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Biomedical subjects

M Fukui

Publications and source records attributed to M Fukui.

At least 163 records · Page 9Linked to original sources
PubMed1999

Human chorionic gonadotrophin in CSF, not serum, predicts outcome in germinoma.

OBJECTIVES: Some intracranial germinomas, which may contain syncytiotrophoblastic giant cells (STGCs), are associated with a mildly to moderately increased human chorionic gonadotropin (HCG) concentration in serum, and patients with such germinomas are thus treated more aggressively than those with "pure" germinoma. However, the patients with germinoma and detectable HCG in CSF but not in serum have been classified and treated similarly to those with "pure" germinomas. The outcome of these patients and the relevance of HCG in the CSF were analysed. METHODS: The outcomes of patients with germinoma and increased serum HCG concentration (n=7) were compared with those of patients having detectable HCG titre in the CSF but not in the serum (n=5). RESULTS: Both groups in our series received similar treatments and also showed similar recurrence rates. The 40% recurrence rate in the group with HCG only in CSF did not correspond to the rate typical for "pure" germinoma: these tumours would be expected to have a better outcome. An additional patient whose CSF HCG were raised without increased serum HCG at recurrence is presented. CONCLUSIONS: It is recommended that patients with an increased HCG concentration in CSF should be considered to have "HCG producing germinoma", and they should be treated and followed up accordingly.

Adolescent↗
PubMed1999

Acute response of the lung mechanics of the rabbit to hypoxia.

We measured the change in total lung resistance (RL) and that in total lung elastance (EL) induced by hypoxia (n = 7) and compared the results with those by intravenous histamine bolus (n = 5) at three different positive end-expiratory pressure (PEEP) levels (2, 5, and 8 hPa) in open-chest and vagotomized rabbits. The percent increase ratio of RL (PIRR) and EL (PIRE) was defined as the change in RL and EL, respectively, induced by hypoxia compared with that in the normoxic condition, expressed as a percentage. PIR values for the change in RL and EL induced by bolus injection of histamine were also calculated. The PIRR and PIRE induced by hypoxia and by histamine were positive by a statistically significant amount at every PEEP level, except for the PIRE value at 8-hPa PEEP in the hypoxic challenge. The PIRE-to-PIRR ratio values in the hypoxic challenge at 2-hPa PEEP were significantly larger than those in the histamine challenge (hypoxia: 0.91 +/- 0.23%; histamine: 0.37 +/- 0. 065%, P < 0.05). The increase in EL induced by histamine in the acute phase has been reported to be mainly derived from tissue distortion secondary to bronchial constriction. Thus our results suggest that a part of the increase in EL by hypoxia was originated in different parenchymal responses from histamine and imply that this hypoxic response of lung parenchyma is sensitive to the increase in parenchymal tethering at high PEEP levels.

Airway Resistance↗
PubMed1999

Serum levels of soluble Fas and disease activity in patients with IgA nephropathy.

Using a sandwich ELISA, we studied 48 patients with IgA nephropathy and 10 patients with diffuse mesangial proliferative glomerulonephritis without IgA deposition (non-IgA PGN) to determine if levels of serum soluble Fas (s-Fas) might reflect the disease activity. The levels of serum s-Fas in patients with the advanced stage of IgA nephropathy were significantly higher than those in patients with the mild stage of the disease, in non-IgA PGN or in healthy controls. The results showed that advanced stage IgA nephropathy patients who showed heavy proteinuria and the presence of urinary casts revealed high levels of serum s-Fas. It was thus suggested that the measurement of serum s-Fas is useful in evaluating the degree of renal injury in patients with IgA nephropathy.

Adolescent↗
PubMed1999

Three-dimensional reconstruction system for imaging of the temporomandibular joint using magnetic resonance imaging.

This study was undertaken to develop a three-dimensional reconstruction system using magnetic resonance (MR) images in order to visualize three-dimensional images of the temporomandibular joint (TMJ) including the disk. The computerized reconstruction program (written using Visual Basic for Windows, Microsoft Corp.) could reliably generate three-dimensional images of the TMJ. Image processing techniques made the tracing of images unnecessary, reduced complex human manipulation and associated measurement errors. This system, capable of treating fifty thousand pixels or more, generates smooth three-dimensional images of the TMJ.

Data Display↗
PubMed1999

A new amyloidogenic transthyretin variant, [D38A], detected by electrospray ionization/mass spectrometry.

A new variant of transthyretin (TTR) was detected by mass spectrometry (MS) in a 63-year-old Japanese female patient suffering from amyloidosis. TTR was analyzed by 2-dimensional liquid chromatography coupled with electrospray ionization MS. Variant TTR showed extra peaks in addition to normal TTR peaks. The extra peaks were about 44 Da smaller than normal TTR peaks, and the abundance of variant peaks showed about 80% of the corresponding normal free and adduct peaks. Direct genomic DNA sequencing of TTR exon 2 showed both adenine and cytosine in the position corresponding to the second base of codon 38. This codes for a variant alanine (GCT) as well as the normal aspartic acid (GAT), indicating that the case is heterozygous for the substitution, [D38A].

Amyloid↗
PubMed1999

[Clinical experience of image-guided neurosurgery with a frameless navigation system (StealthStation)].

We have applied the frameless navigation system (StealthStation) to various neurosurgical procedures to examine its usefulness. The system consists of a UNIX based workstation that creates triplanar and 3-dimensional images; an infrared optical digitizer with camera array; a reference-light-emitting diode (LED) array (e.g., reference array); and pointer probe modified by the addition of LEDs. This system was used to assist in placing a minimal skin incision and craniotomy in 4 cases, to determine the tumor/brain interface in 2 cases, to target the subcortical lesion in one case, and to correlate bony structure with a skull base tumor in 3 cases. The combined use with magnetic source imaging of the somatosensory cortex allowed a fast orientation of eloquent areas in 2 cases with peri-Rolandic tumor. This system, thus, was proved to be a useful adjunct to open-tumor biopsy or resection.

Adult↗
PubMed1999

[Carbamazepine induced hyponatremia].

Carbamazepine (CBZ) is a drug which can induce the syndrome of inappropriate antidiuretic hormone (SIADH). Until 1980's, there were reports regarding CBZ-induced SIADH, but it is rarely reported these days. We here report two cases of CBZ-induced SIADH. Hyponatremia in these cases was rapidly improved by withdrawal of administration of CBZ. According to the previous reports, the rate of hyponatremia in patients receiving CBZ is not small. It ranges from 48% to 31%. As CBZ is frequently used for patients with epilepsy and neuralgia, not only their blood CBZ concentration but also their serum Na level should be monitored.

Adult↗
PubMed1999

[General anesthesia with propofol and fentanyl for adult cardiac surgery].

We employed propofol anesthesia with a restricted dose of fentanyl in adult cardiac surgery with the aim of early tracheal extubation and evaluated its effects on the intraoperative factors and postoperative recovery compared with those of a previous benzodiazepine-fentanyl regimen. During surgery, control group patients (n = 17) received intermittent bolus of benzodiazepines and fentanyl without restriction, whereas propofol group patients (n = 17) received continuous administration of propofol and the restricted dose of fentanyl (20 micrograms.kg-1). There were no significant differences in the times to eye opening (average 2.4 hr vs 1.6 hr, respectively, P = 0.30) and tracheal extubation (average 5.4 hr vs 4.0 hr, P = 0.25) between the groups. Both groups had similar postanesthetic circulatory status: cardiac index (average 3.6 l.min-1.m-2 vs 3.4 l.min-1.m-2, P = 0.46). The propofol group patients required smaller doses of vasodilators during cardiopulmonary bypass (average PGE1: 0.096 microgram.kg-1.min-1 vs 0.047 microgram.kg-1.min-1, P = 0.046, NTG: 0.69 microgram.kg-1.min-1 vs 0.31 microgram.kg-1.min-1, P = 0.009). It is suggested that propofol-based anesthesia could replace the previous regimen with no adverse hemodynamic effects and might have a potential to provide faster recovery and improve peripheral circulatory status in adult cardiac surgery.

Adult↗
PubMed1999

Macrophage infiltration and heme oxygenase-1 expression correlate with angiogenesis in human gliomas.

Macrophages are key participants in angiogenesis. In this study on human brain tumors, we first investigated whether macrophage infiltration is associated with angiogenesis and malignant histological appearance. Immunostaining of macrophages and small vessels in resected glioma specimens indicated that numbers of infiltrating macrophages and small vessel density were higher in glioblastomas than in astrocytomas or anaplastic astrocytomas. Macrophage infiltration was closely correlated with vascular density in human gliomas. Heme oxygenase-1 (HO-1), which is the rate-limiting enzyme in heme catabolism, was also associated with activated macrophages. Expression of mRNA encoding HO-1 was correlated with macrophage infiltration and vascular density in human glioma samples. Infiltrating macrophages were positively stained with anti-HO-1 antibody by immunohistochemical analysis, and in situ hybridization for HO-1 indicated that HO-1 was expressed in infiltrating macrophages in gliomas. HO-1 gene may be a useful marker for macrophage infiltration as well as neovascularization in human gliomas.

Adolescent↗
PubMed1999

[Surgical treatment for intractable epilepsy: update and future].

For successful surgical treatment of intractable epilepsy, identification of the epileptogenic area and functional cortex, by using the intracranial electrodes such as subdural and depth electrodes, is important. Since 1994, via chronic subdural electrodes recording, we performed anterior temporal lobectomy with hippocampectomy for 18 patients with temporal lobe epilepsy. For 10 patients with extratemporal lobe epilepsy, cortical resection of the epileptogenic cortex was performed. For the epileptogenic cortex overlapping with functional area, we added the multiple subpial transection. Favorable postoperative seizure outcome was obtained in most of the patients. Although non-invasive presurgical evaluation modalities such as MRI, video-EEG monitoring, MEG, and FDG-PET are useful in the diagnosis of epilepsy, it is impossible to localize precisely the exact epileptogenic zone and functional cortex.

Electrodes, Implanted↗
PubMed1999

[Usefulness of T2* weighted magnetic resonance image in the diagnosis of head injury on chronic stage].

T2* weighted gradient echo image has heightened diagnostic sensitivity to hemorrhage, which is attributed to magnetic susceptibility-induced static field inhomogeneities arising from paramagnetic blood breakdown products such as hemosiderin, which shorten T2*. We examined 4 cases of head injury in chronic stage by T2* weighted images and assessed the clinical application of this sequence for diagnosis of the intracranial lesion. All patients underwent CT scan on acute stage and long-term follow up was performed. In all cases, abnormally low signals in the brain and subarachnoid space were more conspicuous with the T2* weighted image than with any of the conventional sequences. In 2 cases with diffuse axonal injury, of which lesions were not detected on acute stage CT scan, hypointensity area was clearly demonstrated in the cerebral peduncle and corpus callosum on T2* weighted images. Selection of T2* weighted image into the routine MR examination of patients with chronic stage of the head injury is recommended.

Adult↗
PubMed1999

[Temporal lobe epilepsy associated with old intracerebral hemorrhage due to capillary telangiectasis in the temporal lobe: case report].

A case of 45-year-old female, who presented with temporal lobe epilepsy was reported. The patient was found to have old intracerebral hemorrhage due to capillary telangiectasis in the temporal lobe. On the intraoperative electrocorticography, frequent paroxysmal activities were recorded independently both on the medial and lateral aspects of the temporal lobe. Even after resection of the lateral temporal lobe, frequent paroxysmal discharges were noted on the hippocampus. Histologically, there are astrogliosis and hemosiderin deposits in the white matter around the telangiectasis and the old hematoma. It is postulated that the hippocampus gained secondary epileptogenicity.

Adult↗
PubMed1999

[Assessment of oxygen transport in individual splanchnic organs using critical oxygen extraction].

Vulnerability in individual organs under ischemic stress can be assessed by critical oxygen extraction (critical O2ER). We measured critical O2ER in the whole-body, total splanchnic organs, liver and gut using a biphasic regression model of the oxygen delivery-consumption relationship in 7 dogs subjected to hemorrhagic stress under 1% isoflurane anesthesia. The difference in critical O2ER between the whole-body and total splanchnic organs was not significant, while hepatic critical O2ER was significantly larger than that of the gut (P < 0.05), 89.7 +/- 2.4% (mean +/- SD) and 66.1 +/- 5.1%, respectively. This finding indicated that the liver functions well under ischemic conditions due to its excellent ability to extract oxygen. The anatomical character of the sinusoid and the microcirculatory improving effect of isoflurane may affect the ability of oxygen extraction of the liver. The critical threshold of hepatic venous oxygen saturation as a marker of hepatic oxygen imbalance was considered to be below 10%.

Anesthesia, Inhalation↗