ULTRASONIC WAVE DIAGNOSIS OF PELVIC TUMOURS.
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Biomedical subjects
Publications and source records attributed to M Ishihara.
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BACKGROUND: Double contrast magnetic resonance (MR) imaging using superparamagnetic iron oxide (SPIO) and gadolinium (Gd) is performed to detect and characterize focal liver lesions. However, this technique is a costly and lengthy process. The purpose of this study was to determine the usefulness of SPIO-enhanced MR imaging including SPIO-enhanced T1-weighted imaging in diagnosing focal liver lesions. METHODS: Eighty-four focal liver lesions were examined with a 1.5-T MR unit. Transverse precontrast T1- and T2-weighted images and SPIO (ferumoxides)-enhanced T1- and T2-weighted images were obtained, followed by Gd-enhanced T1 -weighted imaging. The Gd set (i.e., precontrast T1- and T2-weighted and delayed-phase gadolinium-enhanced T1-weighted images) and ferumoxides set (i.e., precontrast T1- and ferumoxides-enhanced T1- and T2-weighted images) were reviewed by two independent readers. RESULTS: More lesions were detected from the ferumoxides set than from the Gd set. Ferumoxides-enhanced T1-weighted imaging showed enhancement patterns of the lesions similar to those of delayed-phase Gd-enhanced T1-weighted imaging. The diagnoses of hepatic metastasis and cyst by the ferumoxides set were similar to those by the Gd set. However, a dynamic study may be inevitable for the diagnosis of hepatocellular carcinoma and hemangioma. CONCLUSION: The ferumoxides set was useful for the detection of focal hepatic lesions. Ferumoxides-enhanced T1-weighted imaging may replace delayed-phase gadolinium-enhanced T1-weighted imaging in the diagnosis of hepatic metastasis and cysts.
A sensitive radioimmunoassay for dexamethasone 17,21-dipropionate and its four metabolites in human plasma and urine has been developed using single anti-dexamethasone antiserum. The antiserum was obtained by immunizing rabbits with dexamethasone-3-oxime-bovine serum albumin conjugate. All of the endogenous steroids tested cross-reacted less than 0.07%. Before radioimmunoassay, dexamethasone 17,21-dipropionate and dexamethasone 17-propionate were hydrolyzed to dexamethasone, and 6 beta-OH-dexamethasone 17-propionate was hydrolyzed to 6 beta-OH-dexamethasone in 3% ammonia/methanol at 5 C for 16 h. A standard curve was established with a useful range between 0.005 and 2 ng in the case of dexamethasone, between 0.05 and 5 ng in the case of 6 beta-OH-dexamethasone. Measurement of plasma concentrations and percent urinary excretion of the metabolites in healthy men was performed following occlusive dressing of dexamethasone 17,21-dipropionate cream and ointment. The main metabolites in plasma were dexamethasone 17-propionate and dexamethasone, which increased gradually and reached maximum levels (160-200 pg/mL) at 24-32 h after application. The major metabolites observed in urine were 6 beta-OH-dexamethasone 17-propionate and 6 beta-OH-dexamethasone. Total percentage of their urinary excretions within 72 h after application amounted to 0.28-0.50% of the dose administered.
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Metallic artifacts of intravascular stents were assessed with MR angiography and contrast-enhanced spiral CT. Stainless steel showed less metal artifact than tantalum stent in CT. Metallic artifact in coronary and iliac arteries treated with tantalum stent was not remarkable in MR angiography. Contrast-enhanced CT might be preferable to assess patency of arteries treated with stainless steel stent. while MR angiography was useful in depicting intraluminal signal in tantalum stent.
HIV/AIDS coordinator nurses (CNs) are key professionals in ensuring the provision of quality health care to patients with HIV/AIDS and to their families. Through this case study, the functions of the HIV/AIDS CN in Japan were identified, and an initial model of the HIV/AIDS CN role was developed. Four categories of responsibility were identified: (a) assessment, (b) diagnosis of nursing problems, (c) coordination, and (d) other related nursing activities. The category of other nursing activities included four subcategories. These were (a) consultation, (b) patient education, (c) expansion of the patient's support network, and (d) administrative or office work. These categories and subcategories contribute to an understanding of the role of the HIV/AIDS CN.
Recent studies have suggested that the regulation of apoptosis during wound healing is important in scar establishment and the development of pathological scarring. In this study, we demonstrate that keloid fibroblasts can be identified as apoptotic cells because of their highly condensed chromatin and discrete nuclear fragments. To further reveal the phenomenon of apoptosis, we quantified the number of terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL)-positive cells in surgically resected tissues of keloids (N = 10), hypertrophic scars (N = 10), normal healed flat scars (N = 10), and dermatofibroma (N = 10). The number of TUNEL-positive cells was relatively low, but was significantly higher for the keloid group compared with the normally healed flat scar group (p = 0.004), suggesting reduced cell survival and increased apoptotic cell death in a subpopulation of keloid fibroblasts. Furthermore, the number of TUNEL-positive cells was significantly higher for the keloid group compared with the dermatofibroma group (p = 0.044), suggesting that a subpopulation of keloid fibroblasts may suppress tumorgenicity at a greater rate than dermatofibroma by undergoing cell death. Hypertrophic scars had significantly higher levels of apoptosis than normally healed flat scars (p = 0.033). Therefore, these results suggest that selected fibroblasts in keloids and hypertrophic scars undergo apoptosis, which may play a role in the process of pathological scarring.
Application of ultraviolet light irradiation to a photocrosslinkable chitosan aqueous solution resulted in an insoluble, flexible hydrogel like soft rubber within 60 seconds. In order to evaluate its accelerating effect on wound healing, full-thickness skin incisions were made on the backs of mice and subsequently a photocrosslinkable chitosan aqueous solution was added into the wound and irradiated with UV light for 90 seconds. Application of the chitosan hydrogel significantly induced wound contraction and accelerated wound closure and healing compared with the untreated controls. Histological examination also showed an advanced contraction rate on the first 2 days and tissue fill rate on days 2 to 4 in the chitosan hydrogel-treated wounds. Furthermore, in cell culture studies, chitosan hydrogel culture medium supplemented with 5% fetal-bovine serum was found to be chemoattractant for human dermal fibroblasts in an invasion chamber assay using filters coated with Matrigel and in a cell migration assay. Due to its ability to accelerate wound contraction and healing, chitosan hydrogel may become accepted as an occlusive dressing for wound management.
The purpose of this study is to develop a non-contact method to evaluate the heart and respiratory rates simultaneously using a single optical sensor which can be used without the removal of clothes before a decontamination procedure in biochemical hazards. We measured the heart and respiratory rates with and without clothes to assess the vital sign monitoring before decontamination. In order to monitor the heart and respiratory rates of rabbits simultaneously, the respiratory and cardiac peaks were separated using fast Fourier transform from a 5 mW helium-neon laser (wavelength 632.8 nm) reflected off the chest walls of rabbits. A cloth (50 mm x 50 mm, 2 mm thick) was placed on the chest of the rabbits to simulate the vital sign monitoring with clothes. The heart rate measured using this method agreed with the rate derived from an electrocardiogram (r = 0.82, p<0.05). The respiratory rate correlated with the manually measured respirator rate (r = 0.93, p<0.05). This method appears promising as a non-contact method for monitoring the heart and respiratory rates of patients under biochemically hazardous conditions.
To determine continuous body temperature distribution, an inexpensive temperature mapping system was developed using a deep body thermometer adopting the finite-element method. A stripe with 16 thermocouples was wrapped around the waist of rats to measure body surface temperatures (the boundary conditions). The abdominal deep temperature of the rats was measured from the dorsum using the thermal compensation probe of a deep body thermometer. The abdominal temperature of the rats was mapped by solving a heat conduction equation using surface and deep temperatures obtained in real time. The temperature measured with a thermocouple inserted into the abdominal centre of the rats correlated well with the calculated temperature (r = 0.93, p < 0.01). The system is low cost and simple to use compared with the magnetic resonance temperature mapping system. Our temperature mapping system could potentially result in improved management of patients in critical care medicine.
A continuous monitoring system was designed for detection of systemic inflammatory response syndrome (SIRS) using spectrum analyser and local temperature mapping system with deep body thermometer. This method demonstrated significant increases of heart and respiratory rates and deep body temperature from normal levels within 120 minutes after lipopolysaccharide administration in rats. Our monitoring system appears promising for clinical detection of SIRS in the early stages to prevent multiple organ failure.
In order to conduct non-contact estimation of arterial blood pH after massive haemorrhage, we calculated the arterial pH based on linear-regression analysis of exhaled gas concentrations (CO and CO2) and vital signs (heart rate, respiratory rate, and surface temperature) measured using non-contact methods in hypovolemic animals.
The preventive effect of argatroban, a synthetic thrombin inhibitor, on cerebral infarction was evaluated with ellagic acid (EA)-induced cerebral thromboembolism in rats. Platelet-rich thrombi containing fibrin and EA crystal were formed in the microarteries in the affected hemisphere by the injection of EA suspension into the cerebral arteries. The mortality in saline control was over 80% 6 h after the EA injection. Argatroban decreased the mortality to 0% at a dose of 3 mg/kg/h, and significantly reduced the ischemic area in the affected cerebral hemisphere. Heparin also decreased the mortality to 30% at a dose of 600 U/kg/h, but marked bleeding was observed at the incised wound. These findings suggest that argatroban is a more effective and safer anticoagulant than heparin for the prevention of ischemic damage on cerebral thrombosis.
The correlation between diabetic retinopathy and blood pressure was analyzed in 742 type II diabetic patients. Systolic and pulse blood pressures were significantly higher in the patients with retinopathy than in those without (mean systolic pressure 142 vs. 139 mmHg, P less than .01; mean pulse pressure 60.5 vs. 56.4 mmHg, P less than .001). There was no difference in the diastolic blood pressure between these two groups. The correlation between blood pressure and the components of retinopathy (including microaneurysms, hemorrhages, and exudates) was also analyzed. Even when the patient with microaneurysms or dot hemorrhages, blot hemorrhages, or hard or soft exudates were separately evaluated, systolic and pulse blood pressures were higher in those with one of these diabetic changes than in patients without them. To avoid the influence of nephropathy, the patients were divided into nonproteinuric or proteinuric groups. In the nonproteinuric group, pulse blood pressure was higher in patients with retinopathy than in those without. In the proteinuric group, systolic blood pressure was also higher in patients with retinopathy than in those without. However, these observed differences in blood pressure were slight after the division of the patients. With respect to the components of retinopathy, systolic and pulse blood pressures were significantly higher in the patient with blot hemorrhages than in those without in both nonproteinuric and proteinuric groups (nonproteinuric: systolic pressure 142 vs. 137 mmHg, P less than .005, and pulse pressure 60.4 vs. 55.5 mmHg, P less than .001; proteinuric: systolic pressure 155 vs. 146 mmHg, P less than 0.01, and pulse pressure 69.0 vs. 63.5 mmHg, P less than .05).
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The relationship between diabetic complications and age, sex, duration, mode of therapy, body weight, control of blood glucose, blood pressure, and serum triglyceride and cholesterol was analyzed in a population with non-insulin-dependent diabetes in Japan. The prevalences of complications in the subjects varied from 6.5% for cerebrovascular strokes to 85.1% for sclerotic changes in retinal vessels; 35.8% of the patients had diabetic retinopathy and 19.8% had proteinuria. Univariate and multivariate analyses revealed that control of diabetes (blood glucose, mode of therapy, and duration) was closely correlated with retinopathy and proteinuria. However, blood glucose did not correlate with coronary insufficiency or cerebrovascular strokes. These macrovascular complications were related to aging and blood pressure. The data suggested that not only good glycemic control but also sufficient antihypertensive therapy was necessary for treating diabetic patients. The coefficient of determination of the risk factors was calculated for each diabetic complication. Except for sclerotic changes in retinal vessels, the coefficients were too small to fully explain the development of diabetic complications, especially for macrovascular diseases. The current data suggest that susceptibility of the individual patients to the diabetic complications is an important determinant.
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