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Biomedical subjects

R Murakami

Publications and source records attributed to R Murakami.

At least 127 records · Page 7Linked to original sources

Transcatheter hepatic subsegmental arterial chemoembolization therapy using iodized oil for small hepatocellular carcinomas. Correlation between lipiodol accumulation pattern and local recurrence.

Lipiodol accumulation patterns were correlated with local recurrences after subsegmental or conventional arterial chemoembolization therapy using iodized oil (Lipiodol-TAE). Thirty-six patients with solitary small hepatocellular carcinomas (HCCs) less than 3 cm in diameter were included in this retrospective study. Superselective subsegmental catheterization was performed in 14 patients (subsegmental Lipiodol-TAE). In the remaining 22 cases, embolization was performed from the proximal portion of the hepatic artery (conventional Lipiodol-TAE). Patterns of Lipiodol accumulations within the tumors were classified in 2 groups: complete and incomplete accumulation. Complete accumulation was observed in 71% of subsegmental Lipiodol-TAE and in 32% of conventional Lipiodol-TAE. The rate of local recurrences within 12 months was significantly higher (p < 0.01) in incomplete accumulation (100%) than in complete accumulation (13%). We suggest that when small HCCs are to be treated with TAE, subsegmental Lipiodol-TAE should be performed because of its superior capability for achieving complete Lipiodol accumulation.

Adult↗

[Transcatheter hepatic arterial embolization for the treatment of blunt hepatic injury].

To examine the indications of transcatheter arterial embolization (TAE) for blunt hepatic injury, angiographic images, CT images and medical records were reviewed. Hepatic angiography was performed in 30 patients with blunt hepatic injury. Sixteen of them who underwent TAE therapy immediately after angiography formed the TAE(+)group, while the 14 patients who were not followed by TAE formed the TAE(-)group. Angiographic extravasation of the contrast medium was confirmed in 14 of 16 patients in the TAE(+)group. On CT scan, the most common finding in the TAE(+)group was a deep hepatic laceration, which was classified as type III according to the criteria of the Japanese association for the surgery of trauma. Hemoperitoneum and fresh hematoma were visualized in most of the TAE(+)group. The preoperative hemodynamics of the TAE(+)group were markedly unstable, but were significantly improved after TAE therapy. No major complications were encountered during or after TAE. These results suggested that TAE was an effective therapeutic procedure for the control of blunt hepatic injury in patients associated with unstable hemodynamics, deep hepatic laceration shown by CT scan and extravasation confirmed by angiography.

Adolescent↗

Relationship between plasma triglycerides and apolipoprotein CII in infants during the first year of life.

Plasma triglyceride and apolipoprotein CII (apo CII) levels were measured in normal full-term infants and low-birth-weight infants at birth (from umbilical cord blood at 0 weeks), as well as at 2, 3, 4, 8, 24, and 48 weeks of age, and the relationship between plasma triglyceride and apo CII levels was studied. In both full-term and low-birth-weight infants, the plasma triglyceride and apoprotein CII levels were very low at birth, but they increased rapidly thereafter in the full-term infants and somewhat more slowly in the low-birth-weight infants. Both triglyceride and apoprotein CII levels became stable from 3 weeks of age in full-term infants and from 8 weeks in low-birth-weight infants. When the logarithmic values of triglyceride and apoprotein CII levels were compared, they showed a close correlation, and slopes of regression lines were 0.62 in full-term infants aged 0-2 weeks, 1.04 in full-term infants aged 3-48 weeks, 0.56 in low-birth-weight infants aged 0-4 weeks, and 1.04 in low-birth-weight infants aged 8-48 weeks. These results suggest that there may be some differences in triglyceride transport between full-term infants aged 0-2 weeks and 3-48 weeks as well as between low-birth-weight infants aged 0-4 weeks and 8-48 weeks.

Apolipoprotein C-II↗

A case of neonatal calf with meningitis associated with Klebsiella oxytoca infection.

A 16-days-old calf exhibited pyrexia, difficulty to stand and walk, cloudiness of the ocular aqueous humor, and swelling of the shoulder joints. The primary pathological lesion was fibrinopurulent meningitis with Gram-negative small bacilli, and which was concurrently accompanied with endophthalmitis, polyarthritis, and purulent inflammation in several visceral organs. Klebsiella oxytoca was isolated from the brain and spinal cord. These results suggest that this is a rare case of meningitis with septicemic K. oxytoca infection in neonatal calf.

Animals↗

[An evaluation of a therapy with antibacterial and antifungal agents infections with hematological disorders].

The primary objective of this study is to confirm the efficacy and safety of combination therapy with antibacterial and antifungal drugs for patients with hematological disorders complicated with infections of unknown causative organisms. The subjects consisted of 55 patients with hematological disorders, 28 males and 27 females, ranging from 1 to 78 years of age, with an average age of 34 years. The breakdown of the patients by disease was: 41 leukemias, 10 malignant lymphomas, 3 myelodysplastic syndromes and an aplastic anemia. All patients were treated with sulbactam/cefoperazone (SBT/CPZ) and aminoglycoside (AG) plus fluconazole (FLCZ) as an empiric therapy. Overall efficacy rate was 54.5% for all the patients: 57.7% for patients with suspected sepsis and 0% for those with pneumonia from which unknown organisms were detected. The efficacy rate was 59.4% for patient who had been previously treated with other antibiotics and 47.8% for those who had not previously been treated. The above results suggested that this combination therapy might be effective for severe infections of unknown causative organisms associated with hematological disorders.

Adolescent↗

The roles of Ca2+/calmodulin- and cGMP-dependent pathways in gametogenesis of a rodent malaria parasite, Plasmodium berghei.

The induction mechanism of gamete formation (gametogenesis) in a rodent malaria parasite, Plasmodium berghei, was investigated using Ca2+ antagonists, protein kinase inhibitors and amiloride, an inhibitor of monovalent cation/H+ exchange. Treatment with 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester (TMB-8, a Ca2+ release inhibitor) and W-7/W-66 (calmodulin inhibitors) blocked formation of male gametes by inhibiting DNA synthesis from 1.5C to 8C level. In contrast, inhibitors of cAMP/cGMP-dependent protein kinases such as H-8, H-87, H-89 and staurosporine also ceased the development of gametocytes, but DNA synthesis in male gametocytes occurred as in the controls. Electron microscopy revealed that male gametocytes treated with TMB-8 and W-7 failed to enlarge nuclei and to form axonemes in the cytoplasm. In female gametocytes, treatment with both Ca2+ antagonists resulted in a dramatic morphological change in the endoplasmic reticulum (ER), which is thought to be a Ca2+ store. The ER network condensed near nuclei and was laminated by the abnormal attachment of ribosomes between two ER membranes. On the other hand, male gametocytes treated with protein kinase inhibitors or amiloride had enlarged nuclei and axonemes, but failed to develop further. The ER network in female gametocytes treated with these inhibitors was similar to that in the controls.

Animals↗

A newly identified null allelic mutation in the human lipoprotein lipase (LPL) gene of a compound heterozygote with familial LPL deficiency.

In a Japanese patient with familial LPL deficiency, a new null allelic mutation, one base pair deletion at nucleotide position 916 was identified in exon 5 of one allele. In exon 3 of the other allele, we found the same nonsense mutation as we described previously in other Japanese kindreds. For the deletional mutant allele, we developed a simple detection method and constructed the DNA haplotype.

Alleles↗

Unique karyotypes in two patients with Prader-Willi syndrome.

A physical disruption of the Prader-Willi syndrome (PWS) chromosome region is thought to cause PWS. We describe 2 girls with PWS phenotype, who had unique chromosome 15 abnormalities. The first patient showed mosaicism: 45,XX,t(15;15)(qter----p11.1::q11.200----qter)/46,XX,t(15;15)(qter----p1 1.1::q 11.200----qter), +mar. The band 15q11.2 apparently remained intact in the t(15;15) chromosome, and the mar chromosome was considered as r(15) (p11.1q11.1). The second patient had a karyotype of 47,XX,del(15)(q11.200----q11.207), +idic (15)(pter----q11.1::q11.1----pter). The complex breakage and reunion involving the 15q11.2 regions of the father's homologous chromosomes 15 at meiosis appeared to have resulted in the idic(15) and the del(15) chromosomes. These cytogenetic findings suggest that the PWS chromosome region may be localized on the very proximal portion of band 15q11.2.

Child↗

De novo complex chromosome rearrangement in identical twins with multiple congenital anomalies.

A de novo and apparently balanced complex chromosome rearrangement (CCR) was found in monozygotic (MZ) twin infants with multiple congenital anomalies. The rearrangement involved 4 chromosomes with 6 breakpoints including 2p23, 2q13, 2q21.1, 3p23, 11q13.1, and 12q24.1. This seems to be the first report of a CCR in MZ twins. The relationship between this chromosome abnormality and MZ twinning is discussed.

Abnormalities, Multiple↗

Cutaneous vascular anatomy of the thoracic region of the dorsum and its role in flap design in the rat.

The cutaneous vascular anatomy of the proximal one-half of the dorsum (the thoracic region) and its role in flap design was studied in the rat. The investigation included anatomical dissection, ink injection into the axial artery, and flap harvesting in live animals. Anatomical dissection and india ink injection of the thoracic region revealed that the skin derives its principal blood supply from the lateral thoracic artery. The cutaneous vascular territory of the lateral thoracic artery was defined as follows: the medial border, along the midline of the back from the level of the inferior angle of the scapula to the lower border of the last rib; the lateral border, anterior axillary line corresponding with the length of the medial border; the cephalic border, a line joining the medial and lateral border at the level of the inferior angle of the scapula; and the caudal border, a line corresponding to the lower border of the last rib. Bilateral vascular pedicle island cutaneous flaps were harvested in living rats based on the vascular territory demarcated by India ink injection. All flaps survived; hence, this flap is reliable, with consistent vascularity, and is easy to harvest, and therefore, can be used as a vascular pedicle experimental model to study flap hemodynamics.

Animals↗

Detection and quantitative assessment of a Vibrio cholerae O1 species in several foods by a novel enzyme immunoassay.

A selected antibody enzyme immunoassay (SAEIA) for the general detection of Vibrio cholerae O1 species has been developed using the immunological reagents of a rabbit antiserum specific for V. cholerae O1 classical Inaba 569B and immobilized cell fragments of V. cholerae O1 El Tor 85P6, and beta-D-galactosidase-labeled goat anti-rabbit immunoglobulin G as tracer. The SAEIA was specific for V. cholerae O1 species and showed low cross-reaction values to other microorganism species tested including Vibrio parahaemolyticus. The detection limit of the SAEIA was 4,500 cells per assay for all the 13 strains of V. cholerae O1 examined. Quantitative comparison on the growth of the El Tor 85P4 in several foods cultured for 24 hr were studied using the SAEIA. Preceding the experiments, little inhibition of every food homogenate for the measurement of the SAEIA was first demonstrated and then the homogenate was directly used for an assay sample. The interaction of the growth of Escherichia coli to that of V. cholerae O1 in a food was also found to be little under the mixed culturing of both bacteria using the SAEIA.

Escherichia coli↗

Diagnostic validity of fecal occult blood tests for detecting gastroenterological cancers.

In order to estimate the diagnostic validity of chemical fecal occult blood tests, i.e. orthotolidine (Shionogi A) and guajac (Shionogi B) slides for detecting cancers of the esophagus, stomach and colorectum, the authors followed up all the examinees (n = 3,449) of comprehensive medical check-ups at the Center for Adult Diseases, Osaka, by means of record linkage to the Osaka Cancer Registry's files. Then, diagnostic validity was calculated based on the results of two years' follow-up. Sensitivity for the respective cancers was 20.0%, 11.8% and 62.5% for Shionogi A, and 20.0%, 5.9% and 43.8% for Shionogi B slides. Likelihood ratio for the respective cancers was 1.4, 0.8 and 4.5 for Shionogi A, and 3.3, 1.0 and 7.5 for Shionogi B. Specificity was analogous among the three cancer sites, being 86% for Shionogi A and 94% for Shionogi B. These results suggest that the diagnostic validity of chemical occult blood tests for detecting cancers of the esophagus and the stomach is very poor, and therefore imply that close examinations of these sites for screening positives is unnecessary in mass screenings for colorectal cancer.

Adult↗

A case of small round cell tumor of the thoracopulmonary region with myogenic and neurogenic elements.

We here report a unique case of a young boy with an intrathoracic tumor which consisted of neurogenic and myogenic elements. The initial pathological diagnosis was alveolar rhabdomyosarcoma. The tumor tissue from surgical resection was composed of three parts, each showing a different histological appearance, i.e. a monotonous small cell area, an alveolar area, and an area consisting of pleomorphic rhabdomyoblasts. The small round cells in the monotonous area were immunoreactive with the antibodies for Leu7, neuron-specific enolase (NSE), neurofilament proteins (NFP), and beta 2 microglobulin, but not with the antibody for desmin. These cells also had dense core granules. The tumor cells in the alveolar area were immunoreactive with the antibodies for Leu7 and desmin, but not with the antibody for NFP. Pleomorphic rhabdomyoblasts were immunoreactive with the antibody for desmin, but not with the antibodies for Leu7 and NFP. These findings imply that this tumor consisted of neurogenic and myogenic elements and is considered to be a special type of rhabdomyosarcoma.

Antibodies, Monoclonal↗

Terminal 22q deletion associated with a partial deficiency of arylsulphatase A.

A 7 month old girl with psychomotor retardation, hypotonia, and minor malformations was found to have a terminal deletion of the long arm of chromosome 22, del(22)(q13.31). The partial deficiency of arylsulphatase A (ARSA) and the normal level of NADH diaphorase 1 (DIA1) suggests that the ARSA locus can be regionally assigned to 22q13.31----qter and the DIA1 locus can be excluded from the same segment. This report is the third published case with a terminal 22q deletion.

Cerebroside-Sulfatase↗

Listeric septicemia with meningitis in a neonatal calf.

A 9-days-old calf which had exhibited depression and difficulty to stand and walk was examined pathologically and bacteriologically. The primary pathological changes consisted of multifocal necrosis in several visceral organs and fibrinopurulent meningitis. The necrotic lesions were most frequently found in the liver, and accompanied with mononuclear cell infiltration and Gram-positive small bacilli. The organisms were also present in the foci of mononuclear cells at the central gray matter of the mesencephalon. Listeria monocytogenes was isolated from the brain and other organs of the whole body.

Animals↗

Systolic and diastolic left ventricular dysfunction in middle-aged asymptomatic non-insulin-dependent diabetics.

Radionuclide ventriculographic studies were performed at rest and during exercise in 15 middle-aged asymptomatic patients with non-insulin-dependent diabetes mellitus (NIDDM) whose mean age was 58.7 +/- 10.5 years (mean +/- SD), and in 10 age- and sex-matched normal control subjects. The patients had neither clinical evidence of cardiovascular diseases nor obvious perfusion defects during maximal exercise testing with thallium-201 myocardial scintigraphy. The average left ventricular ejection fraction (LVEF) at rest was 69.1 +/- 5.3% in the diabetic patients and 65.6 +/- 4.2% in the control subjects, and during exercise, the average LVEFs were 68.3 +/- 6.9% and 72.1 +/- 5.0%, respectively. The changes in LVEF during exercise were -0.7 +/- 7.6% in the diabetic group and +6.5 +/- 2.6% in the control group (p < 0.01). However, the filling fraction during the first third of diastole at rest was significantly less in the diabetic group than in the control group (p < 0.05), the time to peak filling rate (TPF) was longer, and the TPF/R-R, normalized by the R-R interval and expressed as a percentage, was greater in the NIDDM patients than in the control subjects. There was close correlation between the abnormal response of LVEF to exercise and the reduced early diastolic filling in the diabetic patients. We concluded that 1) not only the response of LVEF to exercise but also the early left ventricular diastolic filling at rest are impaired in middle-aged asymptomatic NIDDM patients, and 2) some common factors could cause dysfunction of both the systolic and diastolic left ventricles in NIDDM patients, possibly latent global myocardial ischemia or metabolic myocardial disturbances.

Adult↗

Aberrant left gastric vein directly draining into left portal venous system. A case report.

A 66-year-old man with early gastric cancer and liver cirrhosis was diagnosed by preoperative angiography as having an aberrant left gastric vein communicating directly with the left lateral portal vein system. This communication was confirmed during operation for the gastric cancer. Our report is the first of an aberrant left gastric vein showing direct communication with the left portal vein system.

Aged↗