[Metabolism of 3-deoxosteroid in the rabbit liver. 2].
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Anabolic Agents↗
Biomedical subjects
M Sumi
Publications and source records attributed to M Sumi.
[Metabolism of 6-dehydro-progesterone in the rabbit].
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Animals↗
[Metabolism of 6-dehydro-retroprogesterone in rabbits].
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Animals↗
Spin-echo and dynamic gadolinium-enhanced FLASH MR imaging of hepatocellular carcinoma: correlation with histopathologic findings.
Evaluation of histologic subtype and degree of differentiation in hepatocellular carcinoma (HCC) is essential because it affects patient prognosis and treatment planning. To evaluate the histologic subtype of HCC with magnetic resonance (MR) imaging, conventional spin-echo and dynamic studies were correlated with histopathologic and angiographic findings in 72 HCCs. Dynamic MR imaging was performed with the fast low-angle shot (FLASH) technique after administration of gadopentetate dimeglumine. There was considerable overlap in signal intensity between various tumor grades on both T1- and T2-weighted images. On dynamic MR images, the peak contrast enhancement ratio correlated with tumor grade (well-differentiated, 29.5 +/- 24.7; moderately differentiated, 63.5 +/- 24.1; poorly differentiated, 86.9 +/- 26.4) or degree of dilatation of the sinusoidlike vascular space between tumor cells. The maximum contrast-to-noise ratio in tumor (relative to surrounding liver) was achieved within 60 seconds in 45 HCCs (mostly of the trabecular or pseudoglandular type). Enhancement was slight or minimal in 17 tumors (mostly small, well-differentiated tumors). In 10 tumors, the degree of enhancement increased with time, with maximum enhancement in the delayed phase (most frequently in scirrhous HCC). These dynamic patterns correlated with angiographic findings. These data indicate that the degree and pattern of enhancement on dynamic MR images reflect tumor differentiation and architecture of HCC.
Angiography, Digital Subtraction↗
Endostatin levels in exudative pleural effusions.
Endostatin is an angiogenesis inhibitor that is an endogenously produced proteolytic fragment of type XVIII collagen. Although serum levels of endostatin have extensively been studied in patients with malignant diseases, endostatin in pleural effusion has not been fully evaluated. In order to determine whether endostatin is present in pleural effusion, and to determine whether endostatin levels vary in pleural effusion of different etiology, we measured levels of endostatin in 38 malignant pleural effusion due to lung cancer patients and 29 patients with non-malignant disease using an ELISA kit. Free form of endostatin was measurable (> 11.2 pg/ml) in 26 of 38 malignant and 13 of 29 non-malignant pleural effusion. Endostatin levels in the 38 malignant pleural effusion were significantly higher than those in patients with the 29 patients with non-malignant diseases ( p = 0.0131). However, there was not statistically significant difference between the patients with pleuropneumonia and those with tuberculous pleurisy ( p = 0.2194). In malignant pleural effusion due to lung cancer, the pleural effusion endostatin levels did not differ when the histological types of lung cancer were considered ( p = 0.0674). Endostatin was present in both malignant and non-malignant pleural effusion, and elevated levels of endostatin were observed in malignant pleural effusion. Although the mechanisms are unclear, elevated levels of endostatin in pleural effusion may represent the local productions of endostatin in pleural space.
Adenocarcinoma↗
The addition of epinephrine increases intensity of sensory block during epidural anesthesia with lidocaine.
BACKGROUND AND OBJECTIVES: Little is known about the effect of adding epinephrine to local anesthetic solutions on the intensity of sensory block during epidural anesthesia. This study examined development of sensory block during lumbar epidural anesthesia using a cutaneous current perception threshold (CPT) quantitative sensory testing device. METHODS: Twenty ASA I patients who were randomly divided to receive 10 mL 1% lidocaine with (group E) or without (group P) epinephrine 1:200,000. Current perception threshold at 2,000, 250, and 5 Hz stimulation at the trigeminal (V), ninth thoracic (T9), and second lumbar (L2) dermatomes, and the dermatomal levels of block of light touch, temperature, and pinprick discrimination were measured before and every 5 minutes, until 60 minutes after injection of epidural lidocaine. RESULTS: After epidural administration of lidocaine with epinephrine, all CPT significantly increased at T9 and L2, whereas no increase was detected after epidural plain lidocaine. Areas under the curves, calculated to express overall magnitude and duration of CPT values, were significantly larger in group E than those in group P at 2,000 and 250 Hz at T9. No differences were observed in the maximal levels of loss of cold, pinprick, and touch sensations between both groups. CONCLUSIONS: These results suggest that lumbar epidural anesthesia using 10 mL 1% lidocaine with epinephrine produces a more intense block of both large and small diameter sensory nerve fibers than that with plain lidocaine. It appears, therefore, that the addition of epinephrine improves the quality of sensory block during epidural anesthesia with lidocaine.
Adrenergic Agonists↗
Immature glandular features in squamous cell carcinoma of the uterine cervix as an independent indicator of resistance to radiotherapy.
The aim of this study was to evaluate the significance of "immature glandular features" in cervical squamous cell carcinoma (SCC) as an indicator of tumor radioresistance. Pretreatment biopsied tissue specimens of cervical SCC from 100 patients who were uniformly treated with radiotherapy alone were classified into clinically radioresistant (cR) and radiosensitive (cS) groups. Seven histologic parameters comprising glassy cells, signet ring cells, squamous differentiation, recognizable gland, nuclear atypia, stromal response, and mitotic counts were examined. Glassy cells and signet ring cells were regarded as "immature glandular features". The correlation of these seven parameters with tumor response to radiotherapy and patient prognosis was analyzed by univariate and multivariate analyses. As objective indicators of glandular differentiation, alcian-blue staining and immunostaining of cytokeratins 7 and 20 were also performed. It was revealed that immature glandular features, absence of squamous differentiation, and low nuclear atypia were significant indicators of radioresistance of the tumor and of poorer patient prognosis. Combining those histological parameters, the present SCC cases were classified into 26 pathologically radioresistant (pR) and 74 radiosensitive (pS) groups. In the pR group, 54% (14 of 26) were clinically radioresistant, whereas 20% (15 of 74) of the pS group were clinically radioresistant (P = 0.002). The overall prognosis of the pR group was much poorer than that of the pS group (P < 0.0001). This correlation also held true in cases of identical stage and age. We could not show objectively glandular differentiation of "immature glandular features". Nonetheless, the identification of "immature glandular features" was effective in predicting the radiotherapy resistance of cervical SCC and poorer patient prognosis.
Adult↗
Supratentorial and spinal cord hemangioblastomas: gadolinium enhanced MR appearance with pathologic correlation.
A case is presented that illustrates the magnetic resonance appearance of supratentorial hemangioblastomas both prior to and following intravenous administration of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). Spinal cord hemangioblastomas were also present and were visualized only after Gd-DTPA administration. Pathological verification of the multiple tumoral lesions was obtained.
Adult↗
Spinal anesthesia with tetracaine in 0.75% glucose: influence of the vertebral interspace used for injection.
BACKGROUND AND OBJECTIVES: The anesthetic behavior and hemodynamic consequences of spinal anesthesia with marginally hyperbaric tetracaine containing a low concentration of glucose injected at two different interspaces were examined and compared with those of conventionally hyperbaric solution. METHODS: One-hundred twenty ASA Physical Status I or II patients scheduled for elective surgery to the lower limb were sequentially assigned to one of three equal groups to receive spinal anesthesia: Group 1 received 0.5% tetracaine in 0.75% glucose with 0.125% phenylephrine at the L2-L3 interspace; group 2 0.5% tetracaine in 0.75% glucose with 0.125% phenylephrine at the L3-L4 interspace; group 3 0.5% tetracaine in 7.5% glucose with 0.125% phenylephrine at the L3-L4 interspace. Neural block was assessed in a double-blinded manner by cold, pinprick, and touch sensation, and a modified Bromage scale after the injection of the study drug. RESULTS: Injection at the L2-L3 interspace produced significantly higher spread of analgesia [median T7 (10th, 90th percentiles T10, T4)] than injection at L3-L4 interspace [T10 (L1, T5)] when using the solution in 0.75% glucose. There were no significant differences in peak dermatomal levels between groups 1 and 3, but the number of patients who required ephedrine for the treatment of hypotension was larger in group 3. CONCLUSIONS: A marginally hyperbaric tetracaine solution injected at the L2-L3 interspace with the patient in the lateral position produced greater extent of cephalad spread than that at the L3-L4 interspace. When compared to a conventionally hyperbaric tetracaine solution injected at the L3-L4 interspace, the marginally hyperbaric solution injected at the L2-L3 interspace caused less hemodynamic variability despite similar levels of maximum sensory block.
Anesthesia, Spinal↗
Clinical evaluation of CYFRA 21-1 in malignant pleural fluids.
The diagnostic value of the novel tumor marker CYFRA 21-1 in malignant pleural fluid was assessed in comparison to carcinoembryonic antigen (CEA). CYFRA 21-1 and CEA were measured in pleural fluid obtained from patients with 108 malignant and benign diseases. The levels of pleural fluid CYFRA 21-1 in malignant diseases (median: 84.5 ng/ml) were statistically higher than those in benign diseases (median: 13.9 ng/ml; p < 0.01). The CYFRA 21-1 test was able to discriminate significantly between squamous cell lung cancer and pneumonia (p < 0.01), while pleural fluid CEA levels could not. Receiver operating characteristic (ROC) curve analysis showed that the CYFRA 21-1 test has an advantage over CEA because of its higher specificity. These results indicate that measurement of CYFRA 21-1 in pleural fluid is a new tool, in addition to cytologic examination, to discriminate between malignant and benign diseases.
Adult↗
Long-term cure of a malignant lymphoma of the pleural cavity treated by irradiation.
Malignant lymphomas arise in the pleura in association with a long-standing chronic tuberculous pyothorax. We report a case of a non-Hodgkin's lymphoma of the pleural cavity, inoperable because of local invasion into thoracic wall, who has survived more than 6 years without recurrence. This patient represents the longest reported survival after radiation therapy alone. Radiotherapy holds an important role in the treatment of locally advanced lymphoma of the pleural cavity.
Aged↗
Brain involvement in Hodgkin's disease: case reports and review of the literature.
Hodgkin's disease involving in the central nervous system is extremely rare. It usually spreads contiguously, as visceral involvement is generally thought to occur secondary to involved adjacent lymph nodes. We report three such cases found in our institution in the last two decades. Based upon our limited experience together with reported data, whole brain irradiation combined with systemic chemotherapy remains the treatment of choice for these lesions.
Adolescent↗
Automatic search for optimal conditions in clinical studies.
BACKGROUND: A program for an automatic search for the optimal conditions of important prognostic factors in clinical studies was developed. METHODS: The program was developed for the following steps: (1) Input of the maximum and minimum values and of the interval of the variable to be investigated. Automatic calculation of the Cut Points. (2) Division of the patient data into two groups at every Cut Point and calculation of survival rates. (3) Sequential calculation of P-values and chi-square values for the two sets of survival rates. To determine the usefulness of this program, the optimal irradiation dose was searched for 537 patients with non-small cell lung cancer. RESULTS: The P-value reached its minimum value and the chi-square value its maximum when the Cut Point was 5,925 cGy (0.0001 and 30.18). Between 5,925 cGy and 6,900 cGy, the P-value stayed at less than 0.05. CONCLUSION: Artificial errors in grouping by prognostic factors can be avoided and the search for optimal conditions can be conducted automatically and scientifically.
Automation↗
Correlation of CT patterns with histologic findings in parauterine masses.
CT findings were correlated with histologic and surgical findings in 162 parauterine masses. CT findings were classified into four types and 14 patterns. These classifications were useful in the diagnosis and differential diagnosis of parauterine masses. Malignant ovarian tumors, uterine myogenic tumors, metastatic tumors, endometrial cysts, and benign cystadenoma revealed characteristic CT findings, making differential diagnosis possible on CT. Contrast enhancement of the solid part, bilaterality, and the presence of ascites were useful for differential diagnosis. Although CT is one of the major modalities for the diagnosis of intrapelvic mass lesions, MR imaging will be another important method for the delineation and characterization of these lesions in the future.
Adult↗
MR imaging of late radiation brain injury.
One hundred and four patients treated with radiotherapy for intracranial tumors and their related conditions were reviewed to evaluate the usefulness of magnetic resonance (MR) imaging in demonstrating increased signal intensity areas on T2-weighted images that were considered to be late adverse effects of irradiation of the brain. High signal intensity areas of the white matter were divided into five patterns according to their size and extension. Severity was found to increase with age and irradiation doses of more than 50 Gy. In patients with irradiation doses of more than 60 Gy, the severity of increased with shorter interval after radiotherapy than in those given low irradiation doses. Clinical findings such as mental deterioration, motor abnormality, and visual defect were observed in 12 patients. These findings were closely correlated with the severity of the MR pattern. In most patients, high signal intensity areas were stable or progressive during the course of follow-up. However, these areas were regressive in three patients. Imaging with Gd-DTPA was performed in 36 patients, six of whom showed enhancement. Pathological findings on enhancement included astrocyte proliferation and coalescing vacuoles in neural tissue. MR imaging is an excellent method with which to monitor the adverse effects of radiotherapy of the brain.
Adult↗
MR Gd-DTPA enhancement of radiation brain injury.
MR examinations of 104 patients who had undergone radiotherapy to the brain were reviewed. Thirty-six patients received Gd-DTPA enhanced study during the course of MR evaluation and six of the patients showed enhancing radiation necrosis. Histopathological confirmations were obtained in three patients. Gd-DTPA enhancing radiation lesions were multiple and patchy in three patients, multiple and patchy with cyst formation in two and ring shaped in one. In terms of their distribution, enhancing lesions in four patients were seen only in the white matter within the irradiated field and these patients had undergone radiotherapy within five years. The interval after radiotherapy was more than eight years in two patients and their enhanced lesions were observed in both the white and gray matter. Histopathological findings of Gd-DTPA enhancing radiation necrosis were gliosis and coalescing vacuoles of the neural tissue. None of these enhanced radiation lesions showed significant mass effects. Patterns of the enhancement were not specific. It was considered to be difficult to differentiate tumor recurrence from radiation necrosis with conventional Gd-DTPA enhanced MR examinations. In one patient, delayed MR images after Gd-DTPA administration showed increases in the size and number of radiation enhanced lesions. Dynamic and delayed MR study might add more information to conventional imaging after Gd-DTPA. Further studies are necessary to differentiate radiation lesions from tumor recurrences.
Adult↗
Carbon-13 chemical shift imaging of [1-13C] glucose under metabolism in the rat head in vivo.
Carbon-13 chemical shift images (metabolic maps) of [1-13C] glucose in the heads of rats were obtained and compared with proton images of the same rats in terms of signal allocation. Wistar rats were kept awake or anesthetized. [1-13C] glucose was injected intravenously in a dose of 1 g per kg of body weight. The head of the Wistar rat was placed on or into circular coils. Carbon-13 images were obtained using a 7.05 Tesla system. A simple spin echo sequence was used with a chemical shift selective (CHESS) pulse. The frequency band width was set to cover the spectral breadth of the carbon-13 signal of [1-13C] glucose. The slice thickness of the image was 4 mm or 6 mm, and the field of view (FOV) was 60 mm x 60 mm, with a matrix size of 64 x 64. The total acquisition time was 36 minutes. Strong signals were observed from the scalp muscles and tissues outside the brain, but signal strength from the brain itself was minimal. This was presumably due to the metabolism of [1-13C] glucose in the brain. Little difference was recognized between [1-13C] glucose images of the heads of rats with and without anesthesia. Chemical shift imaging of carbon-13 could be useful methods for the in vivo study of physiochemical structures and metabolic pathways of living organs.
Animals↗
Turbo short tau inversion recovery imaging for metastatic node screening in patients with head and neck cancer.
BACKGROUND AND PURPOSE: A rapid and sensitive MR imaging technique would be beneficial for screening of metastatic nodes in the neck. We preliminarily evaluated the coronal MR imaging with a turbo short tau inversion recovery (STIR) sequence for that purpose. METHODS: The coronal turbo STIR imaging (repetition time [TR]/echo time [TE]/inversion time [TI] = 3850 ms/20 or 80 ms/180 ms) and axial fat-suppressed spectral presaturation with inversion recovery (SPIR) T2-weighted imaging (fsT2WI) (TR/TE = 3500 ms/80 ms) were performed on 29 patients with head and neck cancer. We obtained coronal turbo STIR images and axial fsT2WI of the necks. The section thickness, intersection gap, matrix size, and field of view were the same in both techniques. The diagnostic ability for metastatic nodes was assessed at each neck level by using various cutoff size criteria. The nodal involvement was confirmed by histologic examination. RESULTS: The image acquisition time for the whole neck by coronal turbo STIR and axial fsT2WI techniques was approximately 2 minutes and 4 minutes, respectively. When the size criteria (cutoff sizes of short axis diameter were 8 mm at level I and 5 mm at levels II and III) were used, the STIR imaging yielded compromised diagnostic ability having 100% sensitivity and 100% negative predictive value (NPV). fsT2WI technique yielded 100 sensitivity and 100% NPV by using cutoff sizes of 6 mm at levels I and II and 5 mm at level III. CONCLUSION: Coronal STIR imaging provided a rapid screening technique for cervical metastatic nodes and could be a diagnostic tool before detailed MR studies of the neck.
Adult↗