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Biomedical subjects

S Hagiwara

Publications and source records attributed to S Hagiwara.

At least 91 records · Page 5Linked to original sources

Comparison of bone scans, parathyroid hormone levels and bone mineral densities in hemodialysis patients.

We have evaluated bone scans, parathyroid hormone (PTH) levels and bone mineral densities (BMDs) of hemodialysis (HD) patients. The bone scans were grouped into 4 types (type 1-4). Type 1 showed a diffusely high activity of the tracer in the whole skeleton especially in the skull: secondary hyperparathyroidism pattern. Type 2 showed high background activity, the same pattern as osteomalacia. Type 3 was a mixture of types 1 and 2. Type 4 was almost normal. The PTH levels of type 1 were higher and the radius BMDs were lower than those of the other types. The radius BMDs in one third of type-2 patients were lower than the normal range. A comparison of bone scans, PTH and BMDs helps to evaluate bone changes in HD patients.

Adult↗

[Assessment of bone mineralization of hemodialyzed patients with SPA and DPA--different effect of PTX with the site].

We analyzed the bone changes at each site of secondary hyperparathyroidism (2 degrees HPT) on hemodialyzed patients using both single photon absorptiometry (SPA) and dual photon absorptiometry (DPA). The subjects were 35 hemodialysis patients (12 male, 24 female) with 2 degrees HPT. The bone mineral densities (BMD) of 1/3 radius, head, total body and 3rd lumbar spine were measured before and after parathyroidectomy (PTX). Before PTX, the BMD of 2 degrees HPT patients were lower than the normal range of all sites, especially at the radius which mainly consisted of cortical bone. After PTX, the BMD at all sites increased especially in the head. The BMD of the radius also continued to increased up two years after PTX, but it was not as increased as the BMD of head. The BMD of the lumbar spine which consisted of cancellous bone mainly increased after PTX for one year and decreased thereafter. This decrease was influenced by age. There was a difference with the site of BMD after PTX. The determination of changes of BMD of head and radius was considered useful for the judgment of treatment.

Absorptiometry, Photon↗

[Hypersensitivity pneumonitis caused by a home humidifier].

A 33-year-old man was admitted complaining of a fever, dyspnea, and a dry cough almost every night since December of 1992. He had been using an ultrasonic humidifier at home. The chest CT scan and roentgenogram showed bilateral reticulonodular shadows. After admission, the symptoms resolved spontaneously. These findings were suggestive of hypersensitivity pneumonitis. After analysis of fluid obtained by bronchoalveolar lavage and of a specimen obtained by transbronchial biopsy, "humidifier lung" was diagnosed. Ten species of microorganisms were isolated from the water left in the patient's humidifier. On precipitation and complement fixation tests of the patients serum, the results were positive for three of those microorganisms: Flavobacterium multivorum, Yersinia pseudotuberculosis, and Aureobacterium liquefaciens. The titer on the complement fixation test increased immediately after a provocation test. The laboratory results suggest that at least one of these three microorganisms was the causative antigen in this case.

Adult↗

Dual x-ray absorptiometry forearm software: accuracy and intermachine relationship.

An ash study was performed to analyze the accuracy of forearm measurements at the one-third site of three dual x-ray absorptiometry (DXA) systems using 20 cadavers. A Hologic QDR-2000, a Hologic QDR-1000/W, and a Lunar DPX-L system were used. The correlations between ash weight and DXA BMC were excellent for the three instruments (r > 0.97, p < 0.001), with accuracy errors < 5.2%. To perform a forearm cross-calibration of bone mineral content (BMC) and density (BMD) between the scanners, 10 healthy volunteers were additionally scanned at the distal one-third radius. The correlations among the DXA machines were excellent (r > 0.95); the absolute BMC and BMD values were significantly different between the two Hologics and the Lunar machine. The slope and intercept of both the BMC and BMD between the two Hologic systems were close to unity. In conclusion, the DXA forearm software packages provide accurate methods for assessing bone mineral content and density. The conversion of data among different manufacturers should be performed by careful cross-calibration measurements.

Absorptiometry, Photon↗

Universal standardization for dual x-ray absorptiometry: patient and phantom cross-calibration results.

The comparison of patient data among different dual x-ray absorptiometry (DXA) scanners is complicated because no universally accepted cross-calibration procedure or standard currently exists. This study was performed under the auspices of the International DXA Standardization Committee to establish appropriate cross-calibration parameters. Posteroanterior (PA) lumbar spine measurements of 100 women, ages 20-80 years (mean 52.6 +/- 16, range of BMD = 0.4-1.6 g/cm2) were obtained on a Norland XR26 Mark II, a Lunar DPX-L, and a Hologic QDR 2000 densitometer using standard procedures (pencil beam mode for all three scanners). Area, BMC, and BMD results from the different scanners were compared for all patients. In addition, the European spine phantom (ESP) and the European spine phantom prototype (ESP prototype), as well as standard phantoms from all three manufacturers, were evaluated on the three systems. To achieve universal scanner calibration, we used the intercept and slope of the patient's correlations and the value of the middle vertebra of the ESP as a reference point in a series of standardization formulas, and we have expressed the results as sBMD (mg/cm2). The correlations of the patients' spinal BMD values were excellent for each of the three scanner pairs. The average absolute difference in patient spinal BMD values (L2-4) between Hologic and Norland was 0.012 g/cm2 (1.3%); it was 0.113 g/cm2 (11.7%) between Hologic and Lunar and 0.118 g/cm2 (12.2%) between Norland and Lunar. The phantoms' regression lines approximated those of the patient regression lines, and the phantoms with only one measurement point were very close to the patients' regression lines. After applying the standardization formulas, the average absolute differences for the 100 patients were 28 mg/cm2 (2.7%) for Hologic/Norland, 23 mg/cm2 (2.2%) for Hologic/Lunar, and 29 mg/cm2 (2.8%) for Norland/Lunar. Average BMD results for the patients before correction were 0.972 mg/cm2 for Hologic, 1.100 g/cm2 for Lunar, and 0.969 g/cm2 for Norland. After correction, sBMD results for patients were 1045 mg/cm2 for Hologic, 1047 mg/cm2 for Lunar, and 1043 mg/cm2 for Norland. The standardization approach as performed in our study provided compatibility of DXA results obtained on different scanners.

Absorptiometry, Photon↗

Total body and regional bone mineral content in hemodialysis patients.

Bone mineral content (BMC) in the total body and lumbar spine was evaluated in 126 hemodialysis patients (60 males, 66 females) by dual photon absorptiometry with the Norland DBD 2600. Measurements of: 1) total body BMC divided by lean body mass (BMCTB/LBM), 2) bone mineral density (BMD) of total body, 3) BMD of four regional sections (head, trunk, pelvis, and legs), and 4) BMD of lumbar spine, generally showed a significant decrease in the hemodialysis patients compared to the reference population. However, arm BMD did not show a significant difference between patients and control populations. The z-score of BMCTB/LBM declined significantly throughout the duration of hemodialysis, although that of the lumbar spine BMD did not. It should be noted that the degree of decrease in BMC was more prominent in the total body measurement than in the lumbar spine measurement. There was preferential osteopenia of the total body in the hemodialysis patients. Although the lumbar spine BMD showed a lower value than the control population, the lumbar spine is not the recommended region to monitor the BMD change in hemodialysis patients.

Absorptiometry, Photon↗

Radiographic absorptiometry for bone mineral measurement of the phalanges: precision and accuracy study.

PURPOSE: To evaluate the accuracy and precision of a radiographic absorptiometry (RA) method for assessment of bone mineral of the middle phalanges. MATERIALS AND METHODS: Nineteen cadaveric hands were radiographed with an aluminum wedge, once at 50 kVp and 400 mA and once at 60 kVp and 300 mA. Bone mineral content (BMC) and bone mineral density (BMD) of the second to fourth middle phalanges, expressed in arbitrary units (BMC-AU and BMD-AU), were analyzed and averaged in each hand. RESULTS: The precision error of this method was 1.0% for BMC-AU and 0.6% for BMD-AU. A 2.0%-2.4% reduction in BMD-AU seen on radiographs obtained through ethanol thicknesses of 5 and 6 mm compared with that seen on controls was statistically significant (P < .01). The correlation between BMC-AU and forearm BMC determined with dual x-ray absorptiometry was good (r = .887), and that between BMC-AU and ash weight in the phalanges was excellent (r = .983). CONCLUSION: The RA method is precise and accurate for bone mineral assessment of the peripheral appendicular skeleton.

Absorptiometry, Photon↗

Evaluation of a monoclonal antibody-based colony blot test for rapid identification of virulent Rhodococcus equi.

We recently generated a monoclonal antibody immunoglobulin G1 (MAb 10G5), which can recognize 15- to 17-kDa antigens, virulence-associated antigens of Rhodococcus equi, and developed a colony blot enzyme-linked immunosorbent assay with MAb 10G5 for the rapid identification of virulent R. equi. In this epidemiologic study, we evaluated the results of the colony blot test in the identification of virulent isolates of R. equi from feces of horses and soil and compared them with those from a conventional procedure (plasmid profiles of isolates by agarose gel electrophoresis). Environmental isolates (778 isolates from feces of foals, 170 isolates from feces of dams, and 1,267 isolates from soil on horse-breeding farms in Hokkaido) were tested by the colony immunoblot test, and 238 of the 778 isolates, 6 of the 170 isolates, and 85 of the 1,267 isolates showed positive signals. Positive isolates were then analyzed for the presence of virulence plasmid DNA, and 235 (98.7%) of the 238 isolates from foals, 6 (100%) of the 6 isolates from dams, and 75 (88.2%) of the 85 isolates from soil showed the presence of virulence plasmids. On the other hand, 50 isolates from each source, which were randomly selected from the isolates that showed negative signals by colony immunoblot, did not contain virulence plasmids. These results demonstrated that the colony blot test that uses a monoclonal antibody specific for virulence-associated antigens is a rapid and reliable test for the identification of virulent R. equi.

Actinomycetales Infections↗

[Two cases of advanced breast cancer effectively treated with chemoendocrine therapy and radiotherapy].

We reported 2 cases of breast cancer with lymph node metastasis treated with CAF (cyclophosphamide, adriamycin, 5-fluorouracil) and medroxyprogesterone acetate (MPA). Case 1 was stage IV [T4b, N3 M1 (lung)] and case 2 was stage IIIa (T1, N2, M0). The two cases responded well to CAF and MPA therapy in local and systemic lesions, and then underwent radiotherapy and lymph node resection without mastectomy. After these treatments, both cases were thought to be disease-free. Major side effects were allopecia, obesity, and leukopenia. These results suggest that combination chemoendotherapy, radiotherapy, and surgery can be utilized for most patients with moderately advanced breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗

Noninvasive bone mineral density measurement in the evaluation of osteoporosis.

Bone densitometry has developed considerably during the past several decades. Because the techniques have become more precise than before, osteoporotic patients can now be followed over time, allowing for assessment of disease or response to treatment. Several densitometry techniques have been shown to allow for the assessment of fracture risk. Factors other than density, however, additionally influence fracture risk. The next step will be the evaluation of microstructure and bone quality.

Aged↗

Effects of felodipine, nifedipine and verapamil on cytosolic Ca2+ and contraction in vascular smooth muscle.

The inhibitory effects of felodipine, nifedipine and verapamil were compared in vascular smooth muscle. In rat aorta, these inhibitors attenuated the high K(+)-induced contraction with a parallel decrease in the cytosolic Ca2+ level ([Ca2+]i). Maximal inhibition was obtained with 10 nM felodipine, 100 nM nifedipine and 10 microM verapamil. The inhibitory effects were antagonized by an increase in external Ca2+ concentration to 6.5 mM and the addition of a Ca2+ channel activator, 100 nM Bay k 8644. These inhibitors also attenuated the contraction induced by norepinephrine although these effects were weaker than those on high K(+)-induced contraction. Furthermore, these inhibitors attenuated the norepinephrine-stimulated [Ca2+]i more strongly than contraction. In contrast, none of these inhibitors inhibited the transient increase in [Ca2+]i and muscle tension induced by norepinephrine in Ca(2+)-free solution and the Ca(2+)-induced contraction in permeabilized smooth muscle. These results suggest that felodipine, nifedipine and verapamil inhibit smooth muscle contraction by inhibiting Ca2+ channels at concentrations which do not change Ca2+ release or Ca2+ sensitivity of contractile elements.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

A novel gene product associated with mu chains in immature B cells.

A previously unreported B cell specific gene, which we have named 8HS-20, was isolated from the cDNA library of a pre-B cell clone by subtraction and differential hybridization. This gene is selectively expressed as a 0.75 kb transcript in pre-B and bone marrow-derived B cell lines; a transcript of the same size is also found in bone marrow and, albeit at low levels, in spleen. The deduced amino acid sequence of the 8HS-20 cDNA displayed homology to a B cell specific gene, VpreB-1, and to members of the immunoglobulin supergene family including V lambda, V kappa, VH, TCRV alpha, V beta and CD8. Biochemical analysis using purified antiserum against 8HS-20 oligopeptides indicates that the gene encodes proteins with mol. wts of 13.5, 14, 15.5 and 16 kDa, which associate with mu chains in pre-B cell lines, and that these molecules are expressed concomitantly with VpreB-1 and lambda 5 gene products in the same cell lines.

Amino Acid Sequence↗

Recurrence of symptomatic Rathke's cleft cyst: a case report.

A 65-year-old man presented with bitemporal hemianopsia. He had undergone frontal craniotomy for a Rathke's cleft cyst associated with narrowed visual field 8 years earlier. His vision had returned to normal soon after surgery and he remained asymptomatic until the present complaint. Neurodiagnostic imaging revealed a recurrence of the intrasellar cyst extending into the suprasellar cistern. His vision improved rapidly after a second surgery. The histological findings were the same as those of the previous operation; the cyst wall was composed of a single layer of ciliated columnar epithelium resting on a collagenous connective tissue stroma.

Aged↗

Precision and accuracy for rat whole body and femur bone mineral determination with dual X-ray absorptiometry.

Precision and accuracy for rat whole body and excised femur bone mineral density (BMD) measurements were evaluated with two dual X-ray absorptiometry (DXA) systems. The 'small subject' mode on the Norland XR-26 (XR), and the 'ultra high resolution mode' on the Hologic QDR-1000/W(QDR) were used for the analysis. The whole body mode was only available on the XR. The lowest precision error for the whole body was found using a scan resolution of 1.0 x 1.0 mm and a scan speed of 15 mm/s. The scan spatial resolution of the femur measurement was approximately eight times higher on the QDR than on the XR. However, the XR allowed analysis of an arbitrary region of interest within the femur, which was not easily done with the QDR. Precision for the total femur measurement on the QDR (0.5-0.9%) was approximately two to four times superior to that of the XR (1.5-4.3%). The difference may be due to the superior scan resolution of the QDR. Bone mineral content and BMD on the QDR significantly declined with an increase of water depth (P < 0.001). No significant change was observed on the XR. Both DXA systems demonstrated an excellent correlation (r > or = 0.98) with ash weight under the scan conditions examined. The optimal scan condition for the excised femur measurement on the XR was obtained with 1.5-2.5 cm of perspex or water and a scan speed of 10 mm/s. For the QDR, we recommend scanning the rat femur with approximately 2.5 cm of perspex or water in terms of precision and accuracy.

Absorptiometry, Photon↗

Penetration of intravenous antibiotics into brain abscesses.

INTRA-ABSCESS CONCENTRATIONS OF the intravenously administered latamoxef (LMOX, moxalactam in the United States) and cefotetan (CTT), were studied in 11 patients with intracranial abscess. None of these patients underwent surgical ablation of the abscess. In all cases, the abscess was aspirated, and multiple aspirations were required in five patients. Antibiotic concentrations in 18 aspirates were, therefore, determined by the agar well method. LMOX concentrations in 16 aspirates drawn from nine brain abscess cases ranged from 0 to 10.9 micrograms/ml, with a mean (standard deviation) of 4.18 (3.04) micrograms/ml. The CTT concentration in one patient with a brain abscess was 8.51 micrograms/ml, and the LMOX concentration in the one remaining patient with subdural empyema was 5.20 micrograms/ml. In one patient, the serum-to-pus penetration rate of LMOX was estimated to be 0.11 against the peak value of the concentration in serum or 0.44 against the simultaneously obtained level in serum. Significantly higher concentrations of LMOX were produced in abscess cavities with multiple-dose administration or by prior drainage of pus. More-advanced stages of local inflammation, as demonstrated by computed tomography, correlated with higher concentrations. However, the routine indexes of systemic inflammation, such as body temperature, white blood cell count, and level of C-reactive protein in serum, cannot be used to predict the concentration present in intracerebral pus. A tendency for LMOX concentrations in pus obtained after single dose-administration to decrease with increasing duration from symptom onset to sampling was observed but was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Asymptomatic calcified chronic subdural hematoma--report of three cases.

Three adults with asymptomatic calcified chronic subdural hematoma are described. Plain skull x-ray films following head trauma disclosed calcified chronic subdural hematomas and computed tomography (CT) revealed large, frontoparietal, calcified hematomas in all cases. A 49-year-old male received hematoma removal because of his lower age and CT evidence of cerebral compression. An 83-year-old male was not operated on and remained asymptomatic. The third patient died of trauma-related injuries. In the non-elderly, surgery for asymptomatic calcified chronic subdural hematoma with significant cerebral compression should be considered for relief of cerebral compression and prevention of possible future brain damage.

Aged↗

Solitary pyogenic thalamic abscess--two case reports.

We report two patients with solitary thalamic abscesses, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.

Adult↗