Endoscopic retrograde extraction of common bile duct stones with drip infusion of isosorbide dinitrate.
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Catheterization↗
Biomedical subjects
M Kudo
Publications and source records attributed to M Kudo.
Proliferation patterns of dorsal root ganglion neurons of cutaneous, muscle and visceral nerves in the rat.
In a previous study we provided evidence that dorsal root ganglion (DRG) neurons of different phenotypes have different birthdates. The present study aimed at determining if birthdates of DRG neurons are related to different types of peripheral nerves, namely cutaneous versus muscle, and somatic versus visceral. Pregnant rats were injected intraperitoneally with bromodeoxyuridine (BrdU) to label the neurons on one of the embryonic days E12-E16. When the progeny rats reached adulthood, a mixture of 1% B-fragment of cholera toxin and 1% isolectin B4 from Griffonia simplicifolia I was injected into the peripheral nerves, or a 5% Fluoro-Gold solution was applied to the transected end of the nerves. The saphenous and sural nerves were used as cutaneous nerves, the gastrocnemius nerve as a muscle nerve, the intercostal nerves T9-11 as somatic nerves and the greater splanchnic nerve as a visceral nerve. Cell size measurements were made of DRG neurons labeled from the two cutaneous nerves and the muscle nerve, as well as of neurons of the saphenous and gastrocnemius nerves labeled by BrdU at different embryonic stages. Most of the DRG neurons of the muscle and intercostal nerves were generated early, with peaks at E13, and those of the cutaneous and visceral afferent nerves later, with peaks at E14. The temporal differences were reflected in the cell size spectrum, the muscle nerve having a greater proportion of large neurons compared to the cutaneous nerves. The findings add to previous knowledge regarding the sequence of development of different DRG phenotypes.
Age Factors↗
Hepatic angiomyolipoma pre-operatively diagnosed by imaging.
An asymptomatic patient with pre-operatively diagnosed solitary angiomyolipoma is reported. The tumour was a well defined, fat density mass on computerized tomography (CT) and magnetic resonance imaging (MRI), and a hyperechoic nodule with a sharp margin on ultrasonography (US). The lesion was hypervascular on arteriography and CT during hepatic angiography. Chemical shift MRI confirmed the fat component within the lesion. Although a review of the literature shows this tumour to be rare and difficult to differentiate from a malignant lesion pre-operatively, the pre-operative diagnosis of angiomyolipoma is considered feasible when the characteristic findings as described here are present.
Angiomyolipoma↗
A systematic nerve-sparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function.
The objective of this study is to describe a technique for preserving the autonomic nerve systematically, including the hypogastric nerves, pelvic splanchnic nerves, and pelvic plexus and its vesical branches, based on anatomic considerations for the autonomic nerves innervating the urinary bladder, in radical hysterectomies and to assess postsurgical bladder function. A nerve-sparing radical hysterectomy was carried out on 27 consecutive patients with uterine cervical cancer treated between 2000 and 2002. The FIGO stages of the disease consisted of 10 stage Ib1, 6 stage Ib2, 3 stage IIa, and 8 stage IIb. The nerve-sparing procedure was successfully completed in 22 of the 27 patients (81.5%) in the study. At 1 year after the operation, bladder symptoms were significantly improved in the nerve-sparing group compared to the non-nerve-sparing group. Urinary incontinence and abnormal (diminished) bladder sensation were observed in three of the five patients (two patients had both symptoms), for whom the nerve-sparing procedure could not be performed, but none of the 22 patients for whom the nerve-sparing procedure was performed had incontinence, and only two patients had abnormal (increased) bladder sensation (P= 0.0034 for incontinence and P= 0.030 for abnormal bladder sensation). The patients' survival was not adversely affected by the nerve-sparing procedure. Although it is still preliminary, the surgical technique described in this report is thought to be effective for preserving bladder function, and thus, the quality of life could be improved for patients with cervical cancer who are treated with a radical hysterectomy. For further evaluation of the efficacy of nerve-sparing radical hysterectomy, a prospective randomized trial needs to be performed.
Adenocarcinoma↗
Urodynamic study on postsurgical bladder function in cervical cancer treated with systematic nerve-sparing radical hysterectomy.
The objective of this study was to assess the postsurgical bladder function by urodynamic study in patients with cervical cancer treated with nerve-sparing radical hysterectomy. A total of 27 consecutive patients were included in the study. Of the 27 patients, autonomic nerves had been completely preserved at least on one side in 22 patients (group A), and autonomic nerves could not be successfully preserved in five patients (group B). In group A, there was no significant difference in compliance at the moment of strong desire to void, maximum flow rate, and residual urine volume between before the operation and at 12 months after the operation. However, abdominal pressure at maximum flow had significantly increased in patients of group B than of group A. Detrusor contraction pressure at maximum flow had significantly decreased in patients of group B than of group A. Bladder sensation was diminished in three cases (60%) of group B but preserved in all the patients of group A. Although it is still preliminary, our surgical technique described in this report is thought to be effective for preservation of bladder function. For further evaluation of the efficacy of nerve-sparing radical hysterectomy in terms of quality of life and survival of patients, a prospective randomized trial needs to be performed.
Adult↗
Cytologic features of pleural effusion in apocrine sweat gland carcinoma. A case report.
BACKGROUND: Carcinoma arising in the apocrine sweat glands is very rare, and there are few reports of the cytologic features. We encountered a case of metastatic apocrine carcinoma in a pleural effusion. CASE: A 46-year-old male had a dark reddish nodule in the right axillary region that was diagnosed as apocrine carcinoma of skin appendage origin. Three years after wide resection and chemotherapy, widespread metastases developed with a massive pleural effusion. Needle aspiration fluid cytology contained clusters of adenocarcinoma. Some tumor cells had abundant cytoplasm or periodic acid-Schiff-positive, coarse granules. Decapitation secretion was occasionally found on the cell surface. Immunohistochemically, the tumor cells were often positive for BRST-2 and BRST-3. CONCLUSION: Cytologic features of metastatic apocrine sweat gland carcinoma show some characteristics of adenocarcinoma. Moreover, its definitive diagnosis in a pleural effusion can be made because of retaining the characteristics of apocrine sweat gland.
Apocrine Glands↗
Scratch cytologic findings on surgically resected solitary fibrous tumors of the pleura.
OBJECTIVE: To ascertain the cytologic characteristics of solitary fibrous tumors of the pleura (SFTPs) on smear preparations. STUDY DESIGN: Fine needle aspiration cytology (FNAC) was initially attempted preoperatively in five cases, but the specimens were inappropriate for interpretation because only a few tumor cells were obtained. Therefore, scratch smears made at the time of operation were used. Papanicolaou and immunocytochemical staining was performed in all 10 cases, 2 of which were malignant. RESULTS: As expected, cellular tumors yielded more cells. The cytologic appearance was variable, showing spindle/bipolar, dendritic/stellate and intermediate cells. Atypical cells reminiscent of sarcoma were also present in cellular, benign tumors. Highly atypical epithelioid cells were obtained in two malignant cases. Immunocytochemically, the tumor cells were positive for CD34 and vimentin and negative for cytokeratin, regardless of histologic differences and cell shape. CONCLUSION: It seems difficult to diagnose SFTPs with certainty by FNAC, partly because the cell morphology of SFTPs resembles a wide variety of heterogeneous groups of spindle cell tumors and partly because only a few tumor cells were available in the FNAC specimens in the present study. However, a cytologic diagnosis of SFTP is possible if cytologic preparations yield CD34-positive cells with spindle/bipolar or dendritic/stellate morphology.
Adult↗
Imprint cytologic features of intracytoplasmic lumina in ependymoma. A report of two cases.
BACKGROUND: Intracytoplasmic lumina have been recently recognized as a characteristic histologic feature of ependymoma. However, the cytologic diagnostic usefulness has not been discussed. We encountered two imprint cytology cases of spinal cord ependymomas in which there were intracytoplasmic lumina in the tumor cells. CASES: Two women had spinal cord tumors on magnetic resonance imaging. Imprint cytology study was carried out on the resected tumors. The cytologic specimen of the first case, aged 52, showed tumor clusters consisting of elongated epithelioid cells, a few of which also had intracytoplasmic lumina. Histologically, tumor cells formed ependymal rosettes and pseudoperivascular rosettes. There were a few tumor cells with intracytoplasmic lumina. The cytologic specimen of the second patient, aged 37, had scattered and isolated tumor cells with intracytoplasmic lumina resembling signet-ring cells and paired tumor cells forming small, glandlike structures. Histologically, the tumor was composed mainly of signet-ring-like cells containing intracytoplasmic lumina. CONCLUSION: Intracytoplasmic lumina were observed in the imprint cytologic specimens of spinal cord ependymoma. The diagnosis of ependymomas can be made cytologically when intracytoplasmic lumina are found since no other primary neuroepithelial tumors of the central nervous system possess such a characteristic feature.
Adult↗
An animal model of cerebral infarction. Homologous blood clot emboli in rats.
An experimental model of cerebral infarction is created in rats by intracarotid injection of their homologous blood clots. This is the first small animal model in which embolization was achieved by homologous blood clots. The infarcts were produced predominantly in the territory of the middle cerebral artery. The low mortality rate and excellent reproduction rate make possible the correlative study of morphological, biochemical, and metabolic parameters at selected points in time to reconstruct the pathogenesis and natural history of focal cerebral ischemia and its relation to blood elements.
Animals↗
Two cases of histopathologically advanced (stage IV) early gastric cancers.
We report two cases of early gastric cancer with distant metastases (stage IV). At our institute 1428 cases of primary gastric cancer were resected between 1980 and 1997; 536 were diagnosed as early gastric cancer based on the resected specimens (304 cases of mucosal cancer, Tis--TNM classification--and 232 of submucosal cancer, T1). 528 of these 536 cases were classified as histological stage I, six as stage II, none as stage III and two as stage IV. The incidence of stage IV early gastric cancer was 0.14% of all gastric cancers and 0.37% of the early gastric cancers. The two patients with stage IV early gastric cancer were women. Both tumors were defined as early cancer because they were confined to the submucosa. One was a type 0 IIc + III early cancer, histologically classifiable as a small, moderately differentiated adenocarcinoma (tub2 according to the Japanese Classification of Gastric Carcinoma, G2; TNM classification: ICD-O C16), size 10 x 8 mm; the other was a surface spreading type 0 IIc, classifiable as a signet-ring cell carcinoma (sig, G3), size 50 x 35 mm. Stage IV factors were N3 in the first and ovarian metastasis (Krukenberg tumor) in the second case.
Adenocarcinoma↗
The effects of combination therapy with niceritrol and pravastatin on hyperlipidaemia.
In the present study, we evaluated the effects of combination therapy with niceritrol and pravastatin in patients with hyperlipidaemia. A total of 62 patients with hyperlipidaemia, defined as total cholesterol levels above 220 mg/dl or triglyceride levels above 150 mg/dl, were recruited. Patients were divided into two groups: Group N received initial therapy with niceritrol 750-1500 mg/day, and those in Group P, pravastatin 10 mg/day. After 8 weeks, pravastatin 10 mg/day was added to the Group N treatment regimen for a further 8 weeks, while patients in Group P were given niceritrol 750-1500 mg/day in addition to pravastatin for 8 weeks. After the 8-week combination therapy study period, total cholesterol levels were 209.6 mg/dl in Group N and 220.7 mg/dl in Group P. Decreased triglyceride and lipoprotein(a) levels and increased high-density lipoprotein cholesterol levels, neither of which were achieved by pravastatin administration alone, were achieved with the combination of pravastatin and niceritrol. We conclude that when a single lipid-lowering drug fails to show therapeutic value, attempting combination therapy with a nicotinic acid preparation and a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) is worthwhile.
Cholesterol↗
Pitfalls in the interpretation of multidetector-row helical CT images at window width and level setting for lung parenchyma.
This article describes pitfalls in the interpretation of multidetector-row helical CT (MDCT) images at the window width and level settings for lung parenchyma. On MDCT, linear artifacts, which look like black and white linear densities and are called "hurricane artifacts," radiate out from objects that have very different densities from their neighbors. For the evaluation of fine parenchymal details, a low table speed/slice collimation should be used. In fact, axial (step and shoot) scanning may be more effective for the evaluation of fine details. Since artifacts from vessels highly enhanced by contrast medium cause data blackout in the surrounding areas at high table speed/slice collimation, pulmonary parenchyma in such situations should be evaluated with unenhanced CT. Although multidetector-row helical CT is a promising tool for the evaluation of lung parenchyma, it is important to identify its shortcomings due to artifacts when interpreting images at the window width and level settings for lung parenchyma and to apply the appropriate methods for eliminating such artifacts.
Artifacts↗
Evaluation of image quality and spatial resolution of low-dose high-pitch multidetector-row helical high-resolution CT in 11 autopsy lungs and a wire phantom.
PURPOSE: The aim of this study was to evaluate whether low-dose high-pitch (6:1) multidetector-row helical high-resolution CT is appropriate for the evaluation of various pulmonary abnormalities, including faint opacities. METHODS: Eleven autopsy lungs were scanned with a multidetector-row CT scanner using 2.5 mm x 4 beam collimation, effective slice thickness 3 mm, 6:1 pitch, 0.8 second gantry rotation speed, 20 cm Display FOV, high spatial frequency (bone) algorithm, and various radiation doses (120 kVp; 160, 80, 40, 24, and 8 mAs). The image quality of each CT set was assessed as adequate or inadequate for diagnosis by two independent observers. In addition, a wire phantom was scanned with the same parameters in order to describe the MTF curves. RESULTS: There was excellent agreement between the observers for the evaluation of image quality (kappa statistic, 0.84). The ratio of images evaluated as inadequate for 8 mAs and 24 mAs was significantly higher than that for 160, 80, and 40 mAs (p<0.01: chi-square test). MTF curves of both 8 and 24 mAs were significantly inferior to those of 40, 80, and 160 mAs (p<0.0 1, Friedman test), while the MTF curve of 40 mAs was relatively inferior to that of 160 mAs (p<0.05, Friedman test). CONCLUSION: More than 40 mAs in combination with 120 kVp is preferable for the evaluation of details of lung parenchyma by high-pitch. multidetector-row helical high-resolution CT.
Autopsy↗
Multiple primary left ventricular myxomas with multiple intraventricular recurrences.
A 23-year-old male was operated on for two primary left ventricular myxomas of the "complex" type. Ten months later, abnormal echo reappeared and reoperation was carried out to excise 2 recurrent myxomas in the left ventricle. Multiple foci were most likely responsible for the recurrence. No recurrence has been detected for 20 months postoperatively. This may be the first reported case of multiple primary left ventricular myxoma with multiple recurrences in the left ventricular cavity.
Adult↗
Reticulin fiber staining of crush preparations for the rapid differentiation between schwannomas and meningiomas.
The use of reticulin fiber staining of cytologic crush preparations for the rapid differentiation of schwannomas and meningiomas of the cerebellopontine angle was studied. As in paraffin-embedded sections, the reticulin stain demonstrated distinctly different patterns in the two types of tumors. Schwannomas showed extremely numerous, uniformly delicate straight fibers in a streaming or interlacing pattern in cellular areas and less dense, more wavy or curly fibers in degenerative areas. Fibroblastic meningiomas showed a few loose fibers of variable thickness in a root-like tangle while meningotheliomatous meningiomas showed no fibers, except in areas of fibrovascular stroma; both types showed small scattered round structures made up of reticulin fibers. These findings suggest that reticulin staining of crush preparations should be performed as an adjunct to routine cytologic staining of crush preparations and the study of frozen sections in making the intraoperative diagnosis of these tumors.
Cerebellar Neoplasms↗
Plasma levels of endotoxin and anaphylatoxin in patients with multiple organ failure.
Plasma concentrations of endotoxin and anaphylatoxins were studied inpatients with multiple organ failure (MOF). Thirty one blood samples from nine patients with MOF and twenty samples from preoperative patients as control were determined. The average plasma concentration of endotoxin was 188.7 +/- 37.0 pg-ml-1 (Mean + S.E.) in MOF patients and 12.4 +/- 3.3 pg.ml-1 in control patients (p less than 0.05). Plasma anaphylatoxin (C3a, C5a) levels increased significantly and C4 level decreased in MOF patients as compared with those in control patients. However, no significant correlation was found between plasma endotoxin and anaphylatoxin levels. Endotoxin does not seem to be a major factor in activating of the complement system in patients with MOF.
Adult↗
[Development of a neuropathological state in senile dementia of leprosy--an autopsy case of an aged patient with Tn type].
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Aged↗
Peri-implant tissue reaction in bone irradiated the fifth day after implantation in rabbits: histologic and histomorphometric measurements.
To evaluate tissue reaction to cobalt 60 irradiation around implant materials used in maxillofacial surgery, 2.0-mm titanium alloy bone screws and 2.0-mm cylindrical solid hydroxyapatite implants were placed in mandibular bone of rabbits and irradiated with a single 15-Gy dose on the fifth postoperative day. Tissue reaction around the implants was examined histologically and histomorphometrically at 7, 14, 28 and 56 days after irradiation. Mature bone was relatively radioresistant, but newly formed bone around both implants was damaged by irradiation in several places. After irradiation, the beginning of bone formation was delayed and the amount of new bone formed was less. Bone-implant contact measured histomorphometrically was less in the irradiated group than in the nonirradiated group. All titanium alloy screws showed bone contact, but two of eight hydroxyapatite implants failed after irradiation, probably the result of loss of primary stability of the cylindrical implants caused by radiation damage to newly formed bone.
Alloys↗