaluation of clinical utility of 111In-DTPA-IgG scintigraphy in the detection of inflammation/infection--a report of multicenter phase III clinical trials].

This is the report of phase III study to evaluate the safety and utility of 111In-DTPA-IgG in patients with strongly suspected inflammation/infection. One hundred and forty five patients with suspected sites of inflammation/infection were enrolled in the study. Only a few adverse experiences in one patient were reported, which were interpreted as having a possible relationship to the agent. A total of 171 suspected sites (12 in head and neck, 39 in thorax, 44 in abdomen and pelvis, 62 in musculoskeletal system, and 14 in other regions) were evaluated by investigators at each institute. Out of 171 sites, 18 were determined to be unevaluable, and 12 false negative and 5 false positive cases were observed. Overall sensitivity and specificity was 89.8% and 85.7%, respectively, and the agent proved to be effective in detecting lesions anywhere throughout the body. The analysis of data from this Phase III study indicates that 111In-DTPA-IgG is well-tolerated in patients and effective in determining focal sites of inflammation/infection although the physiological accumulation in some tissues such as the sinus or liver and possible excretion into the gastrointestinal tract may make it difficult to localize lesions.

Aged↗

PubMed1997

[Early HCC and adenomatous hyperplasia: evaluation of arterial and portal blood flow with CTA, CTAP, and pathologic correlation].

In order to analyze the hemodynamic properties of early hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH), three lesions (two HCCs, one AH) depicted as hypoattenuating at CTA and iso attenuating at CTAP were correlated with the histopathological findings. The number of normal hepatic arteries in the tumor was lower than in the liver. Degeneration and narrowing of the lumens were also seen microscopically. All tumors showed the replacing growth pattern and had similar numbers of the portal tracts in the tumor to the liver. The decreased number of intratumoral normal arteries is suspected to be a characteristic finding of the early stage of HCC.

Adenoma↗

PubMed1997

[Clinical aspects of Behçet's disease--epidemiological features and visual prognosis].

Behçet's disease patients who visited the eye clinic of Tokyo University Hospital during the past 20 years were surveyed retrospectively, and their epidemiological features and visual prognosis were demonstrated. We evaluated the number of patients, sex ratio, age of onset, ratio of complete type to incomplete type, and ratio of major symptoms other than the ocular manifestation. The results showed a tendency similar to the results of the nationwide hospital survey in Japan. We also evaluated the visual prognosis of Behçet's disease patients in our clinic by the least square method. In the groups of patients whose visual acuity at the initial visit was over 0.4, the visual prognosis of those who visited from 1984 till 1993 was significantly better than that of those who visited from 1974 till 1983. The use of cyclosporine was presumed to be one of the most important factors in the improved visual prognosis of Behçet's disease patients in our clinic.

Adolescent↗