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Biomedical subjects

N Murakami

Publications and source records attributed to N Murakami.

At least 685 records · Page 38Linked to original sources
PubMedDate not supplied

Classification of papillary cancer of the thyroid based on prognosis.

Between 1965 and 1988 there were 2953 patients with papillary carcinoma treated at Noguchi Thyroid Clinic. Among them 761 patients were excluded because the primary tumor was < 10 mm in maximum diameter, the patient's age was > 80, or the patient underwent noncurative surgery. The remaining 2192 patients, 192 men and 2000 women, were analyzed. The mean follow-up period was 12.5 years. Total thyroidectomy, subtotal thyroidectomy, lobectomy with or without isthmectomy, and less than lobectomy were performed in 2.3%, 40.3%, 44.2%, and 13.2%, respectively. Modified radical neck dissection, partial node excision, and no node excision were performed in 77.8%, 6.4%, and 15.8%, respectively. Men and women were separately analyzed because their risk factors and prognosis were significantly different. Multivariate analysis was carried out according to Cox's regression hazard model. Independently significant factors affecting prognosis in men were aged and gross nodal metastasis; and age, gross nodal metastasis, tumor size, and number of adhered tissues or organs were the factors in women. Based on those risk factors patients were classified into three groups. For men, 65.6% were classified in the excellent group and their 10-year survival was 98.4%; 17.2% were classified as intermediate and 17.2% as poor with survival rates of 90.1% and 74.4%, respectively. For female patients 69.6% were classified in the excellent group, 18.6% in the intermediate group, and 11.9% in the poor group with 10-year survivals of 99.3%, 96.4%, and 88.8%, respectively.

Aged↗
PubMedDate not supplied

Idiopathic lactic acidemia with developmental delay and type 1 muscle fiber atrophy: report of two patients.

Two infants with generalized muscle hypotonia with mild muscle weakness and markedly delayed developmental milestones, had high lactate levels in serum and cerebrospinal fluid from early infancy. Biochemical and morphologic studies of biopsied muscles disclosed no abnormality except for type 1 fiber atrophy, which was quite different from patients with central nervous involvement with type 2 fiber atrophy. In both patients, the disease was not progressive and lactate levels gradually decreased. Although no metabolic defect was found, these patients probably shared common pathogenetic mechanism.

Acidosis, Lactic↗
PubMedDate not supplied

Changes in blood flow of the middle cerebral artery during absence seizures.

Blood flow velocities (BFVs) of the middle cerebral artery were measured by transcranial Doppler blood flowmeter in 2 patients with childhood absence epilepsy; a total of 8 absence seizures were recorded. BFV began to decrease 7-9 sec after the appearance of diffuse bilateral 3 Hz spike-and-wave bursts on electroencephalography, reaching the trough 0-8 sec after the disappearance of spike-and-wave bursts which was followed by BFV recovery with rebound phenomenon. BFV then returned to the pre-ictal value within 1 min after the seizure ended. Pulsatility index increased in accordance with BFV decrease.

Adolescent↗
PubMedDate not supplied

A less invasive surgery for rotator cuff tear: mini-open repair.

As a less invasive surgery of the shoulder, the mini-open repair was carried out from March 1997 through December 1998 in 22 patients (mini-open repair group) for all types of rotator cuff tears, except massive tears. A transacromial skin incision about 3 cm long was made. The anterior deltoid was split along its muscle fibers, and an anterior acromioplasty was accomplished by using a specially designed bone rasp. The rotator cuff was repaired with use of the McLaughlin technique. The results were compared with those obtained in 36 patients subjected to conventional open surgery from April 1994 through February 1997 (control group). No significant difference was seen between the UCLA (University of California, Los Angeles) shoulder scores of the two groups 1 year after the repair. However, active forward flexion in the mini-open group was significantly greater than in the control group 3 and 6 months after surgery. With mini-open repair, patients seem to be able to return to sports or social activities earlier than with conventional open surgery.

Adult↗
PubMedDate not supplied

Shrinkage in the inferior pouch of the scapulohumeral joint is related to postoperative pain after rotator cuff repair: radiographic and arthrographic comparison between patients with postoperative pain and those without it.

Fluoroscopic and arthrographic studies were performed in 50 patients to determine whether pain in the shoulder after rotator cuff repair was related to the restricted movement of the glenohumeral joint. The 50 patients were divided into 2 groups: group A consisted of 22 patients with mild shoulder pain for more than 1 year postoperatively, and group B consisted of the remaining 28 patients without pain after surgery. The motion in the scapulothoracic articulation and that in the glenohumeral joint were analyzed separately by measurement of the scapular motion on radiographs taken under fluoroscopic control. The glenohumeral joint capacity was measured by arthrography. Changes in the glenoid tilting angle with shoulder elevation were significantly greater in group A than those in group B. Patients in group A demonstrated a significantly smaller inferior pouch on arthrograms than those in group B. The patients with shoulder pain after rotator cuff repair thus had reduced capacity and motion of the glenohumeral joint.

Adult↗
PubMedDate not supplied

Enhanced production of leukotriene B4 by peripheral blood mononuclear cells in patients with fulminant hepatitis.

The production rate of leukotriene B4 (LTB4) was measured using peripheral blood mononuclear cells (PBMC) in patients with fulminant hepatitis (FH) or other liver diseases. LTB4 in the culture media of PBMC under stimulation with Ca-ionophore was fractionated by HPLC and measured by radioimmunoassay. The production rate of LTB4 was elevated in 16 of 17 FH patients (3.3 +/- 0.2 ng/10(6) cells for 5 min), while the production was below detectable level in patients with acute or chronic hepatitis and in healthy controls. In FH patients, the highest production rate of LTB4 was observed in the initial period of the disease. Enhanced LTB4 production may indicate the primed state of PBMC--the primed mononuclear cells are regarded as participating in the development of massive liver necrosis and of other organ failures in FH.

Hepatic Encephalopathy↗
PubMedDate not supplied

DNA ploidy and stromal bone formation as prognostic indicators of thyroid papillary carcinoma in aged patients: a retrospective study.

The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy-five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non-survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin-embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non-survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.

Aged↗
PubMedDate not supplied

Postnatal follow-up of hydronephrosis detected by prenatal ultrasound: the natural history.

Babies with hydronephrosis detected antenatally who were born at or referred to our hospital from 1990 to 1995 were followed up with ultrasound (U/S), micturating cystourethrogram (MCU) or nuclear medicine studies after birth. One hundred and three patients were diagnosed antenatally at 17-42 weeks gestation. Twelve cases were excluded from the analysis of the results because of incomplete data. Fifty-one (56%) patients had hydronephrosis without organic obstruction, and 80% of these became normal in 3 years. Fifteen patients (17%) had a normal scan 4 days after birth. This suggests the possibility of antenatal spontaneous regression. Seven (8%) had a ureterocele and 4 (5%) had pelviureteric junction (PUJ) obstruction. Four (5%) had vesicoureteric reflux, and 4 (5%) had primary megaureter. Two (2%) had posterior urethral valves (PUV), 3 (3%) had refluxing primary megaureter, and 1 (1%) had urethral atresia. Fifteen patients (17%) underwent surgical intervention. Six had a nephrectomy, 1 a vesicostomy, 3 an Anderson-Hynes pyeloplasty, 3 had the ureterocele unroofed, 1 had a ureteric reimplant, and 1 ablation of valves. In 42 infants with 60 abnormal kidneys, the renal anteroposterior diameter of the pelvis was measured. Retrospectively, 48 kidneys diagnosed as having hydronephrosis, antenatally had a renal pelvis diameter > or = 4 mm before 33 weeks gestation or > or = 7 mm after 33 weeks gestation. One patient with PUJ obstruction lost kidney function, but there is no good marker to detect these patients. Early unroofing of ureteroceles may rescue kidney function. Our follow-up protocol for antenatal hydronephrosis is U/S at 4 days, 1 month and 1 year of age. An MCU is not required unless the ureter is seen on antenatal U/S. If dilatation persists past 1 month, a radionucleotide (MAG3) scan and repeat U/S are performed at 3 months. The methods for assessing obstruction and the indications for surgical intervention in these patients require reexamination.

Female↗
PubMedDate not supplied

Influence of hepatocyte growth factor secreted from fibroblasts on the growth and invasion of scirrhous gastric cancer.

The objective of this study was to show that hepatocyte growth factor (HGF) and HGF receptor (c-met protein) play an important role in the cancer growth and infiltration in scirrhous gastric cancer. The expression level of c-met protein was examined in 90 cases of advanced gastric cancer using anti-c-met antibody. Co-cultivation of each of four gastric cancer cell lines with gastric fibroblasts was performed using a double chamber method. The expression rate of c-met was 79.5% in type 4 tumors, significantly higher than in other types. The expression rates were 63.6% in undifferentiated-type cancer and 36.3% in differentiated-type cancer. Co-cultivation of undifferentiated-type cancer with fibroblasts showed a significantly higher HGF concentration than fibroblasts cultured alone. The growth in three undifferentiated-type cancers was accelerated by an addition of rhHGF and by co-cultivation with fibroblasts and was inhibited by anti-HGF antibody. Moreover rhHGF stimulated the invasion activity of undifferentiated cancer cell lines. These findings suggested that gastric fibroblasts in scirrhous cancer stimulate tumor growth and invasion through activation of the HGF/c-met system.

Adenocarcinoma, Scirrhous↗
PubMedDate not supplied

MR imaging in patients with primary thyroid lymphoma.

The authors describe two patients with thyroid lymphoma and Hashimoto thyroiditis; T1- and T2-weighted MR sequences were used. In one patient, the region of lymphoma showed a different signal intensity on T2 images; in the other patient, the signal level was identical to the Hashimoto disease. In sum, the processes could not be significantly differentiated using MR.

Female↗
PubMedDate not supplied

Detection of recurrent thyroid cancer: MR versus thallium-201 scintigraphy.

PURPOSE: To compare MR with thallium-201 scintigraphy in the follow-up of patients who have undergone thyroidectomy and modified radical neck dissection for differentiated thyroid cancer. METHODS: Both MR imaging and 201Tl scintigraphy were performed in 39 patients after surgery for differentiated thyroid cancer. Ten patients did not have recurrence; 29 patients had 51 recurrent tumors in the neck and mediastinum. RESULTS: Among 51 tumor sites, 39 sites of recurrence were detected by MR and 24 were detected by 201Tl scintigraphy. The true-positive rate, false-negative rate, true-negative rate, and false-positive rate in detecting recurrent thyroid cancer were 76.5, 23.5, 100, and 0%, respectively, for MR and 47.1, 52.9, 100, and 0%, respectively, for 201Tl scintigraphy. MR was more sensitive than 201Tl scintigraphy in detecting recurrent tumors (especially small metastatic nodes). On T2-weighted MR images, recurrent tumor was characterized by high signal intensity. Scarring in the postoperative thyroid bed was characterized by low signal intensity on both T1- and T2-weighted images. Abnormal accumulation of 201Tl in the postoperative thyroid bed was not observed. CONCLUSIONS: Although both MR images and 201Tl scintigraphy were effective in distinguishing recurrent tumor from postoperative fibrous tissue, MR images were more sensitive than 201Tl scintigraphy in detecting recurrent tumors. These results suggest that MR imaging is more useful than 201Tl scintigraphy in the follow-up evaluation of patients after neck surgery for differentiated thyroid cancer.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Choledochoduodenal fistula: a complication of a penetrated duodenal ulcer.

A 44 year old man who had a 5-year history of recurrent duodenal ulcer with a choledochoduodenal fistula is reported. He showed bulbar stricture and was successfully treated with an truncal vagotomy and distal gastrectomy by Billroth II method, leaving the fistula intact. Choledochoduodenal fistula is an uncommon complication of penetrated peptic duodenal ulcer. Surgical treatment for duodenal ulcer has been recommended. Medical management with the recent anti-ulcer drugs for choledochoduodenal fistula also has been reported to gain good results.

Adult↗