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Biomedical subjects

M Maruyama

Publications and source records attributed to M Maruyama.

At least 163 records · Page 9Linked to original sources
PubMed1997

In vivo properties of an intramedullary hydroxyapatite plug to improve femoral stem fixation.

An intramedullary hydroxyapatite (HA) plug was inserted in each tibia of five rabbits. Histological observation showed the presence of newly formed bone tissue bridging between the inner cortex and the HA plug at 3 months postoperatively. This new bone was in direct contact with the HA plug, and there was no fibrous tissue intervention. Based on these results, the HA plug was used in a hip hemiarthroplasty with bone cement. The radiograph taken 4 years postoperatively showed that the plug-bone interface was indistinct, and some of the plug's edges became rounded by replacement with newly developed bone. The femoral component was stable without subsidence. The HA plug stabilized by bone ingrowth in the femoral canal would certainly be useful to prevent the femoral component from subsiding, in addition to increasing the cement-bone interface pressure at the time of surgery.

Aged↗
PubMed1997

Tibial tubercle osteotomy in revision total knee arthroplasty.

In revision total knee arthroplasty, osteotomy of the tibial tubercle provided satisfactory exposure to extract the broken tibial metal tray with rigidly fixed stem easily and safely. Three patients (three knees) underwent this osteotomy and were followed for a minimum of 2 years (range 2 years and 2 months to 2 years and 8 months). All of the osteotomies had healed within 6 months postoperatively. There were no complications related to the surgical technique.

Aged↗
PubMed1997

Postoperative outcome of insufficient surgery for small differentiated thyroid carcinoma.

We performed conservative surgery for small differentiated thyroid carcinoma, but also inadvertently carried out minimal insufficient surgery, such as enucleation (Ex) or partial lobectomy (pLx) without regional node dissection for malignant thyroid nodules. In this study, the long-term postoperative outcome after such insufficient surgical treatment was evaluated. Of 348 patients with differentiated thyroid carcinoma who underwent initial surgery between 1953 and 1976, 84 underwent either Ex or pLx and their records are herein reviewed. The frequency of recurrence from the remnant gland or regional lymph nodes was examined in relation to the tumor diameter (< or = 1.0 cm, tis; 1.0 cm-2.0 cm, t1; > 2.0 cm, t2). After Ex/pLx, the recurrence rate in the tis group was 13.3% and not significantly different from that (13.6%) in the t1 group. The recurrence rate was notably increased in the t2 group. Moreover, there was no significant difference between the recurrence rate in the tis and t1 groups after Ex/pLx and that after lobectomy with nodal dissection. These results suggest that a reoperative procedure with a more extensive thyroidectomy and neck dissection might not necessarily be required immediately after minimal insufficient surgery is inadvertently carried out in patients with small differentiated thyroid carcinoma measuring 2.0 cm in diameter or less.

Adolescent↗
PubMed1997

Significance of Helicobacter pylori infection as a risk factor in gastric cancer: serological and histological studies.

We conducted a case-control study to examine the association of Helicobacter pylori infection as a risk factor in gastric cancer in the Japanese population. Serum IgG antibodies for Helicobacter pylori were determined in 55 consecutive patients with gastric cancer and in 75 age- and sex-matched mass survey subjects and 57 age- and sex-matched cancer-free patients with conditions considered at a high risk for development of gastric cancer (precancerous condition). We examined the histology in all subjects and particular focus was placed on the extent of Helicobacter pylori-associated gastritis. The seroprevalence of Helicobacter pylori in gastric cancer patients (82%) and those with a precancerous condition (89%) was significantly higher (P < 0.005) than that in the mass survey subjects (60%). Positive relative risk associations were found for patients with gastric cancer (odds ratio, 3, with 95% confidence intervals of 1.69-5.33) and those with a precancerous condition (odds ratio, 5.66, with 95% confidence intervals 2.66-12.03). Significant differences were found when comparisons were made among the case-control groups who were H. pylori-positive and had inflammatory cell infiltration (P = 0.0127). The characteristics of Helicobacter pylori in histologically examined gastric mucosa showed differences between Helicobacter pylori-infected and uninfected persons in all groups. However, for none of these groups was there a significant differences between background mucosa for Helicobacter pylori-infected persons with or without gastric cancer. Helicobacter pylori seroprevalence is strongly associated with an increased risk of gastric cancer and with a precancerous condition; histological investigation did not define additional factors that might be associated with increased cancer risk.

Adult↗
PubMed1997

Geographic variation in mortality among individuals with youth-onset diabetes mellitus across the world. DERI Mortality Study Group. Diabetes Epidemiology Research International.

The aim of this study was to evaluate the geographic variation in mortality among individuals with youth-onset insulin-dependent diabetes mellitus (IDDM) across the world. The study was based on the currently available IDDM incidence and mortality data. Mortality data for diabetes in the 0-24 year age group were obtained from the World Health Organization (WHO) statistics. The mortality rates were adjusted for the frequency of occurrence of IDDM and dividing the mortality rates by the IDDM incidence rates which were obtained from the WHO DiaMond project. There was a more than 10-fold geographic variation in mortality between the developed countries and Eastern European populations. The areas with the highest mortality rates were located in Japan, Eastern Europe and Russia. The areas having the best outcome associated with IDDM were Northern Europe, Central Europe, and Canada. An ecological study demonstrated a relationship between the incidence-adjusted mortality (estimated case-fatality) with IDDM incidence itself (Spearman's correlation coefficient = 0.45) as well as infant mortality and life expectancy at birth. These data demonstrated the possibility of an enormous geographic variation in mortality of youth-onset diabetic patients even in developed countries. It is important to note that these excess deaths are potentially preventable. The ecological study also suggested that the mortality differences may be in part related to overall and diabetes related care.

Adolescent↗
PubMed1997

Understanding the thyrotropin receptor function-structure relationship.

The thyrotropin (TSH) receptor (TSHR) is a key protein in the control of thyroid function and a major thyroid autoantigen. Recently, molecular cloning of the receptor has been carried out and we now review the impact of this work on our understanding of the physiology and pathophysiology of the TSHR. Analysis of recombinant TSHR proteins expressed in prokaryotic and eukaryotic systems has indicated that post-translational processing is important for the formation of active receptors. Studies of TSHR glycosylation have shown that a 'mature' form of the receptor containing mainly complex-type sugar residues is principally involved in TSH and TSHR autoantibody (TRAb) binding. In addition, the processing of the TSHR peptide chain into two subunits observed with native TSHR has been confirmed using recombinant TSHR. However, despite considerable efforts in many laboratories, the binding site(s) for TSH and TRAb on the TSHR have not been well characterized as yet and lessons learned from the discovery of naturally occurring amino acid mutations of the TSHR confirm the complexity of the hormone and autoantibody binding sites. Future progress in producing large amounts of pure TSHR as well as monoclonal TRAbs, followed by crystallographic analysis of TSHR-TSH complexes and TSHR-TRAb complexes, should be helpful in providing a better insight into the relationship between TSHR structure and function.

Animals↗
PubMed1997

[Usefulness of 7 day therapy with cefluprenam in the management of respiratory tract infections].

Efficacy and safety of a newer injectable cephalosporin, cefluprenam (CFLP) on cases with bacterial pneumonia and chronic respiratory tract infections were evaluated at a dose of 1g (potency), d.i.d for 7 days. 1. Of 130 cases in total, 116 cases were enrolled for the clinical efficacy evaluation. The efficacy rate (excellent and good responses) was 94.8% (110/116). The efficacy rate was 93.8% (60/64) for cases with bacterial pneumonia, and 96.2% (50/52) for cases with chronic respiratory tract infections. The recurrence was noted in 1.2% (1/82). The bacteriological response rate was 100.0% (32/32) for gram positive cocci, 93.8% (15/16) for gram negative rods and 97.9% (47/48) in total. 2. Adverse drug reactions were noted in 3.9% (5/129), consisting of 2 cases with skin rash, 1 case with drug fever, 1 case with skin rash and skin itching and 1 case with drug fever and headache. The abnormal laboratory changes were noted in 23.6% (30/127), mainly containing the elevation in GPT and GOT, and eosinophylia. The safety rate (no problem evaluation) was 74.8% (95/127). 3. The usefulness rate (very useful and useful evaluations) was 93.1% (108/116). As suggested by the evaluation on the secondary endpoint in the phase III comparative studies with both bacterial pneumonia and chronic respiratory tract infections, it was confirmed that the 7 day therapy of CFLP was promising for treatment of moderate bacterial pneumonia and chronic respiratory tract infections, because the high clinical efficacy was obtained and also the incidence of allergic reactions with CFLP was almost the same as that of ceftazidime (CAZ) evaluated highly safe. Based on these results, it was concluded that CFLP was useful in the management of moderate respiratory tract infections and also the recommended therapeutic period with CFLP was within 7 days.

Adult↗
PubMed1997

Detection of interleukin-1 beta in sera and colostrum of dairy cattle and in sera of neonates.

In order to obtain basic information about bovine interleukin-1 (IL-1 beta), levels of IL-1 beta in sera and milk of clinically normal mature Holstein cattle before and after parturition and in sera of newborn calves were examined by ELISA. The level of IL-1 beta was undetectable in sera of mature cattle around the time of artificial insemination, but the concentration gradually increased and reached a peak at parturition and then decreased again to an undetectable level. IL-1 beta in milk was detected on the day of parturition but not thereafter. IL-1 beta mRNA was detected by reverse transcription-polymerase chain reaction in the cells from milk collected during 20 days before and 2 to 3 days after parturition, but was not detected thereafter. Although IL-1 beta was not detected in all the sera of newborn calves, the concentration transiently increased with peak titers on day 3 and became undetectable by day 14 after birth. Newborns that showed serum IL-1 beta on day 3 had been fed on colostrum in which the IL-1 beta concentration was significantly higher than that in colostrum that had been fed to newborns having no detectable IL-1 beta on day 3. These results indicate that IL-1 beta is induced in association with pregnancy in healthy dairy cattle and that the cytokine might be transferred to neonates via colostrum.

Amino Acid Sequence↗
PubMed1997

Molecular typing of methicillin-resistant Staphylococcus aureus by polymerase chain reaction: distribution of the typed strains in hospitals.

Three methods for molecular typing of methicillin-resistant Staphylococcus aureus using polymerase chain reaction (PCR) were compared. The method which amplified the variable number of tandem repeat of dru sequences grouped the isolates into six types. Whereas, the method examining restriction fragment length polymorphism of coagulase gene and the method using arbitrarily primed-PCR showed poor diversity in typing. We investigated the distribution of dru types in two hospitals. Obvious concentration of a type in one ward was not recognized in our hospital. In the other hospital, a rare type was detected from the inpatients in the pediatrics ward. It suggested that the infection was an epidemic. We also found that some patients were infected with more than two strains. Even if two isolates show the same type, it does not necessarily mean that they originated from one clone. However, this method brings meaningful information on nosocomial infection, more easily than other genotyping.

Bacterial Typing Techniques↗
PubMed1997

A remarkable improvement of clinical manifestations in a breast cancer patient with widespread bone metastases after administration of pamidronate.

A breast cancer patient with bone metastases showed a marked response to treatment with a bisphosphonate, an inhibitor of osteoclastic bone resorption. The patient was admitted to our hospital with hypercalcemia, widespread bone metastases and severe disseminated intravascular coagulation (DIC). We treated her conservatively with pamidronate and gabexate mesilate, because the patient had refused any anti-cancer chemotherapy. She showed marked improvement in performance status, hypercalcemia, DIC and tumor markers, whereas splenomegaly due to metastasis progressed. These results suggest that pamidronate has the potential to suppress metastatic tumor growth selectively in bone.

Antineoplastic Agents↗
PubMed1997

Epidemiologic survey of Blastocystis hominis infection in Japan.

The incidence of Blastocystis hominis in a healthy population was determined by fecal examination of 6,422 Japanese and 54 resident non-Japanese who visited the St. Luke's International Hospital Health Screening Center for a routine medical check-up during a one-year period. Of the enrolled subjects, 30 Japanese (0.5%) and four non-Japanese (7.4%) had B. hominis in their stools. These individuals were asymptomatic except for one who reported flatus and one who reported mild abdominal discomfort. Statistical analysis indicated that the prevalence in the Japanese was lower than in the non-Japanese, and lower than the prevalence reported for other countries. Colonoscopic observations on seven B. hominis-positive individuals did not reveal pathogenic intestinal lesions. Several months after the first examination, 23 of the B. hominis-positive individuals, including three non-Japanese, were re-examined. Although they had not been treated with anti-B. hominis drugs, 10 individuals were now B. hominis-negative (by stool examination) and eight were passing fewer organisms. The remaining five individuals were still discharging large numbers of B. hominis. These B. hominis-positive individuals had no reported symptoms despite passing numerous organisms. Therefore, it seems that infection with B. hominis rarely gives rise to clinical symptoms. In no instance was invasion of host tissues by the organisms detected.

Adult↗
PubMed1997

[The distribution and the characteristics in computed tomography (CT) of the lungs in primary Mycobacterium avium complex (MAC) infection].

We investigated the distribution and the characteristics of the lung lesions of patients with primary Mycobacterium avium complex (MAC) infections mainly by computed tomography (CT). They admitted to our hospital during the period from 1984 to 1995 and none of them had a medical history of tuberculosis or other lung diseases. The subjects consisted of fifty patients: fourteen male (average age +/- SD was 66.4 +/- 14.0 year old) and thirty six female (69.0 +/- 11.9 year old). Of 50 patients 24 were M. intracellulare infection, 10 were M. avium infection and others were not identified. First, by using the ratio of slices with lesions on CT to all CT slices from the apex to the base of the lungs, all the patients were divided into two groups; a slight group with less than 15.0% (n = 19) and a severe group with 15.0% or more (n = 31). Next, the density of abnormal shadows in each segment as divided into 5 grades; none (-), minimal (+/-), slight (+), moderate (+2) and severe (+3). The grading was done by taking into account the grade of distribution, density of lesions and destruction of lung parenchym found mainly on CT, and in addition by a standard roentogenographic and tomographic features supplemental. The characteristics frequently observed findings on CT in primary MAC infection patients were nodular (94%), cavitary (74%), bronchiectatic (62%), infiltrative (74%), atelectatic (56%), and pleural-thickened (36%) shadows. Comparing the incidence of segmental lesions in MAC infection patients by segment, it was higher in right and in left lung, but the difference was statistically not significant. As to the number of segments with lesions graded from (+/-) to (+3), many segments were infected unexpectedly: the mean value was 7.7 +/- 1.5 even in the slight group. The proportion of segments with relatively severe lesions graded from (+2) to (+3) in each segment was observed, and the rate in the slight group was 52.6% in S5, 28.9% in S4, 16.7% in S1 (S1 + 2a, b), and 16.7% in S2 (S1 + 2c). In severe group, it was 54.8% in S5, 45.2% in S4, 46.8% in S1 (S1 + 2a, b) 54% in S2 (S1 + 2c), 27.4% in S3 and 26.2% in S6, respectively. The rate of segments with lesions in the lower lobes were less frequent especially in the slight group while it was slightly higher in the severe group. Speculating the initial lesions in the slight group, it was assumed that there might be two types of foci; the one is relatively localized in the beginning and the other is a diffuse type with lesions in many segments even from its early stage. As to the location of initial lesions, the middle lobe and lingula were the most important sites, and the right upper lobe and the left upper division were the next.

Aged↗
PubMed1997

[A randomized comparative study of surgical adjuvant chemotherapy using 5-fluorouracil and dl-leucovorin with CDDP 5-FU and dl-leucovorin for colorectal cancer].

A randomized comparative study of surgical adjuvant chemotherapy using dl-leucovorin (dl-LV) and 5-fluorouracil (5-FU) (FL-therapy) with CDDP, 5-FU, and dl-LV (PFL-therapy) was conducted. The following were the administration schedules: Arm A was 13 mg/m2 of CDDP, 300 mg/m2 of 5-FU, and 30 mg/body of dl-LV for 5 consecutive days and arm B was 300 mg/m2 of 5-FU and 30 mg/body of dl-LV for 5 consecutive days. Both regimens were followed by biweekly administration of the same dose of dl-LV and 5-FU in outpatients. Arm A was started at the 26th postoperative day and arm B at the 21st day on average. Some 26 cases composed of 11 cases of arm A and 15 cases of arm B completed the administration schedules. Only one case in arm A was complicated by local recurrence around 35 months after operation. Major toxicities were anorexia and neutropenia. Both toxicities were seen more in arm A than in arm B, showing complete recovery in all cases. These data suggest that PFL-therapy and FL-therapy seem to be possible and promising surgical adjuvant therapies for advanced colorectal carcinoma.

Adenocarcinoma↗
PubMed1997

[Oro-pharyngeal burn during electrodissection of the adenoid and tonsil].

We present a case of oro-pharyngeal burn which occurred during electrodissection of the adenoid and tonsil in a 5-year-old boy. We intubated the patient with an uncuffed spiral tube of appropriate size and noticed a slight gas leak during positive-pressure ventilation. Anesthesia was maintained with a mixture of 60% nitrous oxide, 40% oxygen and 2.5% sevoflurane. During manipulations of the right tonsil, orange-colored flame blew out about 5 cm from the mouth. Fortunately, the patient underwent the operative procedures without any further troubles, recovered fully from the grade 1 burn in the oral mucosa, and was discharged 23 days after surgery. The surgeons speculated that sevoflurane had been ignited. Although it is well known that sevoflurane is nonflammable in the concentration of clinical use, several reports show that sevoflurane is flammable in concentration of 10% under pure oxygen or nitrous oxide. We concluded that this accident was caused by electrocautery-induced ignition of the gauze packed into the larynx under a high concentration of oxygen which leaked through an uncuffed endotracheal tube. We have to bear in mind that any flammable substance may ignite when using electrocautery in a small space such as the mouth under oxygen-rich environment.

Adenoidectomy↗
PubMed1997

[Allergic bronchopulmonary aspergillosis in a patient with no symptoms of asthma until after bronchial lavage].

An asymptomatic 56-year-old man was admitted to our hospital because of an abnormal shadow on a chest X-ray film. Allergic bronchopulmonary aspergillosis was diagnosed on the basis of five findings: eosinophilia, immediate skin reactivity to Aspergillus antigen, the presence of precipitating antibodies against Aspergillus antigen, a high concentration of IgE in serum, and central bronchiectasis. He had no symptoms of asthma at the time of diagnosis, but did a few days after he underwent bronchial lavage. We speculate that the asthma attack was related to the bronchial Lavage as follows: First, drainage of mucus plugs by bronchial lavage may have exposed the bronchial epithelium, which had already been sensitized, to aspergillus antigens. Second, the scattered antigen may have dose-dependently stimulated the bronchi. Third, the infection may have increased bronchial responsiveness to the antigen. Symptoms of bronchial asthma are not necessary for the diagnosis of allergic bronchopulmonary aspergillosis.

Aspergillosis, Allergic Bronchopulmonary↗
PubMed1997

Massive cutaneous mucinosis associated with systemic lupus erythematosus.

We describe a 23-year-old Japanese man with systemic lupus erythematosus (SLE) who developed massive cutaneous mucinosis. He was diagnosed with SLE when he was 11 years old. Prednisolone therapy (30 mg/day) was initiated and reduced to 10 mg/day 3 months later; the SLE had been well-controlled with this dose of prednisolone for 12 years. However, infiltrated erythematous plaques developed on the middle-lateral area of his back at 17 years old and progressed to erythematous and elastic soft tumorous masses over 20 cm in diameter at 23 years old. Biopsies of the lesions on the nape revealed massive mucin deposition. Topical injection with hyaluronidase decreased the lesion. This cutaneous mucinosis can be distinguished clinically and histopathologically from papular and nodular mucinosis associated with SLE. The present case might be an unusual clinical variant of cutaneous mucinosis associated with SLE.

Adult↗
PubMed1997

[Cisplatin/5-fluorouracil intraperitoneal administration superior to intravenous administration for liver metastases of colonic carcinoma].

A 28-year-old female underwent sigmoidectomy for sigmoid colon cancer with peritoneal seeding. One month later, a solitary metastasis was found in S3 of the liver. After CDDP/5-FU intravenous chemotherapy, another metastasis appeared in S7. Intravenous administration showed PD. But the metastatic tumors shrank and became inobservable by CT after the 1st round of CDDP/5-FU intraperitoneal chemotherapy, and S7 tumor could not be identified after the 2nd round. Many previous reports demonstrated the concentration of cytotoxic drug in intraperitoneal administration was much higher than in intravenous administration. Theoretically, intraperitoneal chemotherapy is superior to intravenous chemotherapy for the prevention and treatment of liver metastases. This case demonstrated this hypothesis was right. We think adjuvant intraperitoneal chemotherapy should be re-considered for the prevention of the liver metastases of gastrointestinal cancers.

Adenocarcinoma↗