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Biomedical subjects

K Soejima

Publications and source records attributed to K Soejima.

At least 19 recordsLinked to original sources

[CT-guided percutaneous lung biopsy using a cutting needle and an automated biopsy gun. Comparison with lung biopsy using a manual aspiration needle].

Twenty-five percutaneous lung biopsies using a 20-gauge cutting needle and automated biopsy gun (ABG) were performed under CT guidance in 25 patients with thoracic lesions. This procedure was compared with that using a 21-gauge manual aspiration needle in 36 patients (40 examinations, 37 lesions) in terms of success rate, rate of correct diagnosis, mean examination time and rate of complications. Specimens obtained from lung biopsy were graded by a histopathologist according to quality and quantity from 0 to 4 (pathological score). There were no statistically significant differences between the two procedures in terms of success rate, rate of correct diagnosis and rate of complications; only the time required was significantly different. However, sufficient biopsy material and a mean pathological score of G-II 2.8 (that of G-I was 1.9, p less than 0.05) could be obtained by the biopsy procedure using the cutting needle. The above results indicated that aspiration needle biopsy was adequate for lung biopsy, but that a cutting needle and ABG should be used when a good biopsy specimen is needed for tissue diagnosis.

Adolescent

Demonstration of inguinal hernia by means of peritoneal 99mTc-MAA scintigraphy with a load produced by standing in a patient treated by continuous ambulatory peritoneal dialysis.

A 45-year-old man receiving continuous ambulatory peritoneal dialysis developed scrotal swelling and edema which was aggravated in the standing position. Physical examination failed to find inguinal hernia and although ultrasonography revealed the patent had processus vaginalias, it failed to prove its continuity to the peritesticular space of the tunica vaginalis. Peritoneal scintigraphy with intraperitoneal instillation of 99mTc-Macroaggregated albumin followed by standing clearly demonstrated the connection. The use of the standing load makes possible faster visualization of a positive finding and more accurate diagnosis than examination in the supine position.

Hernia, Inguinal

Intra-tumor DNA ploidy distribution pattern and its relation to histologic type in gastric carcinoma.

The pattern of intra-tumor DNA ploidy distribution was analyzed in stepwise sections in 64 cases of surgically resected gastric carcinoma. Five varying patterns were identified: Type A comprised only diploidy in all stepwise sections, Type B comprised only aneuploidy with the same DNA Index(DI), Type C comprised diploidy in the great majority of sections with aneuploidy in some parts, Type D comprised aneuploidy in the great majority of sections with diploidy in some parts and Type E comprised only aneuploidy, but with varying DI. These 5 patterns could be grouped into 2 categories; predominantly diploid (Types A and C) and predominantly aneuploid (Types B, D and E). The former category included 34 cases (12 differentiated carcinomas) while the latter included 30 cases (22 differentiated carcinomas). Thus, a statistically significant correlation was detected between the histologic type and the intra-tumor DNA ploidy distribution pattern; in the majority of cases, differentiated carcinoma exhibited predominantly aneuploidy, while undifferentiated carcinoma exhibited predominantly diploidy (p less than 0.01). This tendency was the same for all depths of invasion, except for submucosal carcinomas which exhibited predominantly diploidy.

Adenocarcinoma

Local control of prostate cancer by intraarterial infusion chemotherapy facilitated by the use of angiotensin II.

Intraarterial infusion chemotherapy with angiotensin II was carried out in 8 prostate cancer patients whose ages ranged from 61 to 77 years. They had stage C or D tumor progression and complained of difficult urination, bone pain or lymphedema caused by intrapelvic tumor infiltration. Endocrine therapy had been done before the infusion therapy but the clinical status showed little change with a persistence of local symptoms. Cis-platinum and doxorubicin were infused with an indwelling catheter into both internal iliac arteries. After the completion of 1-5 courses, 6 of 8 patients responded remarkably in local symptoms. It is thought that intraarterial infusion chemotherapy can be used safely and effectively in elderly patients.

Adenocarcinoma

Bi-directional transmission of molecular information by photon or electron beams passing in the close vicinity of specific molecules, and its clinical and basic research applications: 1) Diagnosis of humans or animal patients without any direct contact; 2) Light microscopic and electron microscopic localization of neuro-transmitters, heavy metals, Oncogen C-fos (AB2), etc. of intracellular fine structures of normal and abnormal single cells using light or electro-microscopic indirect Bi-Digital O-Ring Test.

In 1985, Omura, Y. discovered that, when specific molecules were placed anywhere in the close vicinity of the path of a light beam (laser), their molecular information, as well as information on electrical & magnetic fields, is transmitted bi-directionally along the path of this light beam. Namely, this information is transmitted in the direction the light beam is projected and towards the direction from which the light beam is coming. This finding was applied to the following clinical and basic research: 1) In the past, using indirect Bi-Digital O-Ring Test, human or animal patients were diagnosed through an intermediate third person holding a good electrical conducting probe, the tip of which was touching the part of the patient to be examined. However, in order to diagnose the patient in isolation from a distance, or a dangerous or unmanagable unanesthesized animal, such as a lion or tiger, the author succeeded in making a diagnosis by replacing the metal conducting probe with a soft laser beam which is held by the one hand of the third person whose index finger is placed in close vicinity of the laser beam generated by a battery-powered penlight-type solid state laser generator. Thus, diagnosis within visible distance, without direct patient contact, became a reality. 2) Using a projection light microscope, by giving indirect Bi-Digital O-Ring Test while contacting with a fine electro-conductive probe on the magnified fine structure of normal and abnormal cells, various normal and abnormal intracellular substances were localized through a third person holding a pure reference control substance with the same hand that is holding the probe as an intermediary for the indirect Bi-Digital O-Ring Test. Instead of the photon beam in a light microscope, the author found that, using an electron beam passing through the close vicinity of specific molecules of specimens in an electron microscope, the molecular information is transmitted to the magnified fluorescent screen, and an indirect Bi-Digital O-Ring Test could be performed through a projected penlight-type solid state soft laser beam on the magnified intracellular structure through an observation glass window. Using the magnified fine structure of the cells, by either a light projection microscopic field or electron microscope, in various cancer cells of both humans and animals, Oncogen C-fos (AB2) and mercury were found inside of the nucleus. Integrin alpha 5 beta 1 was found on cell membranes and nuclear cell membranes of cancer cells. Acetylcholine was not found anywhere within cancer cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

[Giant seminoma of the left testis: a case report].

A 66-year-old man visited our hospital with a history of a slowly growing left scrotal contents for the past 5 years. Serum beta-human chorionic gonadotropin and lactate dehydrogenase was greatly elevated. The resected mass was 26 cm x 16 cm x 13 cm in size, 2,258 g in weight. It arose from left testis and grew to the left inguinal region. Histologically it was pure seminoma.

Aged

[Demonstration of the architecture of the tracheobronchial wall by MR imaging: an experimental study].

To study the potential of MRI to demonstrate the architecture of the tracheobronchial wall, resected tracheobronchi of rabbits were examined with MRI. As a result, epithelium and cartilage were demonstrated as relatively low intensity bands on T1- and T2-weighted images (T1WI and T2WI). The subepithelium was of intermediate-high intensity on T1WI and of markedly high intensity on T2WI and Gd-DTPA enhanced T1WI. Peritracheobronchial fat was of markedly high intensity on T1WI and of relatively low intensity on T2WI. In conclusion, MRI was found to have the potential to demonstrate the architecture of the tracheobronchial wall as 4 layers on each sequence.

Animals

Growth patterns and prognosis of submucosal carcinoma of the esophagus. A pathologic study.

Sixteen cases of esophageal carcinoma invading the submucosa were analyzed in terms of growth patterns. Seven were classified into the massively penetrating (down growth) type, four into the superficially spreading (spreading growth) type, and five into the unclassified type. In the down growth type, the ratio of the submucosal area to the total (mucosa and submucosa) area was more than 0.2 (one fifth), and in the others that ratio was less than 0.2. The down growth type is characterized by a tendency toward elevated lesions, a high incidence of vessel invasions and lymph node metastasis, and a poor prognosis after surgery. Lymphatic and/or vascular invasions were recognized in six of seven cases, and the 5-year survival rate was 0%. In contrast, the spreading growth and unclassified types was characterized by superficial lesions, a low incidence of vessel invasions and lymph node metastasis, and a favorable prognosis. In only one with the spreading growth type was there lymphatic invasion. Three of the four with the spreading growth type survived over 5 years, and the other one with the spreading growth type and all of five with the unclassified type are alive without recurrences 15 to 52 months after surgery. Thus, growth patterns reflect well the prognosis of the submucosal carcinoma of the esophagus.

Aged

[The appearance of "lambda" and "panda" sign on Ga-67 scintigraphy in sarcoidosis].

The lesions of sarcoidosis generally show relatively high Ga-67 uptake and the usefulness of scintigraphy using this agent in the evaluation of lesion activity is well known. In this report, we assessed characteristic uptake of Ga-67 in intrathoracic lymphnodes, the shape of which resembled the Greek letter Lambda (Lambda sign) and a symmetrical accumulation in bilateral lacrimal and salivary glands which resembled a Panda face (Panda sign) in patients with sarcoidosis. Our review of Ga-67 scans obtained from 15 patients with sarcoidosis and 1,779 patients with other disorders during the past 3 years revealed that the simultaneous presence of both Lambda and Panda signs was specific to patients with sarcoidosis and was not found in patients with various other disorders, although one of these signs might be observed in patients without sarcoidosis. When Lambda-like sign was observed, chest radiogram or CT was necessary for the differential diagnosis of sarcoidosis. Panda sign was observed frequently among patients who had previously received irradiation of the neck. Our results confirmed that sarcoidosis must be suspected when both Lambda and Panda signs were observed.

Adult

[Pulmonary artery banding for double inlet left ventricle].

Thirteen patients with double-inlet left ventricle who had undergone pulmonary artery banding (PAB) were reviewed. At the time of PAB, the age ranged from 2 months to 3 years. Pulmonary-systemic arterial pressure ratio and pulmonary arterial mean pressure were reduced from 0.95 +/- 0.12 to 0.4 +/- 0.18, and from 57.3 +/- 11.6 mmHg to 29.9 +/- 12.7 mmHg after PAB. Pulmonary resistance showed no statistically significant change after PAB. (from 7.6 +/- 5.2 unit to 4.8 +/- 3.9 unit) Ventricular end-diastolic volume decreased from 379.9% +/- 140.0% to 275.7% +/- 118.0% after PAB. The smallest one was 170% who successfully underwent septation procedure. Ejection fraction significantly decreased from 64.5 +/- 6.1% to 56.3 +/- 7.9%. (p less than 0.005) Ventricular end-diastolic pressure showed no significant change after PAB. (from 9.2 +/- 2.8 mmHg to 9.9 +/- 2.0 mmHg) After PAB subaortic stenosis occurred in three cases and pressure gradient were 10, 20, and 85 mmHg, respectively. Seven cases, including three cases with subaortic stenosis, underwent septation procedure and all survived. Before septation, ventricular end-diastolic volume calculated as % of normal left ventricular volume ranged from 173% to 570% and pulmonary resistance ranged from 1.6 unit to 11 unit. These data suggested that the patients with double-inlet left ventricle had efficient ventricular volume and cardiac function for septation even after PAB.

Child, Preschool

Orbital rhabdomyosarcoma. Immunohistochemical studies of seven cases.

An immunohistochemical analysis using a series of mono- and polyclonal antibodies against myoglobin, desmin, vimentin, actin, NSE, S-100 protein and keratin was done on alveolar rhabdomyosarcoma (3 cases), embryonal (3) and pleomorphic rhabdomyosarcoma of the orbit (1). All tumors were stained by monoclonal antibodies to desmin and vimentin, whereas 6 of the 7 cases were stained by myoglobin. The results indicate that desmin and vimentin are highly sensitive immunohistochemical markers for the diagnosis of rhabdomyosarcoma, especially in poorly differentiated ones.

Adult

The role of monokines in granuloma formation in mice: the ability of interleukin 1 and tumor necrosis factor-alpha to induce lung granulomas.

Granulomatous inflammation is associated with many significant human diseases, including tuberculosis, leprosy, sarcoidosis, parasite infection, and berylliosis. Very little is known about the basic mechanism of this type of inflammation. In the present study, we showed that pulmonary granulomas were induced in mice by the intratracheal injection of agarose beads coupled to recombinant interleukin 1 (IL-1) or tumor necrosis factor-alpha (TNF-alpha). Histologically, the bulk of granulomas was composed of macrophages and their derivatives. In contrast, the inflammatory reactions induced by beads coupled to either recombinant IL-2 or murine interferon-gamma were considerably smaller than those induced by beads coupled to monokines. These results suggest that macrophages and monokines such as IL-1 and TNF-alpha, but not T cell-derived lymphokines, play an essential role in granuloma formation.

Animals

Assessment of pancreatic islet-cell population in the hyperglycemic athymic nude mouse: immunohistochemical, ultrastructural, and hormonal studies.

Previous studies in diabetic animal models have demonstrated altered pancreatic islet-cell populations. To further characterize the diabetic syndrome in our athymic nude mouse colony, we studied the population of endocrine cells in pancreatic islets of 4-week-old normoglycemic and 8-week-old hyperglycemic athymic nude (nu/nu) mice using immunohistochemistry, morphometry, and electron microscopy. In normoglycemic 4-week athymic nu/nu mice, the proportions of B (insulin-secreting) cells and A (glucagon-secreting) cells were similar to those in control Balb/c mice; however, the D (somatostatin-secreting) cells were significantly decreased in nu/nu mice. The populations of B and A cells appeared to be normal in hyperglycemic 8-week-old nu/nu mice while there was a significant increase in the proportion of D cells when compared with the proportion in Balb/c mice. Electron microscopic studies indicated that the appearance of B and A cells was similar in the 8-week-old hyperglycemic nu/nu and in controls; however, the D cells appeared to be enlarged and were finely packed with electron-dense secretory granules. Radioimmunoassays of the pancreatic content (micrograms/g fresh pancreas) of insulin, glucagon, and somatostatin in pancreata in 8-week-old normal Balb/c and hyperglycemic athymic nude mice were similar; however, the somatostatin content was significantly increased in the 8-week-old hyperglycemic nu/nu mice compared with age and sex-matched controls. These results demonstrate an altered D cell population and an increase in somatostatin levels in the pancreatic islets of the hyperglycemic athymic nude mouse animal model.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

[Clinical evaluation of the prehospital phase of acute myocardial infarction in the elderly].

In order to clarify the clinical characteristics of the prehospital phase of acute myocardial infarction (AMI) in the elderly, we studied 92 elderly (65 years old or more) and 41 younger patients with first AMI. Fifty eight elderly (63.1%) and 30 younger (72.7%) patients had typical symptoms such as chest pain at onset. There were 5 elderly cases who had no symptom, although all of the younger had some symptoms at onset. More than 70% of the younger cases developed their symptoms either between 6 am and noon or between 6 pm and midnight, whereas the elderly showed no such tendency. Intervals between the onset of symptoms and hospital admission (admission time) averaged 6.8 hours (hr) in the younger and 7.7 hr in the elderly. Approximately one half of the elderly and a quarter of the younger showed admission time more than 6 hr, respectively. Elderly cases with atypical symptoms tended to have a longer admission time than younger cases (7.2 vs 3.1 hr), although there was no significant difference between the elderly and the younger with typical symptoms (8.0 vs 7.9 hr). Younger patients with heart failure had significantly shorter admission time than those without heart failure (3.6 vs 8.6 hr). However, the elderly with heart failure showed a prolonged admission time (6.1 hr). Although there was no difference on admission time between survivors and non-survivors within 28 days after admission in the elderly (7.5 vs 8.4 hr), the elderly non-survivors with atypical symptoms had the longest admission time (13.0 hr).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors

Interaction of S-activated enkephalin analogs with opiate receptors.

Enkephalin analogs containing a thiol activated by a thiomethyl (SCH3)*** or 3-nitro-2-pyridinesulfenyl (Npys) group were synthesized. Incubation of such S-activated enkephalin analogs as [D-Ala2, Leu(CH2S)SCH(3)5]enkephalin or [D-Ala2,Leu(CH2S)Npys5]enkephalin with guinea pig ileum (GPI) resulted in the continuous stimulation of the mu opiate receptors. This sustained GPI-activity was completely reversed with the antagonist naloxone, while subsequent washings elicited again the full enkephalin activity. When GPI showing full enkephalin activity was incubated with 1 mM dithiothreitol, about 70% of the activity was eliminated. Examination of enkephalin analogs containing Cys(Npys) at position 1, 5, or 6 suggested that no other thiols occur near the enkephalin binding site of the mu receptor. From these results, it is considered that only one thiol group exists near the binding site of the mu receptor in GPI. Similar results were also obtained for the mu receptors in mouse vas deferens.

Animals

Effect of maprotiline combined with conventional neuroleptics against negative symptoms of chronic schizophrenia.

The therapeutic efficacy and target symptoms of maprotiline were tested by administering it in addition to conventional neuroleptic treatment for 10 weeks to a total of 32 chronic schizophrenic patients who showed no, or only partial, response to the neuroleptic medication. The final global improvement rating was 68.8% for all patients. Average therapeutic doses administered were 150 mg per day. Changes in psychotic symptoms were assessed by the Brief Psychiatric Rating Scale (BPRS), Psychiatric Evaluating scale (PES), and the Scale for the Assessment of Negative Symptoms (SANS). All mean improvement rates of these rating scales were observed at the 2nd week after the start of treatment, and maprotiline produced a marked amelioration in negative symptoms such as decreased spontaneity, blunted affect, emotional withdrawal, impaired work or recreation, etc. The incidence of side-effects was 37.5%. Constipation was the most frequently occurring side-effect. Neither side-effects nor laboratory test results were serious enough to discontinue the trial, except in the case of one chronic patient who showed acute exacerbation of symptoms due to maprotiline-induced insomnia, elation and hallucination. These results suggest that maprotiline improves the negative symptoms of schizophrenia by a noradrenaline potentiating action not demonstrated by dopaminergic or serotonergic reward systems.

Adult