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Biomedical subjects

S Murayama

Publications and source records attributed to S Murayama.

At least 109 records · Page 6Linked to original sources

A clinical profile of corticobasal degeneration presenting as primary progressive aphasia.

We report a patient with primary progressive aphasia who first presented with amnesic aphasia that developed over the course of 3 years into nonfluent aphasia with buccofacial apraxia, followed in the next year by cognitive impairment and parkinsonism. Pathological findings were typical for corticobasal degeneration except for the distribution of cortical atrophy. This case suggests that corticobasal degeneration should be included in the differential diagnosis of primary progressive aphasia, especially in association with parkinsonism.

Aphasia, Primary Progressive↗

Focal residual contrast media in the kidney 24 hours after angiography.

PURPOSE: To examine the relationship between focal renal cortical retention (FRCR) and contrast-associated nephropathy (CAN). MATERIAL AND METHODS: We investigated the incidence of both phenomena in 105 patients. CAN was defined as an increase in the creatinine level > 0.3 mg/dl and > 20% on days 1, 3, or 7. We compared predisposing factors for FRCR and CAN. Serum creatinine and blood urea nitrogen (BUN) for renal function were determined on the morning of the day of the angiography. The BUN/creatinine ratio was used as an indicator of the degree of hydration. RESULTS: FRCR was demonstrated in 17 patients (16%) by delayed CT 24 h after angiography, and CAN was found in 16 patients (15%). No significant relationship between CAN and FRCR was found. We found a correlation between high total volumes of contrast and FRCR. Advanced age, high blood urea nitrogen, high creatinine, and dehydration were risk factors for CAN. CONCLUSION: Delayed CT showed a higher incidence of injury to the renal parenchyma than previously detected by conventional radiography.

Angiography↗

Late local recurrence after radiotherapy for tongue and early glottic carcinoma.

BACKGROUND/AIM: Late local recurrence after radiotherapy for tongue and early glottic carcinoma is rarely discussed. In the head and neck cancer, approximately 90% of local recurrence occurred within 2 years after radiotherapy. However, we found that late local recurrence after radiotherapy for glottic cancer was not rare. Our aim was to evaluate the late local recurrence after radiotherapy for early glottic and tongue cancer. PATIENTS AND METHODS: From 1967 through 1982, 633 patients with tongue carcinoma and 330 patients with early (T1T2N0) glottic carcinomas were treated at the Department of Radiology, Osaka University Hospital. Of these 821 patients, 329 patients with tongue carcinoma and 221 patients with early glottic carcinoma survived at 5 years after radiotherapy without local recurrence. For tongue carcinoma, patients were divided by T category. For early glottic carcinoma, patients were divided by the tumor response at 40 Gy. RESULTS: Late local recurrence occurred in 23 of 329 patients (7%) with tongue carcinoma, and in 9 of 221 (4%) with early glottic carcinoma. For tongue carcinoma, late recurrence occurred in 19 of 249 patients (8%) in stage I and II, and 4 of 80 patients (5%) in stage III and IV. For glottic carcinoma, late recurrence occurred in 8 of 137 patients (6%) with tumor clearance at 40 Gy and 1 of 63 patients (2%) with tumor persistence at 40 Gy. The incidence of double cancer was also evaluated. Of 329 5-year survivors with tongue carcinoma, 39 patients (12%) had another malignancy, and 26 patients of 221 5-year survivors with early glottic carcinoma (12%) had also another malignancy. Of 39 double primaries of tongue carcinoma, 10 patients (26%) had head and neck malignancies, and none of 26 double primaries of early glottic carcinoma. CONCLUSION: Late local recurrence was not rare in tongue and early glottic cancer. Poor prognostic group showed lower incidence of late recurrence than good prognostic group. This result suggests that secondary tumor at the same site of primary tumor is late local recurrence.

Carcinoma↗

[Perioperative fractionated high dose rate brachytherapy in bone and soft-tissue tumors].

The 13 lesions of 11 patients with bone and soft-tissue tumors (four primary and nine recurrent lesions) were treated with surgery and postoperative fractionated high dose rate (HDR) brachytherapy started on the 6-7th day after surgery. The total dose was 40-50 Gy/7-10 fr/6-7d(bid) at 5 mm from the source. Local control was achieved in eight of 13 lesions (62%). Four of the five uncontrolled lesions had macroscopic residual tumor after the surgery. There was one peripheral nerve damage as a side effect. This study indicates that the use of perioperative fractionated HDR brachytherapy is feasible and well tolerated.

Adolescent↗

[Clinical usefulness of helical computed tomography in evaluating chronic obstructive pulmonary diseases].

To assess the usefulness of healical computed tomography (CT) in evaluating pathophysiological abnormalities in chronic obstructive pulmonary disease, we compared the results of helical CT with those of pulmonary-function tests in 46 subjects with pulmonary emphysema. We obtained 3-D images of emphysematous lung tissue by choosing voxels with values less than -930 HU because the mean CT score in 10 normal subjects was -869 +/- 29 HU. For each patient the total lung volume (TLV) was computed from the 3-D image of the entire lung with CT score less than -600 HU, and the volume of emphysematous lung tissue (ELV) was computed from the lung with CT score less than -930 HU. TLV measured on inspiration correlated significantly with TLC (r = 0.601, p < 0.001), and TLV measured on expiration correlated significantly with RV (r = 0.836, p < 0.0001). The difference between inspiratory TLV and expiratory TLV correlated significantly with VC (r = 0.781, p < 0.001). ELV both on inspiration and on expiration correlated significantly with FEV1/FVC (p < 0.001) and with RV (p < 0.01, p < 0.001, respectively). These results suggest that the volume data obtained by helical CT reflect functional abnormalities of the lung. In addition to volume data, the distribution of abnormal lung tissue is easily assessed by helical CT. We conclude that helical CT is useful in evaluating pathophysiological abnormalities in chronic obstructive pulmonary disease.

Humans↗

Increased Cu/Zn superoxide dismutase-like immunoreactivity in the swollen axons of rats intoxicated chronically with beta,beta'-iminodipropionitrile.

Demonstration of a genetic linkage between the Cu/Zn superoxide dismutase (SOD1) gene and familial amyotrophic lateral sclerosis (ALS) has aroused interest in the role of SOD1 in spinal motoneuronal death. We used chronically beta,beta'-iminodipropionitrile (IDPN)-intoxicated rats as a model of ALS and investigated SOD1 changes in the spinal cord by immunocytochemical and in situ hybridization techniques. Compared with control rats, SOD1-like immunoreactivity (SOD1-IR) increased in swollen axons of the proximal spinal roots, but not in motoneuronal and dorsal root ganglion neuronal cell bodies where SOD1 gene transcription did not increase. The present data indicate that treatment with IDPN induces accumulation of SOD1 in the swollen axons by blocking slow axonal flow, suggesting the possibility that increased SOD1-IR in ALS is induced by axonal flow blockade.

Amyotrophic Lateral Sclerosis↗

Peripheral nerve pathology in Niemann-Pick type C mouse.

The sciatic nerve of the mouse mutant with Niemann-Pick type C disease (NPC mouse) was investigated using light and electron microscopy, and teased-fiber preparations. As early as postnatal day 20, when clinical symptoms were not yet apparent, focal paranodal swellings with an accumulation of small myelin figures in the Schwann cell cytoplasm were noted. These paranodal changes were more pronounced in the distal segment and became progressively conspicuous with increasing age. The morphometric analysis revealed a hypomyelination of large myelinated fibers in the NPC nerves at 70 days, whereas an essentially similar histogram pattern was noted in both control and NPC nerves at 20 days, suggesting progressively defective utilization of cholesterol in the NPC nerves with age. Intraxonal accumulation of dense bodies was noted in older mice, but no segmental demyelination or Wallerian type of axonal degeneration was observed at any age. The changes noted in the paranodal regions in the NPC mouse closely resemble those found in rats treated with an inhibitor of cholesterol biosynthesis, as well as those seen in remodeling fibers during an early stage of peripheral nerve development. Thus, the morphological changes seen in the sciatic nerve of the NPC mouse may be an expression of perturbation in myelin maintenance as a result of defective cholesterol metabolism.

Animals↗

Cu/Zn superoxide dismutase-like immunoreactivity is present in Lewy bodies from Parkinson disease: a light and electron microscopic immunocytochemical study.

Copper-zinc superoxide dismutase (SOD1)-like immunoreactivity has been demonstrated in Lewy body-like inclusions (LIs) in brain tissues from patients with familial and sporadic amyotrophic lateral sclerosis. Using immunocytochemistry, we studied Lewy bodies (LBs), the original inclusions from which the term LI was derived, in five patients with Parkinson disease (PD). Surprisingly, many LBs were immunostained by an antibody against SOD1. There were two types of staining pattern: a diffuse pattern, and a peripheral pattern with an unstained core. An immunoelectron microscopic study demonstrated that the immunoreactive products were restricted to the fibrillary profiles, sparing the unstructured core. Our results showed that SOD1-like immunoreactivity occurred frequently in LBs and LIs, suggesting that a common cytopathological process is responsible for the formation of LB-type neuronal intracytoplasmic inclusions. Our results also suggest that SOD1 plays a role in the neurodegeneration associated with PD.

Aged↗

Substance P is a possible neurotransmitter in the rat spinothalamic tract.

In order to shed some light on the neurotransmitters in the spinothalamic tract (STT), we examined, biochemically and immunohistochemically, the contents of various neurotransmitter candidates in the terminal field of the STT after cervical hemi-chordotomy (HC) and dorsal quadrant-chordotomy (dQC) in the rat. Substance P (SP), calcitonin gene-related peptide (CGRP), enkephalin, neuropeptide Y, neurotensin, oxytocin and dynorphin A were analyzed immunohistochemically. The contents of neuropeptides (SP, CGRP and cholecystokinin octapeptide) were measured by radioimmunoassay and those of amino acids (aspartic acid, glutamic acid, gamma-aminobutyric acid (GABA) and glycine) and noradrenaline were determined using high-performance liquid chromatography. Cervical hemi-chordotomy, but not dQC, caused significant decreases of the SP-like immunoreactivity in and SP content of the ventral thalamus on the ipsilateral side, compared with that on the contralateral side and of rats subjected to sham-operation. However, neither HC nor dQC resulted in any changes in the ventral thalamic contents of other putative neurotransmitters examined. These results suggest that, in rats, the STT contains SP and that SP-positive fibers run in the ventral half of the ascending spinal tract at the cervical level.

Amino Acids↗

High implantation rate and consequently high pregnancy rate by in vitro fertilization-embryo transfer treatment in infertile women with antisperm antibody.

OBJECTIVE: To examine the effect of antisperm immunity on postfertilization steps, such as implantation of embryos and fetal growth in IVF-ET treatment of women with sperm-immobilizing antibodies. DESIGN: Retrospective analysis of clinical laboratory data. SETTING: The IVF-ET program of the Department of Obstetrics and Gynecology. The University of Tokushima, School of Medicine. PATIENTS: Eighteen women with sperm-immobilizing antibodies and 122 infertile patients with nonimmune etiology as controls. Infertile couples due to a male factor and with unknown etiology were excluded. INTERVENTIONS: All patients received the same IVF-ET program with GnRH agonist. MAIN OUTCOME MEASURES: Rates of fertilization and cleavage, implantation rate per embryo transferred and pregnancy rate (PR) in both test and comparison groups. RESULTS: The rate of fertilization in the antisperm group (61.3%) was significantly lower than that in the comparison group (76.8%). But the implantation rate per embryo transferred (23.5%) and consequently the modified PR per oocyte recovery procedure (34.4%) in immunologically infertile women were significantly higher than those in the comparison group (7.9% and 17.8%, respectively). CONCLUSIONS: Although sperm-immobilizing antibodies prevent sperm-egg interaction, they do not seem to have any adverse effects on achievement of pregnancy. Moreover, the existence of antisperm immunity in woman with antisperm antibodies is suggested to be favorable for successful pregnancy by the IVF-ET procedure.

Adult↗

Enhancement of hematopoietic uptake by granulocyte colony-stimulating factor in Ga-67 scintigraphy.

The authors report on two non-Hodgkin's lymphoma cases which showed markedly enhanced Ga-67 uptake of granulopoietic area induced by recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration. The rhG-CSF is a newly developed agent for reduction of infections, which stimulates the proliferation and differentiation of granulopoiesis. Use of rhG-CSF is becoming increasingly frequent because the indications are so broad that most patients with intensive chemotherapy for malignancies benefit from undergoing this treatment. In this study, the results of the two cases were: 1) G-CSF enhanced the accumulation of Ga-67 citrate in the granulopoietic area; 2) the marked uptake of red marrow looked like involvement; and 3) in contrast, the involved area became relatively "cold." These findings should be considered in the interpretation of Ga-67 scintigraphy.

Adult↗

[Examination of toxin production from environmental Bacillus cereus and Bacillus thuringiensis].

Emetic toxin- and entero toxin-producing activities were examined for 524 strains of Bacillus cereus and 90 strains of Bacillus thuringiensis to determine the distribution and contamination in natural environment, including foods, vegetable, soil and etc. Emetic toxin was assayed by the production of acid from HEp-2 cells induced by the culture supernatants of Bacillus, which was developed as an improved method for the detection of B. cereus heat-stable emetic-toxin by us. In the 524 strains of B. cereus tested, 11 out of 60 strains obtained from bean paste and 5 out of 20 strains obtained from peach produced emetic toxin which was detected by the HEp-2 cell method. All these emetic toxin-producing isolate strains were classified into H1 serotype. The 90 strains of B. thuringiensis did not produce emetic toxin, but the 47 strains produced entero toxin.

Bacillus cereus↗

Effects of GABAergic drugs on the recovery of reflex potentials after spinal cord ischemia in cats.

Effects of GABAergic drugs on the recovery of reflex potentials after spinal cord ischemia were examined in anesthethized spinal cats. Monosynaptic reflex (MSR) and polysynaptic reflex (PSR) potentials, elicited by electrical stimulation of the tibial nerve in spinal cats, were recorded from the lumbo-sacral ventral root. The spinal reflex potentials were immediately depressed by occlusion of the thoracic aorta and the bilateral mammary arteries for 10 min. The potentials recovered gradually to the control level within 90 min after reperfusion. Pretreatment with bicuculline (0.3 mg/kg, i.v.), a GABA antagonist, or semicarbazide (200 mg/kg, i.v.), an inhibitor of GABA synthesis, accelerated the recovery of PSR potentials after the removal of the arterial occlusion. In contrast, pretreatment with aminooxyacetic acid (10 mg/kg, i.v.), an inhibitor of GABA degradation, retarded the recovery of PSR potentials, and this effect was overcome by the addition of the opioid antagonist naloxone (10 mg/kg, i.v.). These results suggest that the GABAergic system retards the recovery of PSR potentials after a brief spinal cord ischemia, which can be antagonized by naloxone.

Animals↗

[Planning for brachytherapy using a 3D-simulation model].

A 3D-simulation model made with a milling system was applied to HDR-brachytherapy. The 3D-simulation model is used to simulate the 3D-structure of the lesion and the surrounding organs before the actual catheterization for brachytherapy. The first case was recurrent prostatic cancer in a 61-year-old man. The other case was lymph node recurrence of a 71-year-old woman's upper gum cancer. In both cases, the 3D-simulation model was very useful to simulate the 3D-conformation, to plan the treatment process and to avoid the risk accompanying treatment.

Aged↗

[High dose rate fractionated interstitial radiotherapy for vulvar cancer using traction technique].

A 73-year-old woman with vulvar cancer T2NO was treated with high dose rate fractionated interstitial radiotherapy after 30 Gy of external radiotherapy. Sufficient space to insert 12 needles was made by pulling the vulva out perpendicular to the perineal skin. Four surgical threads were introduced between the vulva and the underlying pubic bones. A pair of custom-made templates were attached sandwiching the vulva pulled out with the threads. Using traction technique 12 stainless needles were easily inserted and replaced by plastic tubes. Forty Gy/10 fractions/six days was delivered, and the tumor has been controlled clinically and histologically so far.

Aged↗

Overall time in telecobalt therapy for T1 glottic carcinoma treated with 2 Gy per day.

BACKGROUND/AIM: We already reported the tumor response during radiotherapy as a prognostic factor for T1 glottic carcinoma. In these reports, we did not evaluate the overall treatment time. There were many reports of correlation between local control and overall treatment time of radiation for head and neck cancer. Our aim was to evaluate the overall treatment time as a prognostic factor of the local control for T1 glottic carcinoma or not. PATIENTS AND METHODS: From 1967 through 1985, 295 patients of T1 glottic carcinoma were treated with telecobalt therapy at the Department of Radiology, Osaka University Medical School. Of 295 patients, 219 patients treated with 2 Gy per day were evaluated. The median of total doses was 60 Gy (42 to 72 Gy). Overall treatment times of patients with tumor clearance at 40 Gy were significantly shorter than those with tumor persistence at 40 Gy. RESULTS: According to the univariate analysis, there were no statistically significant factors for local control except tumor response during treatment. Of 124 patients treated with a total dose of 60 Gy and the overall treatment time of 40 to 46 days, local control rates of patients treated with the overall treatment time of 40 to 42 days and 43 to 46 days were 88% and 78%, respectively (p = 0.3072). For 91 patients with tumor clearance at 40 Gy, local control rates of patients treated with the overall treatment time of 40 to 42 days and 43 to 46 days were 96% and 82%, respectively (p = 0.1645). Corresponding figures for 31 patients with tumor persistence at 40 Gy were 63% and 65%, respectively (p = 0.4227). CONCLUSION: We compare the treatment results of patients treated with the same total dose and the same tumor response during radiotherapy. We concluded that the overall treatment time was not a prognostic factor for T1 glottic tumor treated with overall time of 40 to 46 days.

Carcinoma↗

Noncalcified pulmonary tuberculomas: CT enhancement patterns with histological correlation.

The objective of this study was to correlate enhanced CT images of noncalcified tuberculomas with histological findings, in order to search for characteristic CT enhancement patterns. Over 7 years, 12 noncalcified tuberculomas were surgically resected. Enhanced CT images of these tuberculomas were reviewed and correlated with histological studies. Ring or central-curvilinear enhancement was present in nine of 12 tuberculomas (75%). In those with ring or central-curvilinear enhancement, the low-density region was histologically confirmed to be caused by caseous or liquefied necrotic material, and a von Willebrand factor stain showed moderate to marked vascularity of the enhanced areas. Three tuberculomas showed nonspecific enhancement patterns. Histologically, each of these contained central caseous necrotic material, and two showed a poor vascularized peripheral fibrotic zone.

Aged↗

[Current status of phase III study of combined treatment with radiotherapy and chemotherapy for head and neck cancer].

Concerning the combined treatment with radiotherapy and chemotherapy for head and neck cancer, in general, there are many discrepancies between a single institutional pilot study and a multi-institutional prospective randomized study. Some of the differences depend on the insufficient number of patients entered into the study, since the annual incidence of head and neck cancer is relatively low, and the treatment result varies from site to site as well as the stage of the disease. Several types of bias, including patient selection and positive publications, and factors related to the design and analysis of clinical trials result in additional differences. To solve these problems, we organized the Quality Assurance Research Group in Japan, funded by the Ministry of Health and Welfare for several years. Based on much effort, it was emphasized the need for increased manpower and equipment in radiation oncology, for a quality assurance program of radiotherapy and the preparation of a standard treatment modality using decision tree and surrogate survey.

Antineoplastic Combined Chemotherapy Protocols↗