Search PubMed⌕ Search

Biomedical subjects

S Naganawa

Publications and source records attributed to S Naganawa.

At least 37 records · Page 2Linked to original sources

Interobserver agreement in sonographic diagnosis of breast tumors.

OBJECTIVE: To evaluate interobserver agreement in the interpretation of breast ultrasonography. METHODS: 55 breast masses (30 benign, 24 malignant) were interpreted by seven radiologists using a CRT viewing station. US criteria for differentiating between benign and malignant lesions included shape, border, boundary echoes, internal echoes, posterior echoes, and bilateral shadows. Each criterion and the observers' final impression was scored using the 5-point rating scales. For analyzing interobserver agreement, the kappa (kappa) values were employed. RESULTS: The kappa values of shape and posterior echoes were significantly higher than those of the other four criteria (P<0.05). Agreement was intermediate in border and internal echoes, and was low in boundary echoes and bilateral shadows. Agreement in the senior group (four observers) was relatively higher than that in the junior group (three observers) for all criteria but for internal echoes. Easily-diagnosed cases showed significantly higher kappa values compared with more ambiguous cases (P<0.05). CONCLUSION: Interobserver agreement in shape and posterior echoes was significantly higher than those of the other four criteria. Agreement was significantly dependent on case difficulty.

Breast Diseases↗

Detection of HIV-Gag p24-specific antibodies in sera and saliva of HIV-1-infected adults and in sera of infants born to HIV-1-infected mothers.

Secretory immunoglobulin A (IgA) is known to play an important role in the mucosal defense against a variety of pathogens. Although the role of IgA antibodies during sexual transmission of HIV is not clear, HIV-specific IgA antibodies have been detected in various mucosal secretions of HIV-infected individuals. Using a monoclonal antibody against human IgA, we established an ELISA system to detect anti-HIV p24 IgA antibodies in sera and saliva. We have analyzed the levels of anti-HIV p24 IgG and IgA antibodies in sera and saliva of 107 and 119 adults, respectively, with HIV infection at different clinical stages, and in the sera of 13 infants born to HIV-infected mothers. The level of anti-HIV p24 IgA antibodies was lower in sera and higher in saliva as compared to that of anti-HIV p24 IgG antibodies. Where the percentage of HIV-specific serum antibody-positive cases decreased with disease progression, that of saliva antibody-positive cases increased in AIDS patients. Among the 13 infants born to HIV-infected mothers, 7 infants were HIV-p24-specific serum IgA positive. These sera were negative for anti-HIV p24 secretory IgA, suggesting that some infants develop their own immune responses against HIV infection. Thus, the detection of HIV-specific IgA antibodies, especially in saliva, could be a simple and reliable test for the diagnosis of HIV infection.

AIDS Serodiagnosis↗

MR imaging of the inner ear: comparison of a three-dimensional fast spin-echo sequence with use of a dedicated quadrature-surface coil with a gadolinium-enhanced spoiled gradient-recalled sequence.

PURPOSE: To prospectively evaluate the sensitivity and specificity of magnetic resonance (MR) imaging in the inner ear with a long echo train, three-dimensional (3D), asymmetric Fourier-transform, fast spin-echo (SE) sequence with use of a dedicated quadrature-surface phased-array coil to detect vestibular schwannoma in the cerebellopontine angle and the internal auditory canal. MATERIALS AND METHODS: In 205 patients (410 ears) with ear symptoms, 1.5-T MR imaging was performed with unenhanced 3D asymmetric fast SE and gadolinium-enhanced 3D gradient-recalled (SPGR) sequences with use of a quadrature surface phased-array coil. The 3D asymmetric fast SE images were reviewed by two radiologists, with the gadolinium-enhanced 3D SPGR images used as the standard of reference. RESULTS: Nineteen lesions were detected in the 410 ears (diameter range, 2-30 mm; mean, 10.5 mm +/- 6.4 [standard deviation]; five lesions were smaller than 5 mm). With 3D asymmetric fast SE, sensitivity, specificity, and accuracy, respectively, were 100%, 99.5%, and 99.5% for observer 1 and 100%, 99.7%, and 99.8% for observer 2. CONCLUSION: The unenhanced 3D asymmetric fast SE sequence with a quadrature-surface phased-array coli allows the reliable detection of vestibular schwannoma in the cerebellopontine angle and internal auditory canal.

Adolescent↗

Three-dimensional fast spin-echo MR of the inner ear: ultra-long echo train length and half-Fourier technique.

We compared the image quality of the newly developed ultra-long echo train length (ETL) 3-D fast spin-echo (FSE) and half-Fourier technique, which is performed in less than 3 minutes, with the conventional 3D-FSE imaging technique, which takes 15 minutes, in assessing MR examinations of the inner ear. The new method's images were almost comparable to the conventional 3D-FSE images in depicting anatomic details and pathologic findings. Implementation of the ultra-long ETL and half-Fourier 3D-FSE imaging technique enables acquisition of inner ear MR studies in a vastly reduced time and with high spatial resolution without significant penalty, opening the possibility for low-cost screening of acoustic tumors without contrast enhancement in less than 3 minutes.

Ear Neoplasms↗

Vertical transmission of human immunodeficiency virus type 1 in Japan, 1989-1997: presence of two subtypes B and E with subtype E predominance. National Cooperative Study Investigators on Vertical Transmission of HIV-1.

A collaborative group for studying vertical transmission of human immunodeficiency virus (HIV)-1 in pregnant women and their babies was established in Japan in 1989. Forty-two infants, including 13 HIV-1-infected, 25 uninfected and four of undetermined status and 15 control children born to HIV-1 negative mothers were diagnosed and followed from birth to 1.5 years. All strains from HIV-positive infants were either clade E (eight infants, 61.5%) or B (five infants, 38.5%) according to DNA sequencing specific for the HIV-1 C2-V3 region. The 42 mothers with HIV-1 were women with sexual-risk behavior from all regions, but were concentrated in the Kanto District. In this group of HIV-infected children, there was no significant difference between the transmissibility of their mother's clade E and B viruses. Eight (61.5%) of the 13 virus-infected babies were Japanese and five (62.5%) of the eight were positive for HIV-1 clade E. The V3 loop region of the clade E virus of the babies was conserved but approximately 60% of the sequences which showed a substitution of aspartic acid by asparagine at position 29. The results suggest that HIV-1 clade E may be predominant in vertical transmissions and are phenotypically different from HIV-1 in persons with various other risk behaviors in Japan.

Consensus Sequence↗

[MR-cholangiopancreatography using three-dimensional Fourier transfer fast asymmetric spin-echo method (3DFT-FASE)--clinical evaluation].

MR-cholangiopancreatography (MRCP) is a new and non-invasive method. With the three-dimensional Fourier transform fast asymmetric spin-echo (3DFT-FASE) method that allows data collection as volume and three-dimensional expression, a higher spatial resolution can be obtained in the direction of both slab thickness and in-plane. In this method, analysis by multi planar reconstruction (MPR) and observation from various angle by maximum intensity projection (MIP) are available. Although further studies are required to shorten the imaging time to stop breathing only once, to use the respiratory gating or navigator echo, clinically useful diagnosis are possible utilizing by the advantages of the 3DFT method.

Biliary Tract↗

Intestinal transcription and synthesis of apolipoprotein AI is regulated by five natural polymorphisms upstream of the apolipoprotein CIII gene.

To understand the factors contributing to the synthesis of human apolipoprotein AI (apoAI), relative apoAI synthesis was measured from endoscopic biopsy samples obtained from 18 healthy volunteers. The relative amount of apoAI synthesis was directly correlated with steady state intestinal apoAI mRNA levels and a 10-fold within-group variability was observed. Analysis of genomic DNA from the subjects revealed five polymorphic sites which defined two haplotypes in the intestinal enhancer region of the apoAI gene located upstream of the apolipoprotein CIII gene transcriptional start site (+ 1): (-641 C to A, -630 G to A, -625 T to deletion, -482 C to T, and -455 T to C). The population frequencies of the wild-type and mutant alleles were 0.53 and 0.44, respectively. Mean steady state apoAI mRNA levels and mean relative apoAI synthesis were 49 and 37% lower, respectively, in homozygotes for the mutant allele and 28 and 41% lower, respectively, in heterozygotes than in homozygotes for the wild-type allele (P < 0.05 for both). Site-directed mutants of apoAI gene promoter/reporter constructs containing the above mutations were transfected into Caco-2 cells and showed a 46% decrease in transcriptional activity compared with the wild type (P < 0.001); however, no significant differences were observed in HepG2 cells. Electrophoretic mobility shift assays showed that the mutated sequences from -655 to -610 bound Caco-2 cell nuclear protein(s) while the wild type did not. These results indicate that intestinal apoAI gene transcription and protein synthesis are genetically determined and are reduced in the presence of common mutations which induced binding of nuclear protein(s), possibly a transcriptional repressor.

Adult↗

MR lmaging of the Primary Breast Lymphoma: A Case Report.

Recently magnetic resonance (MR) imaging has been investigated for the detection and differentiation of benign and malignant breast lesions. Dynamic scan using the contrast material has been shown to increase the specificity of breast MR imaging. Primary breast lymphoma (PBL) is a rare disease and its MR imaging finding has not been described before. We recently experienced a case of PBL that was demonstrated on MR imaging as an early enhancing mass similar to common carcinomas. Other imaging findings including sonography, mammography were also non-specific. Furthermore, lymphoma cells had spread beyond the early enhanced area. Thus the precise delineation of the tumor extent was impossible. However, features such as a quite unclear border on pre-contrast T2-weighted image, and increased uptake of gallium-67-citrate may allow diagnosis of such lesions as malignant lymphoma.

Journal Article↗

High-resolution T2-weighted MR imaging of the inner ear using a long echo-train-length 3D fast spin-echo sequence.

The purpose of this study was to assess the value of a long echo-train-length 3D fast spin-echo (3D-FSE) sequence in visualizing the inner ear structures. Ten normal ears and 50 patient ears were imaged on a 1.5T MR unit using a head coil. Axial high-resolution T2-weighted images of the inner ear and the internal auditory canal (IAC) were obtained in 15 min. In normal ears the reliability of the visualization for the inner ear structures was evaluated on original images and the targeted maximum intensity projection (MIP) images of the labyrinth. In ten normal ears, 3D surface display (3D) images were also created and compared with MIP images. On the original images the cochlear aqueduct, the vessels in the vicinity of the IAC, and more than three branches of the cranial nerves were visualized in the IAC in all the ears. The visibility of the endolympathic duct was 80%. On the MIP images the visibility of the three semicircular canals, anterior and posterior ampulla, and of more than two turns of the cochlea was 100%. The MIP images and 3D images were almost comparable. The visibility of the endolymphatic duct was 80% in normal ears and 0% in the affected ears of the patients with Meniere's disease (p < 0.01). In one patient ear a small intracanalicular tumor was depicted clearly. In conclusion, the long echo train length T2-weighted 3D-FSE sequence enables the detailed visualization of the tiny structures of the inner ear and the IAC within a clinically acceptable scan time. Furthermore, obtaining a high contrast between the soft/bony tissue and the cerebrospinal/endolymph/ perilymph fluid would be of significant value in the diagnosis of the pathologic conditions around the labyrinth and the IAC.

Adult↗

Reduction of intestinal apo A-IV mRNA levels in the cirrhotic rat.

In the present study, intestinal apo A-IV synthesis was investigated using a carbon tetrachloride (CCl4)-induced cirrhosis rat model. Triglyceride (TG) content in rat cirrhotic liver was increased markedly by 170% (P < 0.001) and apo B was increased by 20% (P < 0.05) compared with control levels. These results reflected the steatotic change in the liver. In contrast, TG levels in the small intestine of cirrhotic rats decreased significantly (P < 0.01). In addition, intestinal apo A-IV (jejunum P < 0.001; ileum P < 0.01) and its mRNA levels (jejunum P < 0.01; ileum P < 0.05) were also reduced. The decreased apo A-IV content in the jejunum was confirmed by immunohistochemical analysis. These results indicate that intestinal apo A-IV synthesis in cirrhosis is suppressed, at least under the condition of an overnight fast. Therefore, decreased intestinal apo A-IV synthesis may relate to the decreased ability to absorb fat in cirrhosis, but a fat-loading study will be necessary to confirm this hypothesis. It is unknown from the present study why serum apo A-IV level is not significantly decreased, despite a reduction in apo A-IV synthesis. The clearance of apo A-IV by the liver may be delayed or apo A-IV synthesis may be rather markedly enhanced during fat absorption in liver cirrhosis.

Animals↗

Inner ear barotrauma: computed tomographic evaluation.

Eight patients with inner ear barotrauma were evaluated by computed tomography. The causes of the inner ear barotrauma were diving in four, flying in an airplane in three, and climbing in one. Regarding the width of the cochlear aqueduct, no significant difference was observed between the affected side (3.28 +/- 0.49 mm) and non-affected side (3.63 +/- 0.79 mm) at the base of the infundibulum. The jugular fossa could not be identified on the affected side in three patients. Some relationship may exist between inner ear barotrauma and poor development of the jugular fossa.

Adult↗

[Induction of protective immune responses by a chimeric soluble protein from a recombinant BCG vector candidate vaccine to HIV-1].

We have been isolated HIV strains from blood specimens of HIV infected individuals in Japan for these 6 years. The number of specimens tested reached approximately 1,700 that ninety percent of them were from hemophiliacs repeatedly injected blood products from the United States. More than 300 of field HIV were successfully isolated from the samples. The isolation rates has decreased to 30 percent in 1993 from 40 percent in 1992, suggesting that treatment with anti-HIV drugs such as AZT and/or ddI may be effective to HIV-infected individuals. Further, both of the viral and genomic sequences of HIV were classified to be clade B virus. The clinical isolates that expressed IHIGPGRAFY sequence at the center of the HIV-V3 domain were found to be neutralized by an anti-clade B-V3 monoclonal antibody, mu 5.5. By individual levels, when asymptomatic seropositives have progressed to disease-states, neutralization core motif of GPGR in approximately 6% of the viruses has changed to GPGG and hydrophilic amino acid changed to hydrophobic amino acid, correlating the loss of binding activity to PND-peptide of Japanese Consensus virus. Further, rapid progressors to HIV-induced diseases showed decreased activity of the binding antibody. By using the Japanese consensus sequence of HIV-1, we successfully constructed chimeric protein secretion vectors by selecting an appropriate insertion site of a carrier protein, and established the PND-peptide secretion system in BCG. The recombinant BCG inoculated guinea pigs were initially screened by delayed-type hypersensitivity (DTH) skin reactions to the PND peptide followed by passive transfer of the DTH by the systemic route.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Vaccines↗

[High resolution MR imaging of the inner ear apparatus using 3D-Fast spin echo sequence].

To evaluate the efficacy of high resolution MR imaging of the inner ear with 3D-Fast spin echo sequence, one volunteer and 12 patients were imaged with a 1.5 T MR scanner. High resolution T2-weighted images were obtained with a head coil in 13 minutes, and the voxel size was 0.39mm x 0.45mm x 1.2mm in most subjects. Original images and maximum intensity projection (MIP) images of the inner ear were evaluated. On original images, the endolymphatic duct was visualized in 72% of subjects, the cochlear aqueduct in 96%, three branches of the cranial nerves in the internal auditory canal in 100%, and flow void of the vessel in the cerebellopontine angle in 100%. On MIP images, more than two cochlear turns were visualized in 92% of subjects, three semicircular canals in 100%, and the anterior and posterior ampulla in 100%. MR imaging of the inner ear with 3D-Fast Spin Echo sequence provides a variety of useful information regarding the anatomy around the inner ear.

Ear, Inner↗

Genetic analysis of a Japanese family with normotriglyceridemic abetalipoproteinemia indicates a lack of linkage to the apolipoprotein B gene.

Normotriglyceridemic abetalipoproteinemia is a rare familial disorder characterized by an isolated deficiency of apoB-100. We have previously reported a patient with this disease, who had normal apoB-48 but no apoB-100. To elucidate the genetic abnormalities in this family, we studied the linkage of apoB gene using three genetic markers. The proband and her affected brother showed completely different apoB gene alleles, suggesting that the apoB gene itself is not related to this disorder in this family. By contrast, an American case had a point substitution in the apoB gene generating an in-frame stop codon. These results indicate that this disorder can be caused by defect(s) of either an apoB gene or other genes.

Abetalipoproteinemia↗

[MR imaging of the vestibular aqueduct in normal volunteers and patients with Menière's disease--a preliminary report].

In this paper we attempted MR visualization of the vestibular aqueduct (VA) with a surface coil. Sagittal plane was most preferable from the result of preliminary study using a dry temporal bone. In all of ten normal volunteers, VAs were visualized well. In none of them, proton-density weighted spin-echo (SE) images were inferior to both T1- and T2-weighted SE image. In four of eight patients with Menière's disease, VAs were not visualized due to obstruction of VA, although in all of ten non-Menière's patients with hearing loss or vertigo, VAs were well visualized. Although further investigation is needed, MR imaging of VA including both its content and surrounding bony structure would give important information to manage the patients with either Menière's disease or other disorders of internal ears.

Adult↗

Evaluation of clearance function of the Eustachian tube by sequential contrast CT.

Comparisons of Eustachian tube (ET) functions studied by sequential contrast computerized tomography (CT) and by tubotympanic aerodynamics (TTAG) were made. ET clearance function was assessed by the shape of the cartilaginous portion before, during and at the end of swallowing; ventilatory function was studied by TTAG. ET clarity, real-time dynamics and resolution were all better when observed with sequential CT. Contrast medium was instilled into the middle ear via a drumhead perforation and 1 scan/sec taken during swallowing. We classified ET function based on the presence or absence of a) movement of the cartilaginous portion, and b) contrast medium in the ET as i) movement present, contrast medium seen in ET: ii) movement absent, contrast medium present in ET; and iii) movement present, no contrast medium in the ET. Ventilatory and clearance functions did not parallel one another, attributable to some mechanical, differences between the two functions.

Chronic Disease↗