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Biomedical subjects

M Uchida

Publications and source records attributed to M Uchida.

612 records · Page 34Linked to original sources
PubMedDate not supplied

Abnormal behavior of residents in a long-term care facility and the associated stress of care staff members.

To survey the factors associated with abnormal behavior in 99 elderly residing in a special nursing home, we investigated the relationships between abnormal behavior and depression as well as impairments in cognition and activities of daily living (ADL), and the stress level of 28 care staff members. The clinical criteria for grading of dementia (intellectual level), the Cornell scale for depression in dementia (CSDD), the dementia behavior disturbance (DBD) scale, and rating of performance of ADL were used to assess behavioral and psychiatric symptoms in the elderly patients. Stress levels of care staff members were assessed using the 'burnout' scale. The DBD scale score correlated with the intellectual level, CSDD score, and three categories of ADL (urinary continence, faecal continence, and comprehension of conversation). The DBD scale score correlated negatively with one category of ADL (eating) in men, but did not correlate with ADL in women. No correlation was found between the burnout scale scores of care staff and either their age or work schedules. Present results showed that abnormal behavior in special nursing home residents correlated with depression as well as cognitive impairment. It is believed that the treatment and management of depression will decrease abnormal behaviors and improve their quality of life in special nursing home residents.

Journal Article↗
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Three-dimensional imaging of liver tumors using helical CT during intravenous injection of contrast medium.

PURPOSE: The goal of this work was to determine whether 3D reconstruction of images from CT during intravenous injection of contrast medium, performed in tandem with advanced rendering algorithms, could accurately depict major anatomic structures and hepatic tumors. METHOD: Thirty-one patients (22 with hepatocellular carcinoma, 8 with metastatic lesions, and 1 with intrahepatic cholangiocarcinoma) underwent CT imaging. Twenty-three of the 31 patients underwent needle biopsy or surgery, yielding a histologic diagnosis. The remaining eight patients were diagnosed from imaging findings and laboratory data. We compared the ability of maximum intensity projection (MIP) and volume-rendered technique (VRT) images to depict the hepatic veins and intrahepatic portal veins. RESULTS: Both MIP and VRT depicted the course of vessels up to the second or third branches. The techniques did not significantly differ. In this regard, in most cases, visualization of the liver surface and tumor was excellent with VRT images. CONCLUSION: Volume-rendered 3D-CT images during intravenous injection without the MIP technique produced 3D images of high quality with excellent visualization of tumors and their relationships to vital structures.

Adult↗
PubMedDate not supplied

Intrahepatic peripheral cholangiocarcinoma: comparison of dynamic CT and dynamic MRI.

PURPOSE: The purpose of this work was to compare dynamic MRI (D-MRI) with dynamic CT (D-CT) for the diagnosis of peripheral cholangiocarcinoma (PCC) of the liver. METHOD: Twenty patients with PCC underwent both D-CT and D-MRI during the early, middle, and delayed phase after contrast medium administration. The findings from D-MRI were compared with those from D-CT. RESULTS: D-CT and D-MRI exhibited a similar tumoral enhancement pattern, and this enhancement was more conspicuous on D-MRI. A wedge-like enhancement area peripheral to the tumor was observed in 9 (45%) patients on D-CT and 11 (55%) patients on D-MRI. Ductal dilatation was found in 13 (65%) patients on both techniques. Vascular involvement and extrahepatic invasion were seen in nine (45%) and two (10%) patients, respectively. The relationship of the tumor to the vessels and surrounding organs was more easily evaluated on D-CT. CONCLUSION: Both D-CT and D-MRI can provide important information for the diagnosis of PCC. D-CT is better than D-MRI for demonstrating vascular involvement and extrahepatic invasion. D-MRI gives more conspicuous enhancement.

Aged↗
PubMedDate not supplied

MRI of ganglioneuroma: histologic correlation study.

PURPOSE: The purpose of this study was to evaluate the MR findings of ganglioneuroma and to correlate imaging and histologic features. METHOD: Conventional SE and contrast-enhanced dynamic MRI was used to examine 10 patients with pathologically confirmed ganglioneuroma. The morphologic features, signal intensity, and dynamic enhancement pattern of the tumors were retrospectively analyzed and correlated with histologic features. RESULTS: Capsules were present in all tumors histologically and were also detected in five tumors on postcontrast T1-weighted images. A whorled appearance corresponding to interlacing bundles of Schwann cells and collagen fibers on histologic specimens was visualized in five tumors on T1-and/or T2-weighted images. Tumors with markedly high signal intensity on T2-weighted images consisted histologically of a large amount of myxoid stroma and relatively few cellular and fibrous components. Tumors with intermediate to high signal intensity consisted of numerous cellular and fibrous components and little myxoid stroma. Early enhancement of tumors was usually lacking in dynamic MR studies; however enhancement gradually increased. CONCLUSION: The results suggest that the MR features of ganglioneuroma are well correlated with histologic findings.

Adolescent↗
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A Japanese patient with the rare Rhnull phenotype of the 'regulator type'.

An example of red cells having no reaction with any Rh antisera was found in a Japanese woman. Results of a serological investigation of the family indicated the action of a 'regulator' gene. Her serum contained an antibody which agglutinated all cells of common Rh types, except for Rhnull, by the saline, anti-globulin and papain techniques.

Adult↗
PubMedDate not supplied

Nursing care for dialysis patients in Japan.

In Japan, the number of chronic renal failure patients requiring dialysis treatment is increasing by approximately 10,000 patients a year, totalling 229,538 or 1,801.2 patients per one million population at the end of December, 2002 according to the survey conducted by the Japanese Society for Dialysis Therapy. The primary disease is diabetic nephropathy (28.1% of patients), and with greater numbers of long-term and elderly patients, the incidence and severity of complications continue to increase. Dialysis units provide more diversified care, but budget cuts in health care make it difficult to secure sufficient personnel, and the workload on nurses has intensified. In this study, a survey of 157 out of 300 randomly selected dialysis facilities in Japan was made regarding nursing systems and nurses' concerns for medical care of dialysis patients.

Adult↗
PubMedDate not supplied

MR imaging of soft-tissue masses of the extraperitoneal spaces.

Magnetic resonance (MR) imaging has an increasing role in evaluating soft-tissue masses of the extraperitoneal spaces. Since the MR imaging features of most soft-tissue masses are nonspecific, prediction of a specific histologic diagnosis remains a challenge for the radiologist. However, there are certain specific MR imaging appearances that are helpful for more accurate diagnosis. Some histologic components, such as myxoid stroma, collagen fibers, calcification, and fat, have characteristic MR imaging features. Recognition of these features can assist the radiologist in limiting the differential diagnosis. Dynamic enhancement patterns can reflect the vascularity of masses and may be useful in diagnosis, especially in differentiating benign from malignant soft-tissue masses. Familiarity with specific signs and knowledge of diagnostic pitfalls are also important for shortening the list of differential diagnoses. Specific signs are the target sign, the bowl of fruit sign, a whorled appearance, a flow void, speckled enhancement, associated lymphadenopathy, and extension into the intervertebral foramen. Diagnostic pitfalls are as follows: a myxoid stroma simulating cystic degeneration and necrosis, collagen fibers simulating hemorrhage, a fat component simulating extraperitoneal fat, extensive intratumoral hemorrhage simulating hematoma, benign masses mimicking malignant ones, malignant masses mimicking benign ones, and peritoneal lesions mimicking extraperitoneal masses.

Contrast Media↗
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A case of pseudotumor cerebri following glucocorticoid therapy in which warfarin prevented recurrence.

A patient with nephrotic syndrome developed pseudotumor cerebri following glucocorticoid therapy. Diagnosis of pseudotumor cerebri was based on satisfaction of four criteria proposed by Ahlskog and O'Neill. The symptoms of pseudotumor cerebri disappeared within 10 days. After a three-week interval of remission, relapse occurred. Glycerol and urokinase produced rapid resolution of the symptoms and warfarin prevented further recurrence of pseudotumor cerebri for one year. These results suggest that the pathogenesis of pseudotumor cerebri might be associated with the hypercoagulable state which was induced by glucocorticoid therapy and nephrotic syndrome.

Adult↗
PubMedDate not supplied

Promotive effect of lysozyme on the ciliary activity of the human nasal mucosa.

Lysozyme is an important resistance factor in the respiratory defence mechanism. Few reports exist concerning its effects on the ciliary activity of the human nasal mucosa. To clarify the biological activity of lysozyme in ciliary movement, a quantitative study was undertaken using a photo-electrical method to measure ciliary beats in vitro under conditions of constant temperature. Egg-white lysozyme in a 0.01 M sodium phosphate buffer solution, pH 7.4, dose-dependently accelerated the ciliary beats in the human nasal mucosa, removing overlying mucus continuously for at least 60 min. The buffer alone, however, failed to affect ciliary beats. These results indicate that egg-white lysozyme directly promotes the ciliary beats in the human nasal mucosa.

Animals↗
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Antineoplaston treatment for advanced hepatocellular carcinoma.

Antineoplaston A10 injection (antineoplaston A10 I) exhibited cystostatic growth inhibition of human hepatocellular carcinoma (HCC) cells in vitro and showed minimum adverse effects in a phase I clinical trial. Advanced HCC is hard to control because the potent anticancer drugs or embolizations easily induce hepatic failure. We review herein 2 cases of advanced HCC treated with antineoplaston A10 I. Both cases showed interesting responses to antineoplaston A10 I. One showed massive coagulation necrosis of tumors after intra-arterial infusion of antineoplaston A10 I and the other showed resolution of portal vein tumor thrombosis with systemic infusion of antineoplaston A10 I. The usefulness of anti-neoplaston A10 I in terminal staged HCC is discussed.

Aged↗
PubMedDate not supplied

A novel strategy for remission induction and maintenance in cancer therapy.

The p53 tumor suppressor gene plays an important role in protecting cells from developing undesirable proliferation. The mutant p53 gene or malfunctioning p53 protein found in more than 50% of cancer cells impedes DNA repair or apoptosis induction. This may be why some cancers gain resistance to chemotherapy and radiation and become more resistant after frequent cancer treatments. A non-toxic p53 gene activator would induce cancer cell apoptosis and help damaged cancer cells to recover. Therefore, the combination use of chemotherapeutics or radiation with a non-toxic p53 gene activator will be crucial in cancer therapy, damaging DNA with chemotherapeutics or radiation on the one hand and promoting apoptosis induction with p53 gene activator on the other. This strategy would be most efficient for remission induction and maintenance in cancer therapy. Antineoplastons are naturally occurring peptides and amino acid derivatives that control neoplastic growth. Antineoplaston A10 and AS2-1 are chemically identified and synthesized antineoplastons proven to inhibit cancer cell growth by arresting the cell cycle in the G1 phase and inhibiting tumor growth by reducing mitosis. These agents are thought to be good candidates for clinically easily applicable non-toxic p53 gene activators. Our cases of advanced cancer responded well to combination treatment using chemotherapeutics and irradiation with antineoplaston A10 and AS2-1 in clinical trials being conducted in Kurume University Hospital. We describe herein the clinical cases and discuss the possible mechanism of action of this combination therapy.

Adult↗
PubMedDate not supplied

Xenon contrast-enhanced CT imaging of supratentorial hypoperfusion in patients with brain stem infarction.

BACKGROUND AND PURPOSE: The characteristics of hypoperfusion in the supratentorial region of patients with brain stem infarction are unclear. We investigated the relationships between the presence of hypoperfusion and the location, number, and size of the infarcts with xenon contrast-enhanced CT. METHODS: One hundred five patients with brain stem infarction detected by MR imaging underwent xenon contrast-enhanced CT to measure the regional CBF (rCBF) in the frontal, temporal, parietal, and occipital regions and in the putamen and thalamus. A decrease of more than 10% from the mean rCBF value for normal individuals was considered to indicate hypoperfusion. RESULTS: Thirty-six patients had supratentorial hypoperfusion. The mean rCBF values (measured in mL/100 g/minute) were as follows: frontal region, 36.2 +/- 5.1 (-14.8%, n = 28); parietal region, 42.3 +/- 4.7 (-19.1%, n = 29); temporal region, 41.5 +/- 2.8 (-12.6%, n = 12); and thalamus, 50.1 +/- 3.2 (-19.6%, n = 7). Supratentorial hypoperfusion was associated with pontine infarction in 33 patients (upper pons in 15, middle pons in 18, and lower pons in seven), midbrain infarction in two, and medulla infarction in one. Twenty-three patients had infarcts that were larger than 5 mm, and 11 had infarcts that were 2 to 5 mm. Only two had infarcts that were smaller than 2 mm. Seven patients each had one infarct, 13 each had two, and 16 each had three. CONCLUSION: Supratentorial hypoperfusion was associated with larger infarcts, with more infarcts, and with pontine infarction.

Aged↗
PubMedDate not supplied

Morphologic differences in leukemic cells (L1210) exposed to 1-beta-D-arabinofuranosylcytosine and daunorubicin.

To compare the morphologic differences in leukemic cells exposed to a nucleotide synthesis inhibitor and a DNA strand damage inducer, L1210 cells incubated with 1-beta-D-arabinofuranosylcytosine (ara-C) or daunorubicin (DNR) were investigated by time-lapse video microscopy, flow cytometry and transmission electron microscopy. At 1.0 microgram/ml of ara-C, cells could be separated into two populations, with some becoming ballooned and deformed, i.e. irreversibly damaged, and others remaining unchanged, i.e. in a proliferative state. In contrast, at 0.10 microgram/ml of DNR, nearly all cells were remarkably enlarged and did not proliferate during 72 hours of observation. Such morphologic changes induced at clinically achievable concentrations of each agent seemed to reflect their differing mechanisms of action on the synthesis of DNA. The methods described may allow the characterization of antileukemic agents as well as the development of clinical designs for their rational application in leukemia patients.

Animals↗
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Enzymatic conversion of 5-fluoro-2'-deoxyuridine to 5-fluorouracil or 5-fluoro-2'-deoxyuridine 5'-monophosphate in human tissues.

The relative activities and Km values of pyrimidine nucleoside phosphorylase (PNPase) and thymidine (TdR) kinase were compared in postsurgical human tissues. TdR kinase, which activates 5-fluoro-2'-deoxyuridine (FUdR), was higher in normal liver than in other tissues examined. PNPase, which cleaves FUdR, was higher in normal spleen and liver and lowest in kidney. In normal lung tissue, almost all of the FUdR was cleaved at a high concentration since PNPase activity was much higher than TdR kinase activity. The affinity of TdR kinase as indicated by Km was greater in normal than in cancerous lung tissue. At a low concentration, FUdR is relatively well activated in the normal tissue; thus it may not be suitable for chemotherapy of lung cancer. When comparing normal versus cancerous colon tissues, no difference was seen in either TdR kinase affinities or TdR kinase and PNPase activities. However, the PNPase affinity for FUdR was significantly higher in normal than in cancerous colon tissue. When FUdR is maintained at low concentrations, it might have a selective cytotoxicity for colon cancer tissue since it is well cleaved in normal colon.

Biotransformation↗
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DNA-binding characteristics of aclarubicin as compared with daunorubicin and doxorubicin.

The effect of ionic strength on aclarubicin - DNA complexes was studied in comparison with its effect on daunorubicin - or doxorubicin - DNA complexes, using the spectrophotometric method. The hypochromic shift of aclarubicin, induced by its binding to native DNA, decreased to a lesser extent by the addition of Na+ than those of daunorubicin and doxorubicin, which suggests that aclarubicin-native DNA complexes are the most stable at high ionic strength. Similar examinations were made with heat-denatured DNA and polyvinyl sulfate (PVS). Aclarubicin-denatured DNA complexes showed a greater decrease in the hypochromic shift by the addition of Na+ than the corresponding complexes with native DNA. However, for daunorubicin and doxorubicin, there were no significant differences between the complexes of anthracyclines with native and denatured DNAs. In addition, the hypochromic shift of aclarubicin-PVS complexes decreased more prominently by the addition of Na+ than those of daunorubicin - and doxorubicin - PVS complexes. These results suggest that the electrostatic interaction of aclarubicin with DNA is more labile than that of daunorubicin and doxorubicin, since anthracyclines bind to single-stranded DNA and polyelectrolytes primarily by electrostatic interaction. Therefore, the other types of interaction, which may be stronger than that of daunorubicin and doxorubicin, seem to be associated with the higher stability of aclarubicin-native DNA complexes at high ionic strength. The structural differences between aclarubicin and daunorubicin or doxorubicin are considered to contribute to the differences in DNA-binding characteristics observed in this study.

Aclarubicin↗
PubMedDate not supplied

Reverse effect of guanine on the inhibitory action of mycophenolic acid during nucleic acid synthesis.

Mycophenolic acid (MPA) was demonstrated to inhibit DNA and RNA synthesis in L1210 cells strongly; however these effects were remarkably reduced by guanine. The presence of MPA in the medium decreased the guanine nucleotide contents (GMP, GDP, GTP) of the cells, but the addition of guanine reversed this effect. We have reported previously that MPA had no inhibitory effect on hypoxanthine guanine phosphoribosyltransferase (HGPRTase) activity. Together these findings suggest that the decrease of guanine nucleotides induced by MPA is restored by GMP, which is formed from guanine by HGPRTase in the cells. It is speculated that a suppressor of HGPRTase activity, such as 6-mercaptopurine, may protect the antitumor activity of MPA by preventing the conversion of guanine to GMP.

Animals↗
PubMedDate not supplied

Postoperative adjuvant chemotherapy after radical hepatic resection for hepatocellular carcinoma (HCC).

BACKGROUND/AIMS: This prospective randomized study was aimed to clarify the efficacy of epirubicin after radical hepatic resection for hepatcellular carcinoma (HCC). MATERIALS AND METHODS: One hundred and one patients entered the present study and were randomly allocated to Group A in which UFT (300 mg/day) was given from 5th postoperative week for one year, or Group B in which a bolus injection of epirubicin (40 mg/m2) was given arterially, in addition to the same UFT administration, on day 28. Groups A and B included 40 and 48 eligible cases, respectively. RESULTS: No obvious intergroup differences were observed including prescribed dose of UFT. The 1-, 3- and 5-year survival rates (Groups A vs B) were 82 vs 90%, 50 vs 49% and 35 vs 30% (p = 0.2162). Excluding 4 operative deaths, the recurrence-free survival rates were 65 vs 70%, 32 vs 37% and 14 vs 17% (p = 0.3843). Initial recurrence sites were also similar. CONCLUSIONS: A bolus arterial injection of epirubicin does not change the long term results after radical hepatic resection for HCC.

Aged↗