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Biomedical subjects

S Endo

Publications and source records attributed to S Endo.

At least 199 records · Page 11Linked to original sources

Suboccipital meningocele presenting as a huge retropharyngeal mass in a patient with neurofibromatosis Type 1. Case report.

The authors report an extremely rare case of neurofibromatosis Type 1 (NF1) with a suboccipital meningocele presenting as a huge retropharyngeal mass. A 73-year-old woman with typical cutaneous manifestations of NF1 presented with nasal obstruction and dysphagia due to a retropharyngeal mass. Magnetic resonance imaging revealed a huge mass lesion extending from the right occipital bone defect to the retropharynx through the right paravertebral region. Computerized tomography scanning after intrathecal administration of contrast material confirmed that the mass was a meningocele protruding through a right occipital bone defect. The authors attempted to ligate this meningocele, most of which was excised via a suboccipital approach, but a second transcervical operation was required. Finally, the meningocele resolved and the patient was discharged without symptoms.

Aged↗

[A case of recurrent colon cancer with complete response to modulation chemotherapy using low-dose leucovorin and 5-fluorouracil].

We experienced a case of lymph node recurrence from colon cancer with complete response to modulation chemotherapy using low-dose leucovorin and 5-FU. The patient was a 68-year-old male. He underwent sigmoid colon resection for sigmoid colon cancer in October 1993. In June 1994, he complained of left lower abdominal pain. Swelling of retroperitoneal lymph node was detected by CT scan and cytology revealed cancer cells in urine. He was diagnosed as having lymph node recurrence. He then was given modulation chemotherapy of 30 mg of leucovorin and 500 mg of 5-FU that were bolus injected intravenously for 5 days. After 2 cycles of this regimen, the recurrent mass disappeared completely for further examination. Until May 1998, he had received 14 cycles. Since this regimen started, his survival period has been 46 months, and his response duration 42 months.

Aged↗

Cascade of acetazolamide-induced vasodilatation.

UNLABELLED: Acetazolamide (AZ) has been found to be effective in inducing vasodilatation. To evaluate the mechanism by which AZ acts, we compared the effects of this agent on vascular PGI2, endothelin (ET-1), and NOx, with those induced by CO2 gas inhalation. METHOD: Blood flow (BF) was measured in the liver, kidneys, stomach wall, and abdominal muscle of anesthetized white rabbits with a laser flow meter at baseline and again after sequential doses of AZ (4 mg/kg) or CO2 inhalation. Cardiac output and serum concentrations of PGI2, ET-1, and NOx were also measured in these animals. RESULTS: AZ increased BF in the liver and kidneys, but had no effect on BF in the stomach wall or abdominal muscle. The level of NOx was decreased following the administration of AZ, while PGI2 and ET-1 levels remained unchanged. In contrast, CO2 inhalation increased PCO2, and decreased pH, significantly. CO2 elevated BF in the liver, kidneys, stomach wall, and abdominal muscle, as well as serum levels of PGI2 and ET-1, while having no effect on NOx levels. The alterations in BF, PGI2, ET-1, and NOx in response to AZ, suggest that the mechanism of AZ-induced vasodilatation may involve a cascade that is triggered by CO2 retention similar to that caused by the inhalation of CO2.

6-Ketoprostaglandin F1 alpha↗

Frequent deletion and 5' CpG island methylation of the p16 gene in primary malignant lymphoma of the brain.

A total of 10 primary malignant lymphomas of the brain were examined for deletion, mutation, and 5' CpG island methylation of the p16 gene, which is a candidate tumor suppressor gene with CDK-inhibitory function. In Southern blot analysis, p16 gene deletion was suggested in nine cases, homozygously (five cases) or hemizygously (four cases). In the remaining one case, p16 gene deletion was not suggested. Although single-strand conformation polymorphism and nucleotide analyses suggested no mutations of the p16 gene in these cases, methylation analyses revealed 5' CpG island methylation in three cases, of which two were those with presumed hemizygous deletion and one was that without deletion in Southern blot analysis. Thus, p16 gene abnormality was detected in all 10 of the brain lymphomas examined, and in 8 of them, actual p16 gene inactivation was suggested by their homozygous deletion (5 cases) or 5' CpG island methylation (3 cases). These findings suggest that p16 gene abnormality and inactivation are closely related to carcinogenesis in primary malignant lymphoma of the brain. The p15 gene, another candidate tumor suppressor gene located in the vicinity of the p16 gene, to which it shows structural and functional similarity, was also presumed to be deleted similarly in most cases. Its methylation was seen in one case, the case without the methylated p16 gene.

Brain Neoplasms↗

Subcarinal neurogenic tumor: report of a case.

We present herein the rare case of a 63-year-old man in whom a subcarinal tumor, demonstrated by enhanced chest computed tomograms (CT), was subsequently confirmed to be a neurilemmoma by histological examination following tumor resection through a diagnostic thoracoscopy. Magnetic resonance imaging (MRI) and transesophageal ultrasonogram findings excluded the possibility of malignant lymphoadenopathy. As the patient was also found to have an elevated level of the squamous cell carcinoma (SCC) tumor marker which did not resolve postoperatively, close follow-up will be required.

Humans↗

Pulmonary histoplasmosis in a Japanese male: report of a case.

A case of pulmonary histoplasmosis, which is rare in Japan, is reported herein. A 43-year-old man who had worked in Mexico for 2 years and had come back to Japan 3 months earlier, presented at our hospital because of an abnormal shadow on his chest roentogenogram with no symptoms. His chest roentogenogram as well as chest computed tomograms revealed a 2-cm-diameter nodule in the anterior basal segment of his right lung and an enlargement of the subcarinal lymph node. Although these pictures seemed to indicate an advanced lung cancer, no malignant cells were found based on the brushing cytology findings after bronchoscopy. An exploratory thoracoscopic tumor resection and biopsy of the enlarged lymph node led to a histological diagnosis of an abscess due to histoplasma. The hospital course was uneventful. Postoperatively, amphotericin B was administered for 1 year. This is the eighth case of pulmonary histoplasmosis reported in Japan. A pulmonary nodule together with mediastinal lymphoadenopathy seems to be characteristic in these patients. Histoplasmosis should therefore be considered in the differential diagnosis, since overseas travel has now become common-place for the Japanese.

Adult↗

Administration of methylprednisolone acetate into the subdural cavity in an infant with subdural fluid collection. PAF is a good indicator of the efficacy of the treatment.

We report on the successful treatment of a case of infantile subdural fluid collection after cardiac surgery by administration of methylprednisolone acetate into the subdural cavity. The protein content in subdural fluid did not change even after administration of this steroid and was not a good indicator of the efficacy of treatment; however, the content of platelet-activating factor (PAF), an inflammatory mediator, in the fluid removed from the subdural cavity decreased rapidly after administration of the steroid. Subdural fluid collection subsequently decreased and mental retardation was improved. Our findings suggest that PAF content is a good indicator of the severity of infantile subdural fluid collection.

Anti-Inflammatory Agents↗

Inflammatory cytokines locally elevated in chronic subdural haematoma.

The involvement of inflammation in the development and propagation of chronic subdural haematoma (CSH) was investigated by measuring the levels of inflammatory cytokines (tumour necrosis factor [TNF] alpha, interleukin [IL]-1 beta, IL-6, and IL-8). Peripheral venous blood and subdural fluid were obtained at the time of burr hole surgery from 34 patients with CSH and from 9 with subdural effusion. The levels of the inflammatory cytokines were analysed by enzyme-linked immunosorbent assay. The blood levels of TNF alpha, IL-1 beta, IL-6, and IL-8 in both CSH and subdural effusion groups were almost within the range of normal subjects, and no differences were observed between the two groups. IL-6 and IL-8 in the subdural fluid were much higher than in the blood of both groups, and the levels in CSH patients were significantly higher (10 times) than in subdural effusion patients. Local elevation of inflammatory cytokines in the subdural space of both CSH and subdural effusion without systemic change suggests the presence of local inflammation in the two diseases. The same behavioural patterns of cytokines for these and higher levels of cytokines in the CSH also suggest that inflammatory cytokines may be involved in the continuous development from subdural effusion to CSH and propagation of CSH.

Adult↗

Vasa vasorum of the intracranial arteries.

Most of the major extracranial arteries have vasa vasorum which play an important role in some pathological conditions. However, in the intracranial arteries, the existence of vasa vasorum and their pathological implication have not been adequately investigated. We examined the distribution and incidence of vasa vasorum in the major cerebral arteries and their relationships to certain clinical factors in 50 autopsy cases performed between 1987 and 1994. By light microscopy, vasa vasorum were found in 36 of 50 patients. Of 36 patients, vasa vasorum in 30 cases were localizedly observed in the tunica adventitia and the in other 6 were distributed in the tunica media accompanied by intramural haemorrhage. Existence of vasa vasorum was more common in the proximal arteries (vertebral, internal carotid, and basilar arteries) than in the distal arteries (middle cerebral and anterior cerebral arteries). Vasa vasorum were found more frequently in aged patients with severe atherosclerosis and those with cerebrovascular diseases. Our results indicated that intracranial vasa vasorum existed with a higher frequency in the tunica adventitia of the vertebral and internal cerebral arteries, and the incidence of vasa vasorum related to severity of atherosclerosis. The development of vasa vasorum in the tunica media may reflect some pathological changes of cerebral arteries.

Adolescent↗

Mitochondrial DNA mutations in Japanese patients with optic neuropathy unassociated with a mutation at nucleotide position 11,778.

We examined for mitochondrial DNA (mtDNA) mutations at nucleotide positions(nt) 3460, 14,484, 9438, 9804, and 15,257 in ten Japanese patients with idiopathic optic neuropathy unassociated with a mutation at nt11,778. The mtDNAs were amplified by polymerase chain reaction (PCR), the products were digested with restriction enzymes, and the sizes of the fragments were analyzed on 8% polyacrylamide gel. Of the ten patients, one had an mtDNA mutation at nt3460 and another patient had a mutation at nt14,484. We suggest that mtDNA mutations in Japanese patients with optic neuropathy unassociated with a mutation at nt11,778 should be further investigated.

Adolescent↗

Plasma levels of type II phospholipase A2 and nitrite/nitrate in patients with burns.

Type II phospholipase A2 (type II PLA2), nitrite/nitrate (NOx), tumor necrosis factor-alpha (TNF-alpha) and endotoxin were studied in burn patients. Type II PLA2 values and NOx values were both significantly higher in the group that died, the group with shock as a complication and the group with multiple organ dysfunction syndrome (MODS) as a complication, than in the group that survived, the group without shock as a complication and the group without MODS as a complication, respectively. The results suggested that type II PLA2 and nitric oxide (NO) may play a major role in the pathology of burn patients. Significant correlations were found between TNF-alpha and type II PLA2 values and between type II PLA2 and NOx values, suggesting the possibility of involvement in each other's production.

Adult↗

Generators of visual evoked potentials investigated by dipole tracing in the human occipital cortex.

Current source generators (dipoles) of the human visual evoked potentials to pattern-onset stimuli were investigated with the dipole tracing method, using a realistic four-layer head model of scalp-skull-fluid-brain, which can equate the surface potential distributions on a scalp to one or two corresponding equivalent dipoles. Three healthy adult human subjects were used, and 29 electrodes were set on a scalp of each subject. Visual stimulus of a checkerboard pattern was presented for 250 ms in each of eight different visual fields (central and peripheral parts of each of four quadrant fields). The visual evoked potentials consisting of initial positive-late negative waves (CI and CII components designated by Jeffreys and Axford) were recorded mainly on the occipital region contralateral to stimulated visual fields. The initial positive wave (CI) of visual evoked potentials were divided into two components: early component of the CI (e-CI--an early small positive deflection with approximate peak latency of 70-90 ms) and late component of the CI (l-CI--a late large positive deflection with approximate peak latency of 100-120 ms). The dipole with a fit exceeding 98% dipolarity with our model at the shortest latencies was defined as an "earliest dipole" of the evoked potentials, produced by the primary responses in the occipital cortex to an afferent volley from the lateral geniculate body. These earliest dipoles, for eight different visual field stimulations, were estimated at the approximate peak of the e-CI. Estimated dipoles were superimposed on a three-dimensional magnetic resonance image of each subject's brain. Earliest dipoles for right upper and right lower quadrant-field stimulations were located at the left calcarine cortices below and above the calcarine fissure, respectively; earliest dipoles for left upper and left lower quadrant-field stimulations were located at the right calcarine cortices below and above the calcarine fissure, respectively. Furthermore, earliest dipoles for central and peripheral quadrant-field stimulations were located posteriorly and anteriorly in the calcarine cortex, respectively. The results from these non-invasive analyses of visual evoked potentials indicated topographic localization of the dipoles around the calcarine fissure based on the loci of the visual fields. This was comparable to the retinotopy of the human occipital lobe based on clinicopathological studies.

Adult↗

Positional cloning of the gene for Nijmegen breakage syndrome.

Nijmegen breakage syndrome (NBS), also known as ataxia-telangiectasia (AT) variant, is an autosomal recessive disorder characterized by microcephaly, growth retardation, severe combined immunodeficiency and a high incidence of lymphoid cancers. Cells from NBS patients display chromosome instability, hypersensitivity to ionizing radiation and abnormal cell-cycle regulation after irradiation, all of which are characteristics shared with AT. Recently, the NBS locus was mapped at 8q21 by two independent approaches, complementation studies and linkage analysis. Here, we report the positional cloning of the NBS gene, NBS1, from an 800-kb candidate region. The gene comprises 50 kb and encodes a protein of 754 amino acids. The amino-terminal region of the protein shows weak homology to the yeast XRS2, MEK1, CDS1 and SPK1 proteins. The gene is expressed at high levels in the testes, suggesting that it might be involved in meiotic recombination. We detected the same 5-bp deletion in 13 individuals, and conclude that it is likely to be a founder mutation.

Amino Acid Sequence↗

Effects of trazodone hydrochloride and imipramine on polysomnography in healthy subjects.

Polysomnography was performed on eight healthy men with trazodone hydrochloride, imipramine and placebo. Trazodone hydrochloride increased slow wave sleep significantly. Imipramine prolonged rapid eye movement (REM) latency and decreased the percentage of REM sleep significantly. Trazodone decreased stages 1 and 2 sleep, while imipramine increased it. These findings suggest that the antidepressive effect of trazodone might be different from that of imipramine with the suppression of REM sleep.

Adult↗