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Biomedical subjects

M Miyazaki

Publications and source records attributed to M Miyazaki.

At least 1,261 records · Page 70Linked to original sources
PubMedDate not supplied

Surgical results of combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation.

PURPOSE: To evaluate the results and complications of combined pars plana vitrectomy (PPV), phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation. METHODS: A total of 117 eyes from 114 patients who had undergone PPV combined with PEA and IOL implantation were retrospectively analyzed. Combined surgery was performed for a wide variety of vitreoretinal diseases. Intraoperative and postoperative complications were also reviewed. RESULTS: The postoperative BCVA improved by 2 lines or more in 85 eyes (72.6%). Intraoperative complications consisted of retinal tears in 14 eyes (12.0%) and posterior capsular rupture in 2 eyes (1.7%). Iatrogenic retinal tears occurred more frequently in eyes with a macular hole than in eyes with any other disease (p=0.005, chi-square test). Postoperative complications consisted of posterior capsule opacification (PCO) (21 eyes), transient IOP elevation (29 eyes), vitreous hemorrhage (6 eyes), anterior chamber fibrin exudation (11 eyes), posterior iris synechia (8 eyes), neovascular glaucoma (1 eye), and recurrent retinal detachment (RD) (2 eyes). Fibrin exudation occurred more frequently in eyes with proliferative diabetic retinopathy (PDR) and RD than in eyes with any other disease (p=0.03, chi-square test). PCO occurred more frequently in eyes with PDR than in eyes with any other disease (p=0.03, chi-square test). CONCLUSIONS: The present study suggests that a high success rate can be achieved when recently improved PPV techniques are combined wi th PEA and IOL implantation. The complications that were observed following this combined treatment varied with respect to the vitreoretinal disease present prior to surgery.

Adult↗
PubMedDate not supplied

Increased cytotoxicity of carbon tetrachloride in a human hepatoma cell line overexpressing cytochrome P450 2E1.

Cytotoxic free radicals generated during the metabolism of carbon tetrachloride by cytochrome P450 2E1 (CYP2E1) are thought to cause hepatotoxicity. Here, the cytotoxic effects of carbon tetrachloride in a liver cell line expressing CYP2E1 (HLE/2E1) are compared with those in the mother cell line (HLE). The effects of carbon tetrachloride on the gene expression of HSP70, a potential marker of oxidative stress, were also examined. The viability of HLE/2E1 cells after exposure to carbon tetrachloride was significantly decreased compared with that of HLE cells. Northern blot analysis revealed that the HSP70 mRNA level was significantly increased after carbon tetrachloride treatment in both cell lines, while the magnitude of its increase was much greater in HLE/2E1 cells than in HLE cells. These results suggest that the oxidative stress induced by CYP2E1 plays an important role in the increase in cytotoxicity of carbon tetrachloride in CYP2E1-overexpressing cells.

Blotting, Northern↗
PubMedDate not supplied

Immunological abnormalities in family members of patients with IgA nephropathy.

We examined several immunological parameters such as the number of T cells with CD4 antigen and the receptor for the Fc portion of IgA (T alpha cells), in vitro immunoglobulin production by peripheral blood lymphocytes with or without pokeweed mitogen and serum levels of immune complexes in 19 healthy family members of patients with IgA nephropathy (IgAN). It was shown that the levels of serum IgA, T4 cells, CD4/CD8 ratio of T cell subsets, T alpha cells, IgA circulating immune-complexes and spontaneous synthesis of immunoglobulins were significantly increased in family members of patients with IgAN. No family members had proteinuria or hematuria. It was concluded that immunological abnormalities, including abnormalities of T cells and B cells, were found not only in patients with IgAN but also in their healthy family members. It was suggested that some factors in addition to these immunological abnormalities may be involved in the development of IgAN.

Adult↗
PubMedDate not supplied

Pharmacotherapy for akinesia following anterior communicating artery aneurysm hemorrhage.

The dopamine system may be involved in three situations: the nigral projection to the basal ganglia, the mesocortical projection to the anterior cingulate gyrus, or the medial forebrain bundle projection to cortical and limbic sites. Because of the close association of dopamine systems with the known neurological syndromes of akinesia, we elected to treat a patient with akinesia due to rupture of anterior communicating artery (ACA) aneurysm with the dopamine agonist, bromocriptine. This case has important implications for the understanding of brain/behavior relationships as well as for the development of new therapies for patients who have sustained neurological injury.

Bromocriptine↗
PubMedDate not supplied

Idiopathic acute interstitial nephritis associated with uveitis.

A case of acute interstitial nephritis associated with uveitis is presented, An 18-year-old man developed uveitis followed by renal dysfunction. Moderate renal dysfunction (sCr 3.0 mg/dl), and increased levels of urinary beta 2 microglobulin (over 8,000 micrograms/I) were observed. Renal tissue obtained by open renal biopsy revealed severe infiltration of mononuclear cells in the tubulo-interstitial area. The majority of infiltrating cells were CD4-positive T cells demonstrated by immunoperoxidase staining, suggesting the involvement of T cell-mediated delayed hypersensitivity. Corticosteroid was effective against both uveitis and renal dysfunction. The possible pathogenesis of this syndrome is reviewed from the literature.

Adolescent↗
PubMedDate not supplied

Yeast functional assay of the p53 gene status in 11 cell lines and 26 surgical specimens of human hepatocellular carcinoma.

The structural abnormalities of the p53 gene have frequently been detected in hepatocellular carcinomas (HCCs). To ascertain whether or not functional inactivation of this gene also occurs in HCCs, the transactivation of p53 gene products in 11 HCC cell lines maintained in our laboratory and 26 HCC surgical specimens was examined by yeast functional assay (functional analysis of separated alleles in yeast: FASAY), which determines the functional status of the individual p53 alleles. The p53 gene product was inactivated in 8 of 11 (72.7%) HCC cell lines and in 12 of 26 (46.2%) HCC surgical specimens. The inactivation frequency of the gene was 37.5%, 36.4%, and 71.4% in well, moderately, and poorly differentiated HCCs, respectively. In HCC surgical specimens larger than 5 cm in diameter, the inactivation frequency was 83.3% while in those smaller than 2. 5 cm, it was 14.3%. These results show that functional inactivation of p53 gene products often occurs in HCCs and that the inactivation frequency of the gene in HCCs is well correlated with differentiation degree and tumor size, suggesting that the inactivation of p53 gene products plays a role in progression from well to poorly differentiated HCC.

Alleles↗
PubMedDate not supplied

Identification of a 7-cM region of frequent allelic loss on chromosome band 16p13.3 that is specifically associated with anaplastic thyroid carcinoma.

A total of 17 primary thyroid cancer specimens including seven anaplastic cancers, two papillary cancers adjacent to the anaplastic cancers, and eight papillary cancers were analyzed for loss of heterozygosity (LOH) on chromosome arm 16p. All tumors of anaplastic cancer showed LOHs at one or more loci, and a 7-cM region of the smallest deleted region was found on 16p13.3 between D16S423 and D16S406. This LOH was specifically found in the anaplastic cancer and not in the papillary thyroid cancer. Our present results suggest localization of the putative tumor suppressor gene on 16p13.3, which is likely to play an important role in the anaplastic transformation of thyroid cancer.

Adult↗
PubMedDate not supplied

Selection of mRNA markers for detection of lymph node micrometastases in breast cancer patients.

The aim of this study was to search for specific and sensitive mRNA markers or a combination of markers for RT-PCR detection of micrometastases in axillary lymph nodes (LNs) from patients with breast cancer. LNs (n=177) from 17 patients were examined with Cytokeratin20 (CK20), melanoma-associated genes (MAGE1, MAGE3), carcinoembryonic antigen (CEA), prostate-specific antigen (PSA), mammaglobin (MGB1) and mammaglobin B (MGB2) as molecular markers. CK20, MAGE1 and MAGE3 were slightly positive in primary tumors and CEA, PSA, MGB1 and MGB2 were highly positive. MGB1 and MGB2 were 100% positive in HE-positive LNs while CEA and PSA were only 35.7% and 57.1% positive. MGB1 and MGB2 were also 30.1% and 17.8% positive in HE-negative nodes. Thus, MGB1 and MGB2 are specific and a combination of the two should be useful for detection of micrometastases in axillary LNs of breast cancer patients.

Biomarkers, Tumor↗
PubMedDate not supplied

The relationship between carboplatin AUC and serum thrombopoietin kinetics in patients with lung cancer.

To clarify the relationship between the carboplatin AUC and the extent of damage to thrombopoiesis, we monitored both endogenous serum TPO kinetics and carboplatin pharmacokinetics after single-agent carboplatin administration. Previously untreated 12 patients with stage IV non-small-cell lung cancer were enrolled. The actual carboplatin AUC showed a significant positive correlation with the maximum increase ratio of TPO (TPOmax/TPOday1) (r = 0.74, p = 0.014). Furthermore, the increase ratio of TPO at one week after administration of carboplatin (TPOday8/TPOday1) showed a significant negative correlation with the following platelet nadir around day 19 (r = -0.84, p = 0.005). By monitoring the changes in endogenous TPO concentration, we could estimate the degree of thrombocytopenia and determine the indication, and thus the optimal timing of prophylactic administration of TPO before platelets are markedly reduced.

Adenocarcinoma↗
PubMedDate not supplied

Correlation between human hepatocyte growth factor and interleukin-6 concentrations after surgery.

BACKGROUND/AIMS: The aim of this study was to determine whether the production of human hepatocyte growth factor (hHGF) occurs in injured tissue following surgery in conjunction with interleukin-6 (IL-6) synthesis, and independently of liver resection. METHODOLOGY: The post-operative concentrations of hHGF and IL-6 in the serum and local exudative fluid were measured in 33 patients following abdominal (n = 20) or thoracic surgery (n = 13) (non-HTX), and in 7 undergoing a partial hepatectomy (HTX). RESULTS: Concentrations of two cytokines in the fluid were much higher than those in the serum (p < 0.001) in all patients. The maximum serum levels of hHGF were significantly correlated with those of IL-6 (p < 0.05), intra-operative blood loss (p < 0.005), and operating time (p < 0.005) in patients undergoing non-HTX. In these patients, the fluid levels of hHGF were also significantly correlated with those of IL-6 (p < 0.001). In serum and fluid, the hHGF/IL-6 ratios were markedly higher after HTX than after non-HTX (p < 0.05). CONCLUSIONS: These results suggests that hHGF may be produced in conjunction with IL-6 in injured tissue following surgery, but the production of hHGF may predominate over that of IL-6 in the liver following partial hepatectomy.

Aged↗
PubMedDate not supplied

Serum interleukin-6 levels in patients with biliary obstruction.

BACKGROUND/AIMS: The clinical significance of the interleukin-6 (IL-6) response in patients with biliary obstruction was studied. METHODOLOGY: This study included 30 patients who had biliary obstruction and underwent percutaneous transhepatic biliary drainage. Cases complicated by cholangitis were excluded. The serum levels of IL-6 and standard liver function tests were examined before and after biliary drainage. RESULTS: Serum IL-6 levels were significantly higher in patients with biliary obstruction compared to control subjects (p<0.05). After drainage, serum IL-6 levels decreased significantly (p<0.01). The patients with serum IL-6 levels exceeding 10 pg/ml were characterized by lower hepaplastin values, lower serum levels of total protein and albumin, higher mean age, and more frequently positive cultures of bile compared to those with serum IL-6 levels of less than 10 pg/ml. Serum IL-6 levels were correlated negatively with hepaplastin values and serum levels of total protein and albumin (p<0.05). CONCLUSIONS: These results suggest that subclinical biliary infection, liver dysfunction and advanced age promote the IL-6 response in patients with biliary obstruction. Such a cytokine response may disturb the physiologic immune response after the ensuing major operation and may be related to some post-operative complications.

Aged↗
PubMedDate not supplied

Does aggressive surgical resection improve the outcome in advanced gallbladder carcinoma?

BACKGROUND/AIMS: Patients with advanced gallbladder carcinoma have usually been considered nonresectable, leading to a very poor outcome. This study was aimed to evaluate the results of our aggressive surgical approaches in certain cases of advanced gallbladder carcinoma. METHODOLOGY: Ninety-one patients with advanced gallbladder carcinoma of stages pT3 and pT4 who underwent surgery at our institution were the subjects of this study. Fifty-eight of 91 patients had surgical excision; 44 by hepatic resection and 14 by hilar resection. Post-operative outcome was evaluated. Advanced gallbladder carcinomas were classified according to our previously reported classification: type I hepatic; type II biliary; type III hepatobiliary; type IV others. RESULTS: Curative resection was obtained at a more increased rate in type I tumor patients than in types II and III (91% vs. 29%, p < 0.01). The surgical mortality rate was 17%. Survival rates of resected patients were significantly higher that those of nonresected patients: 45%, 31%, 22%, 17%, 13% at 1, 2, 3, 4, 5 years vs. 9%, 9%, 0% at 1, 2, 3 years (p < 0.01). Survival rates of type I tumor patients after curative resection were remarkably higher than those of type II and III tumor patients, (69%, 64%, 56%, 48%, 39% at 1, 2, 3, 4, 5 years vs. 17%, 17%, 0% at 1, 2, 3 years). CONCLUSIONS: Aggressive surgical approaches might bring about improved prognosis in advanced gallbladder carcinoma, especially for patients with type I tumors.

Adult↗
PubMedDate not supplied

A case of classical carcinoid tumor of the gallbladder: review of the Japanese published works.

A 58 year-old man was admitted to Kimitsu Chuo Hospital complaining of epigastralgia. Abdominal ultrasound and computed tomography revealed a polypoid lesion at the neck of the gallbladder. Given the pre-operative diagnosis of gallbladder carcinoma, we resected the gallbladder along with the extrahepatic bile duct. There was a papillary tumor (25 x 16 mm) at the neck of the gallbladder. Histopathological examinations showed a subserosal nodular proliferation of uniform small tumor cells. Grimelius staining was slightly positive and Fontana-Masson staining was negative. Most of the tumor cells stained positively for chromogranin A and neuron-specific enolase (NSE), and some of the tumor cells were positive for pancreatic polypeptide. The presence of neurosecretory intracytoplasmic granules was proven ultrastructurally. It was diagnosed as a classical carcinoid tumor of the gallbladder. We reviewed the Japanese reported cases and discussed the difference in clinicopathological findings between classical and atypical carcinoid tumors of the gallbladder. Classical carcinoids of the gallbladder have neither a metastatic nor invasive character, and an extremely favorable prognosis compared with atypical carcinoids. The difference in character between classical and atypical carcinoids of the gallbladder is thought to be derived from their histogenetic origin.

Carcinoid Tumor↗
PubMedDate not supplied

Treatment of unresectable hepatic hilar malignancies with self-expanding metallic stents.

BACKGROUND/AIMS: This study assesses the treatment of biliary obstruction in patients with hilar malignancies by metallic stents. METHODOLOGY: Twenty-one consecutive patients with unresectable malignant biliary obstruction at the hepatic hilum (Bismuth type II, III and IV) were treated with percutaneous transhepatic placement of self-expandable metallic endoprostheses. The endoprostheses were successfully inserted in all patients. In 12 patients all segments of the liver were drained and in 9 patients partial segments of the liver were drained. RESULTS: Seventeen patients (81%) showed relief from jaundice and could be freed of external drainage tubes. Ten patients (48%) showed no recurrent symptoms due to stent obstruction until death. Overall survival was 4.86+/-4.15 (mean+/-SD) months, stent patency was 3.76+/-3.64 months and comfort index representing a ratio of well-being was 70.5+/-38.3%. There was no significant difference in survival rate, stent patency or comfort index between the groups with complete and those with partial drainage. CONCLUSIONS: Even in patients with complicated hepatic hilar biliary occlusions, internal drainage using metallic stents can relieve jaundice and leave patients free of external tubes with a comfortable quality of life.

Aged↗
PubMedDate not supplied

High-resolution MR images of inner ear internal anatomy using a local gradient coil at 1.5 Tesla: correlation with histological specimen.

PURPOSE: To obtain high-resolution MR images of the inner ear at 1.5 Tesla with a local gradient coil and to correlate these images with the histological specimen. MATERIALS AND METHODS: All studies were performed on a 1.5 Tesla MR unit with a local gradient coil (23 mT/m, slew rate of 107 mT/m/ms). The cranio-facial region of a cadaver was examined using 3D-fast spin echo (FSE) imaging with the voxel size of 0.27 mm x 0.27 mm x 0.5 mm in 9 h 37 min. Two normal volunteers were examined with the same system using 3D-FSE imaging with the voxel size of 0.20 mm x 0.26 mm x 1.0 mm in 57 min. These images were correlated with the cadaver images and histological specimens. RESULTS: On cadaver images, internal structures such as the macula utriculi, macula sacculi, crista ampullaris, lamina spiralis ossea, ligamentum spirale cochleae, modiolus, scala tympani, scala vestibuli, and cochlear aqueduct were visualized. On the images of both volunteers, the same structures were visualized as on the cadaver images. CONCLUSIONS: This study confirmed that high-resolution MR images obtained at 1.5 Tesla can visualize inner ear internal anatomy. Knowledge obtained in this study may be of significant value for the diagnosis of pathology in the area of the inner ear.

Aged↗
PubMedDate not supplied

Unilateral hepatic artery reconstruction is unnecessary in biliary tract carcinomas involving lobar hepatic artery: implications of interlobar hepatic artery and its preservation.

BACKGROUND/AIMS: The interruption of hepatic arterial flow when performing a bilioenteric anastomosis has been reported to usually bring about serious postoperative complications, such as anastomotic leakage, hepatic abscess and infarction. We aimed to evaluate the surgical implications of the interlobar hepatic artery when patients with advanced biliary tract carcinomas undergo surgical resection with a bilioenteric anastomosis. METHODOLOGY: In 7 patients with advanced biliary tract carcinomas, the combined resection of the liver (greater than hemihepatectomy in 2 and less than hemihepatectomy in 5), extrahepatic bile duct, hepatic artery (right hepatic artery in 5, right and left hepatic artery in 1, left hepatic artery in 1), and the portal vein was performed in 4 patients. The portal vein was reconstructed in all 4 patients. The hepatic artery was reconstructed in only one patient, with combined resection of both right and left hepatic arteries, but was not reconstructed in 2 other patients, even though they underwent resection greater than hemihepatectomy. RESULTS: The interlobar hepatic artery running into the Glissonian sheath around the hepatic duct confluence could be preserved in 5 patients, as shown by angiography, but could not be preserved in 2 patients who underwent greater than hemihepatectomy. Moderate and transient ischemic liver damage occurred, but no serious postoperative complications were induced in any of the 5 patients in the unilateral hepatic artery preserved group. However, both cases without preservation of the hepatic artery encountered liver failure, liver abscess and leakage of bilioenteric anastomosis, and one patient died of multiple organ failure. CONCLUSIONS: One major lobar branch of the hepatic artery involved by cancer invasion could be safely resected without reconstruction in patients with advanced biliary tract carcinomas when the interlobar hepatic artery running into the Glissonian sheath around the hepatic duct confluence is preserved.

Adult↗
PubMedDate not supplied

Durability of enamel bond strength of simplified bonding systems.

The purpose of this study was to investigate the influence of thermal cycling on enamel bond strength of 2-step bonding systems. The systems used were self-etching primer systems; Imperva Fluoro Bond, Clearfil Liner Bond II, and Mac Bond II; and self-priming adhesive systems; One Step, OptiBond Solo, Prime & Bond 2.0, and Single Bond. Bovine mandibular incisors were mounted in self-curing resin and the facial surfaces were wet ground with #600 SiC paper. Enamel surfaces were treated following each manufacturer's instructions. Adhesives were applied and composites were condensed into a Teflon mold (phi 4 x 2 mm) and light cured. Bonded specimens were divided into four groups; stored in 37 degrees C water for 24 hours, followed by thermal cycling between 5 degrees C and 60 degrees C for 3,000, 10,000, and 30,000 cycles. Ten samples per test group were tested in shear mode at a crosshead speed of 1.0 mm/min. One-way ANOVAs followed by Duncan's multiple range test (p < 0.05) were done. For self-etching primer systems, a significant decrease in bond strength was observed for the thermal cycling groups. For the self-priming adhesive systems, a small decrease in bond strength was observed but no significant differences were found for thermal cycling groups. The changes in bond strength after thermal cycling were different between the bonding systems.

Acid Etching, Dental↗