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Biomedical subjects

R Nishimura

Publications and source records attributed to R Nishimura.

At least 55 records · Page 3Linked to original sources

Role of dynamic MRI in the evaluation of head and neck cancers treated with radiation therapy.

PURPOSE: To study the usefulness of dynamic magnetic resonance imaging in the evaluation of head and neck cancers treated with radiation therapy. METHODS AND MATERIALS: Seventy-six patients (58 males and 18 females; ages 20-82) with head and neck cancers (10 nasopharyngeal carcinomas, 22 mesopharyngeal carcinomas, 10 hypopharyngeal carcinomas, 16 oral cavity carcinomas, 11 lingual carcinomas, and 7 laryngeal carcinomas) were treated by radiation therapy combined with concomitant low-dose cisplatinum. Magnetic resonance imaging (MRI) was performed before and 2 weeks after the irradiation in all cases. After bolus administration of gadopentetate dimeglumine (Gd-DTPA) (0.1 mmol kg), images were obtained every 30 s (repetition time 200 ms, echo time 16 ms) using a 1.5 or 0.5-T superconductive unit. Biopsy or surgery was performed after radiation therapy and the histologic findings were correlated with the MRI findings (T1, T2, dynamic, and enhanced T1). RESULTS: Complete remission, partial response, and no response were obtained in 18, 36, and 7 cases, respectively. Dynamic MRI correctly diagnosed 17 of the 18 complete remission cases, 33 of the 36 partial response cases, and all of the 7 no-response cases. The accuracy of dynamic MRI, T1-weighted image, T2-weighted image, and Gd-enhanced T1-weighted image was 94.4%, 68%, 82%, and 86%, respectively. CONCLUSION: Dynamic MRI proved to be useful in the evaluation of the radiation therapy of head and neck cancers.

Adult

The effect of azelastine on acute radiation dermatitis in mice models.

PURPOSE: In our previous report we described the clinical value of azelastine, an oral antiallergic agent, as an inhibitor of radiation dermatitis. Here we studied the effect of azelastine on normal skin and tumor size after irradiation in a mouse model. METHODS AND MATERIALS: The modifying effects of azelastine on both the degree of radiation dermatitis and antitumoral effect of radiation therapy were investigated in the normal skin as well as in SCC VII tumors of C3H/He mice. The right hind legs, with or without tumors, were irradiated with 20-60 Gy at 0.62 Gy/min. Azelastine was administered via the mouse chow, and acute skin reactions and tumor growth curves were compared between the azelastine and control groups. RESULTS: The acute skin reactions of the azelastine group were significantly less prominent than those of the control group (p < 0.01). At a dose of 40 Gy the dose modification factors were 1.19-1.25. The tumor growth curves of the azelastine and control groups were almost identical, indicating that the treatment response of irradiation was not affected by administration of azelastine. CONCLUSIONS: Application of azelastine reduces the degree of acute radiation dermatitis without affecting the antitumoral effect of radiation therapy.

Animals

Geographic variation in mortality among individuals with youth-onset diabetes mellitus across the world. DERI Mortality Study Group. Diabetes Epidemiology Research International.

The aim of this study was to evaluate the geographic variation in mortality among individuals with youth-onset insulin-dependent diabetes mellitus (IDDM) across the world. The study was based on the currently available IDDM incidence and mortality data. Mortality data for diabetes in the 0-24 year age group were obtained from the World Health Organization (WHO) statistics. The mortality rates were adjusted for the frequency of occurrence of IDDM and dividing the mortality rates by the IDDM incidence rates which were obtained from the WHO DiaMond project. There was a more than 10-fold geographic variation in mortality between the developed countries and Eastern European populations. The areas with the highest mortality rates were located in Japan, Eastern Europe and Russia. The areas having the best outcome associated with IDDM were Northern Europe, Central Europe, and Canada. An ecological study demonstrated a relationship between the incidence-adjusted mortality (estimated case-fatality) with IDDM incidence itself (Spearman's correlation coefficient = 0.45) as well as infant mortality and life expectancy at birth. These data demonstrated the possibility of an enormous geographic variation in mortality of youth-onset diabetic patients even in developed countries. It is important to note that these excess deaths are potentially preventable. The ecological study also suggested that the mortality differences may be in part related to overall and diabetes related care.

Adolescent

An implant-supported fixed-removable prosthesis with a milled tissue bar and Hader clip retention as a restorative option for the edentulous maxilla.

Restoration of the edentulous maxilla with implant retained and supported prosthesis is challenging because of inherent anatomic limitations present after the loss of teeth. A fixed-removable prosthesis is one treatment choice for restoration of the edentulous maxilla with implants. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favorable biomechanical stress distribution to the implants. This article presents a procedure for fabrication of a fixed-removable prosthesis with a precision milled bar, Hader clip attachments, and a superstructure prosthesis. The criteria for patient selection and the advantages and disadvantages of this prosthesis are discussed.

Centric Relation

Predictive value of serum medroxyprogesterone acetate concentration for response in advanced or recurrent breast cancer.

Medroxyprogesterone acetate (MPA) is one of the most commonly prescribed drugs for endocrine therapy of metastatic breast cancer. In this study, the serum MPA concentration was measured by high-performance liquid chromatography (HPLC) and evaluated for its usefulness in predicting the response in 79 cases of advanced or recurrent breast cancers. Overall, 29 patients (37%) achieved an objective response. The response rate correlated significantly with the oestrogen receptor (ER) status (P = 0.03), proliferative activity determined by DNA polymerase alpha (P = 0.04), the disease-free interval (DFI) (P = 0.05) and the serum MPA concentration (P < 0.001). Patients with ER-positive tumours, lower proliferative activity, a longer (DFI) or a higher serum MPA concentration responded more frequently. The mean serum MPA concentration in the responders with ER-positive tumours (P = 0.01) or tumours with a lower proliferative activity (P = 0.008) were significantly lower than in cases with ER-negative tumours or tumours with a higher proliferative activity, respectively. Cases with soft tissue metastases showed responses at significantly lower MPA concentrations (P = 0.003) than those with bone or visceral metastases. Furthermore, there was a dramatic decrease in the MPA concentration when a responder with a high concentration became unresponsive to the therapy. Thus, the serum MPA concentration is a determining factor for the response to treatment.

Adult

Wiskott-Aldrich syndrome protein is associated with the adapter protein Grb2 and the epidermal growth factor receptor in living cells.

Src homology domains [i.e., Src homology domain 2 (SH2) and Src homology domain 3 (SH3)] play a critical role in linking receptor tyrosine kinases to downstream signaling networks. A well-defined function of the SH3-SH2-SH3 adapter Grb2 is to link receptor tyrosine kinases, such as the epidermal growth factor receptor (EGFR), to the p21ras-signaling pathway. Grb2 has also been implicated to play a role in growth factor-regulated actin assembly and receptor endocytosis, although the underlying mechanisms remain unclear. In this study, we show that Grb2 interacts through its SH3 domains with the human Wiskott-Aldrich syndrome protein (WASp), which plays a role in regulation of the actin cytoskeleton. We find that WASp is expressed in a variety of cell types and is exclusively cytoplasmic. Although the N-terminal SH3 domain of Grb2 binds significantly stronger than the C-terminal SH3 domain to WASp, full-length Grb2 shows the strongest binding. Both phosphorylation of WASp and its interaction with Grb2, as well as with another adapter protein Nck, remain constitutive in serum-starved or epidermal growth factor-stimulated cells. WASp coimmunoprecipitates with the activated EGFR after epidermal growth factor stimulation. Purified glutathione S-transferase-full-length-Grb2 fusion protein, but not the individual domains of Grb2, enhances the association of WASp with the EGFR, suggesting that Grb2 mediates the association of WASp with EGFR. This study suggests that Grb2 translocates WASp from the cytoplasm to the plasma membrane and the Grb2-WASp complex may play a role in linking receptor tyrosine kinases to the actin cytoskeleton.

Adaptor Proteins, Signal Transducing

Countertorque testing and histomorphometric analysis of various implant surfaces in canines: a pilot study.

As surface roughness may play a role in the mechanical attachment of an implant surface to bone, various implant surfaces have been prepared and analyzed by removal torque (countertorque) or push-out tests in a variety of animal model systems. Rougher surfaces generally have displayed higher mechanical testing values, indicating a stronger implant-bone interface. This pilot study was undertaken to test the countertorque values for integrated threaded implants with surfaces prepared by machining, blasting, and acid-etching, to compare the various implant surface types histomorphometrically for percentage of bone-implant contact under loaded and unloaded conditions, and to determine the degree of correlation between countertorque values and bone-implant contact with varying degrees of surface roughness. The results of this animal investigation suggest that the strength of the bone-implant interface, as determined by countertorque testing, is influenced by different surface characteristics. Acid-etched surfaces resisted countertorque forces more successfully as compared with blasted or machined surfaces. Histologic evaluation of bone contact with the various implant surfaces did not demonstrate a definite advantage for rougher surfaces in regard to percentage of bone contact at the light microscopic level.

Acid Etching, Dental

S-100 protein is a differentiation marker in thyroid carcinoma of follicular cell origin: an immunohistochemical study.

S-100 protein, a dimer of S-100 alpha and S-100 beta subunits (S-100 alpha and S-100 beta), is widely distributed in human tissue, and several papers describing S-100 protein expression in follicular cells of the thyroid have been published. In the present study, 105 cases of thyroid carcinoma (of which 96 were papillary, four follicular, two undifferentiated, and three medullary) were analyzed immunohistochemically for the expression of S-100 protein, S-100 alpha, S-100 beta, and thyroglobulin. In papillary carcinoma, 188 lesions were studied and classified into well differentiated types (56 papillary, 45 follicular) and poorly differentiated types (41 trabecular, four solid, eight squamoid, three tall, and one insular), because the histological structure of each tumor was heterogeneous. The percentage of lesions which expressed positively for S-100 protein and S-100 alpha, respectively, according to type were: papillary, 96 and 99%; follicular, 96 and 100%; trabecular, 95 and 100%; solid, 50 and 50%; squamoid, 50 and 75%; and tall, 33 and 100%. The insular type was negative for both. For papillary carcinoma, well differentiated lesions showed stronger S-100 alpha expression than poorly differentiated lesions. S-100 alpha expression was weaker in follicular and undifferentiated carcinoma than in papillary carcinoma. Medullary carcinoma also expressed S-100 alpha. S-100 beta was positive in lesions that expressed S-100 alpha strongly. Expression of S-100 protein and S-100 alpha protein correlated with thyroglobulin synthesis in the follicular cells. It was concluded that S-100 protein, mainly S-100 alpha, exists in thyroid follicular cells, that it exists in higher quantity in most of the well differentiated lesions but in lower quantity in poorly differentiated or undifferentiated lesions, and that S-100 protein, especially S-100 alpha, is a differentiation marker in carcinoma of thyroid follicular cell origin.

Adenocarcinoma, Follicular

Carcinosarcoma of the uterus: magnetic resonance imaging.

We report the magnetic resonance imaging (MRI) findings with a paramagnetic enhancement agent (gadopentetate dimeglumine (Gd-DTPA)) in a 70-year-old woman with carcinosarcoma of the uterus. In the present patient, the polypoid portion histologically most abundant in the sarcomatous component was strongly enhanced by Gd-DTPA and was clearly demonstrated with high signal intensities on contrast-enhanced T1-weighted images. We suggest that MRI with Gd-DTPA may be clinically useful for detection of carcinosarcoma, and that any patient having endometrial carcinoma with the polypoid portion, which is more strongly enhanced by Gd-DTPA within the tumor, may be suspected of carcinosarcoma.

Aged

Cardiovascular reflex mechanisms by topical instillation of capsaicin and distilled water into the larynx in anesthetized dogs.

Cardiovascular reflex mechanisms by topical laryngeal instillation of capsaicin (CAPS) or distilled water were evaluated in anesthetized chronic tracheostomized dogs. Both CAPS (10 micrograms/ml) and water instillation into the isolated upper airway caused a significant decrease in heart rate (P < 0.05) and a significant increase in blood pressure (P < 0.05) from the values before instillation under both spontaneous and controlled ventilation. The bradycardia was significantly reduced by atropine pretreatment (P < 0.05) and the hypertension was significantly decreased by phentolamine and propranolol pretreatments (P < 0.01). A higher concentration of CAPS (100 micrograms/ml) instillation considerably reduced the response to subsequent CAPS (100 micrograms/ml) instillation, whereas the response to water was sustained, indicating the desensitization of laryngeal CAPS-sensitive endings. All the reflex responses to CAPS and water were eliminated by topical anesthesia with lidocaine. It was concluded that the laryngeal cardiovascular reflex responses were mediated by the afferents such as the laryngeal CAPS-sensitive presumably C-fiber endings or water-responsive receptors and by both the parasympathetic and sympathetic nervous systems as efferents.

Administration, Topical

Inhibitory effects of glucocorticoids on proliferation of canine mast cell tumor.

The inhibitory effect of glucocorticoids (GCs) on proliferation of canine mast cell tumor (MCT) was studied using two types of MCT cells; JuMC cells and LuMC cells derived from spontaneous canine cutaneous and intestinal MCT, respectively. In in vitro study, growth of JuMC cells was significantly inhibited with more than 1 nM GCs and apoptotic-like cell death was seen, while that of LuMC cells was never inhibited even with 10 microM GCs. Growth rate of masses in nude mice developed by inoculation of JuMC cells was reduced in a dose-dependent manner by administration of GC, while growth inhibition of masses developed by inoculation of LuMC cells was minimal with increasing GC doses. Competitive binding studies and Scatchard analysis demonstrated the presence of high-affinity, low capacity GC receptors in both JuMC and LuMC cells. Kd was estimated to be 1.30 nM in JuMC cells and 0.45 nM in LuMC cells, respectively. It is concluded that canine cutaneous MCT cells responded to GCs in vitro and in vivo, whereas intestinal MCT cells did not, though both types of cells had specific GC receptors.

Animals

CT and MR findings of denervated tongue after radical neck dissection.

PURPOSE: To describe the CT and MR findings in the denervated tongue after a radical neck dissection. METHODS: We retrospectively evaluated the radiologic findings in seven patients who had hypoglossal paralysis following radical neck dissection. None of the patients had clinical or radiologic evidence of tumor recurrence. RESULTS: The side of the tongue operated on showed low density on CT scans. At MR imaging, denervated tongues were clearly seen as hyperintense relative to muscle on T2-weighted images; on T1-weighted images, the signal was hypointense to hyperintense, representing increased extracellular water or fatty degeneration. CONCLUSION: In patients who have undergone a neck dissection for a malignant process, abnormal imaging findings in the tongue not only might indicate a recurrence of tumor involving the hypoglossal nerve but also suggest the possibility of postoperative change. Our findings emphasize the importance of the denervated tongue in differentiating inflammatory from neoplastic diseases of the the tongue.

Adult

Cardiopulmonary effects of sevoflurane, compared with halothane, enflurane, and isoflurane, in dogs.

OBJECTIVE: To evaluate cardiopulmonary effects of sevoflurane (Sevo), compared with halothane (Hal), enflurane (Enf), and isoflurane (Iso). ANIMALS: 24 healthy Beagles, randomly assigned to 4 groups of 6 dogs each. PROCEDURE: Dogs under spontaneous ventilation were anesthetized with Sevo, Hal, Enf, or Iso. After minimum elveolar concentration (MAC) of each anesthetic was determined, anesthesia was maintained at light (1 MAC), moderate surgical (1.5 MAC), and deep (2 MAC), stages and cardiopulmonary variables at conscious state (baseline) and each anesthesia stage were measured. RESULTS: In dogs of the Sevo group, heart rate increased significantly from the baseline value at all anesthesia stages. Systemic vascular resistance during Sevo anesthesia decreased gradually with increasing anesthesia stage, which was accompanied by dose-dependent decreases in systolic, mean, and diastolic arterial blood pressures. At 1.5 and 2 MAC Sevo, stroke index decreased slightly but significantly from the baseline value; however, cardiac index was unchanged because of the significant increase in heart rate. Respiratory rate decreased significantly at 2 MAC from that at 1 MAC Sevo. Tidal volume and dead space-to-tidal volume ratio were unchanged at all anesthesia stages of Sevo, resulting in significantly decreased expired and alveolar ventilation at 2 MAC, compared with values at 1 and 1.5 MAC Sevo. PaCO2 increased and pHa decreased significantly, depending on anesthesia stage; PaO2, increased significantly from baseline values, and remained constant because of inhalation of 100% O2. CONCLUSION: Cardiovascular effects of Sevo were greater than those of Hal, similar to those of Iso, and less than those of Enf. Respiratory effects of Sevo were similar to those of Iso at all anesthesia stages, greater than those of Hal at 2 MAC, and less than those of Enf at 1.5 and 2 MAC. Up to the moderate surgical anesthesia stage, Sevo can be used safely in dogs undergoing spontaneous ventilation.

Anesthetics, Inhalation

[A familial case of postural reflex disorder presenting high intensity area mainly in the globus pallidus on T1-weighted cerebral MRI without clear liver damage].

A 56-year-old woman was admitted because of chronic postural reflex disorder. A cerebral MRI revealed symmetrical high intensity area mainly in the globus pallidus on T1-weighted image. The symptom became manifested as gait disturbance from the age of 2 and gradually progressed. Her condition has, however, remained stable since the age of 26. The only sign of parkinsonism was akinesia. There was clear retropulsion but cerebellar ataxia was minimal, and dystonia was negligible. She had no dementia. Her parents were cousins and similar symptoms and high intensity area were found in one of her sisters. Routine liver function tests were normal, with only ICG elevated. Serum copper and ceruloplasmin were normal. A hereditary factor was suspected. There are no similar cases reported in the literature, thus we thought it worth reporting.

Female

[Clinical significance of orthostatic blood pressure decline in patients with Binswanger-type infarction].

We analysed the blood pressure change in 40 patients with Binswanger-type infarction after 10 minutes of 90 degrees head-up tilting to clarify the clinical significance of orthostatic blood pressure decline observed in this disease. We investigated the correlation of orthostatic decline in systolic blood pressure to dementia, gait disturbance and nocturnal decrease in 24-hour variation of systolic blood pressure. Orthostatic blood pressure decline in patients with this disease was significantly marked in comparison with that in 50 patients with lacunar infarction, especially in the males. This blood pressure decline was significant in patients with dementia and moderate or severe gait disturbance, compared with those without such symptoms. There was no difference in orthostatic change between patients suffering from this disease with non-dementia and mild or absent gait disturbance and those with only lacunar infarction. Orthostatic blood pressure decline was found to be correlated significantly with the disorder of nocturnal blood pressure decrease. It is suggested that the decline of blood pressure on standing is a parameter indicating the progression of this disease.

Aged