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Biomedical subjects

S Uehara

Publications and source records attributed to S Uehara.

At least 73 records · Page 4Linked to original sources
PubMed1999

Upward migration of the L-P shunt catheter into the cranial base.

A rare complication of upward migration of the L-P shunt catheter into the cranial base is reported. A 59-year-old female with hydrocephalus underwent L-P shunt with a one-piece catheter. The catheter was secured with a clip but migrataed up to the cranial base without the clip becoming detached from the catheter. We assume that the catheter slipped at the position of the clip as the result of a strong force produced by lumbar movements, and that the clip may have acted like an one-way valve to push the catheter into the spinal canal. To prevent such a complication, we should tighten the clip as firmly as possible and use more clips, or use another type of clip which prevents slipping of a one-piece catheter such as the one described by Imaizumi et al.

Cerebrospinal Fluid Shunts↗
PubMed1998

A grazing-incidence reflectometer for BL-39XU at SPring-8.

A new grazing-incidence reflectometer has been designed for the X-ray undulator beamline BL-39XU at SPring-8. It will be used for analytical applications, especially ultra-trace-level determination by total reflection X-ray fluorescence (TXRF), nanometer-scale surface topography by specular/non-specular X-ray reflection, and thin-film interface studies by combined measurements of X-ray fluorescence and X-ray reflection. The requirements for the instrument and the solutions in the present design are discussed. A prototype has been developed to test the feasibility of the design. It has been confirmed that the measurements planned at the beamline are achievable with this reflectometer.

Journal Article↗
PubMed1998

Adenocarcinoma arising in a tailgut cyst: report of a case.

We report herein the unusual case of a 66-year-old woman found to have adenocarcinoma arising in a tailgut cyst. The patient had been observed for 6 months following the discovery of a presacral cystic mass measuring 10 x 9 cm for which she had refused surgery. The serum tumor marker, carcinoembryonic antigen, became slightly elevated, and diagnostic imaging distinctly revealed a tumorous lesion with papillary projection into the cyst lumen. The cystic mass was then excised through the transsacral approach. The pathological findings were compatible with moderately differentiated adenocarcinoma arising in a tailgut cyst. This entity is extremely rare, and only six cases, including our own, have been reported in the English literature. Early complete excision is advised because it is almost impossible to determine for certain whether presacral cystic masses are benign or malignant prior to surgery.

Adenocarcinoma↗
PubMed1998

Age-specific incidences of chromosome abnormalities at the second trimester amniocentesis for Japanese mothers aged 35 and older: collaborative study of 5484 cases.

The aim of this study was to calculate the expected incidences of chromosome abnormalities found at amniocentesis in Japanese women aged 35 and older. From four clinics in Japan, we gathered genetic amniocentesis data on 5484 pregnant women at risk only due to their advanced age, 35 years and older. We analyzed the data using the logistic regression model. Of the 5484 fetuses, 117 (2.1%) were diagnosed with a chromosome abnormality. The abnormal karyotypes included 42 cases of trisomy 21; 13 of trisomy 18; 7 of trisomy 13; 10 of 47,XXY; 4 of 47,XXX; 1 of 47,XYY; 27 with various structural aberrations; and 13 with various types of mosaicism. The incidences of trisomy 21, lethal autosomal aneuploidies (trisomy 18 and trisomy 13), and sex-chromosome abnormalities (XXY, XXX, XYY) increased with maternal age. Parameters of the regression equations with their standard errors were calculated and the expected incidences of chromosome abnormalities at each maternal age were derived. The expected incidences of chromosome abnormalities obtained in this study are the first data published for Japan and will be useful for the counseling of pregnant women. The incidence of trisomy 21 is not different from the rates published previously for Western countries. The incidences of chromosome abnormalities are not affected by race or by geographic factors.

Age Factors↗
PubMed1998

The incidence of, and factors leading to, parvovirus B19-related hydrops fetalis following maternal infection; report of 10 cases and meta-analysis.

OBJECTIVES: to clarify the approximation of the frequency of B19-related nonimmune hydrops fetalis (NIHF), and to know the critical period during which maternal infection led to NIHF. METHODS: we investigated the characteristics of 10 cases of antenatal B19 infection diagnosed over the past 10 years in Miyagi prefecture, Japan, and performed a meta-analysis of these cases and those previously reported in the literature. RESULTS: NIHF caused by intrauterine B19 infection was diagnosed between 11 and 23 weeks of gestation in 10 women over the past 10 years in Miyagi prefecture, Japan. The source of infection was the mother's older child in six out of 10 cases, and children at a kindergarten where the mothers worked in two cases. The interval between the onset of infection and the diagnosis of NIHF ranged from 2 to 6 weeks. B19 infection was responsible for 10 (15.2%) in 66 cases of aetiology unknown NIHF in this study, and for 57 (19.1%) of 299 cases of non-malformed or aetiology-unknown NIHF by meta-analysis of the literature. Meta-analysis of the 165 reported cases of antenatal B19 infection, including the 10 cases described above, showed that there was a 10.2% excess risk of fetal death in women infected with B19 during pregnancy and a 12.40% excess risk in women infected during the first 20 weeks of pregnancy. Transplacental transmission was confirmed in 69 (24.1%) of 286 cases. The mean gestational age at diagnosis of NIHF was 22.8 +/- 5.1 weeks. The mean interval between the onset of maternal infection and diagnosis of NIHF was 6.2 +/- 3.7 weeks. CONCLUSIONS: these approximations will be useful for counselling and management for pregnant women. The critical period during which maternal infection led to NIHF correlated with the hepatic period of hematopoietic activity. These findings suggest that parvovirus B19 may have an affinity for erythroid lineage cells at the hepatic stage of hematopoiesis, which may strongly influence the clinical features of feto-maternal B19 infection.

Female↗
PubMed1998

Track structure in radiation biology: theory and applications.

PURPOSE: A brief review is presented of the basic concepts in track structure and the relative merit of various theoretical approaches adopted in Monte-Carlo track-structure codes are examined. In the second part of the paper, a formal cluster analysis is introduced to calculate cluster-distance distributions. METHOD: Total experimental ionization cross-sections were least-square fitted and compared with the calculation by various theoretical methods. Monte-Carlo track-structure code Kurbuc was used to examine and compare the spectrum of the secondary electrons generated by using functions given by Born-Bethe, Jain-Khare, Gryzinsky, Kim-Rudd, Mott and Vriens' theories. The cluster analysis in track structure was carried out using the k-means method and Hartigan algorithm. RESULTS: Data are presented on experimental and calculated total ionization cross-sections: inverse mean free path (IMFP) as a function of electron energy used in Monte-Carlo track-structure codes; the spectrum of secondary electrons generated by different functions for 500 eV primary electrons; cluster analysis for 4 MeV and 20 MeV alpha-particles in terms of the frequency of total cluster energy to the root-mean-square (rms) radius of the cluster and differential distance distributions for a pair of clusters; and finally relative frequency distribution for energy deposited in DNA, single-strand break and double-strand breaks for 10MeV/u protons, alpha-particles and carbon ions. CONCLUSIONS: There are a number of Monte-Carlo track-structure codes that have been developed independently and the bench-marking presented in this paper allows a better choice of the theoretical method adopted in a track-structure code to be made. A systematic bench-marking of cross-sections and spectra of the secondary electrons shows differences between the codes at atomic level, but such differences are not significant in biophysical modelling at the macromolecular level. Clustered-damage evaluation shows: that a substantial proportion of dose ( 30%) is deposited by low-energy electrons; the majority of DNA damage lesions are of simple type; the complexity of damage increases with increased LET, while the total yield of strand breaks remains constant; and at high LET values nearly 70% of all double-strand breaks are of complex type.

Alpha Particles↗
PubMed1998

Monte Carlo simulation of in vivo measurements of 90Sr + 90Y bremsstrahlung.

The purpose of this study was to calculate the 90Sr + 90Y bremsstrahlung yield generated in bone quantitatively, and to determine the optimum conditions required for in vivo measurements of the yield, assuming that a given amount of contamination, due to the ordinary activities of 137Cs and 40K, is present within the human body. Several approximations in the distribution of activities in various body phantoms, simulating the human leg, waist and head, were made for simplicity. All the calculations were carried out using an in-house Monte Carlo code. The photon spectra incident on a detector window, of diameter 200 mm, positioned 1 mm from the surface of each phantom were obtained. A pseudo-peak of 90Sr + 90Y bremsstrahlung was observed at approximately 50 keV with a full width at half maximum of 60 keV (FWHM). The signal-to-background ratio, eta, where eta represents the ratio of the number of photons in the energy interval between 30 to 160 keV in the bremsstrahlung spectrum produced by 1 Bq kg(-1) of 90Sr and the background spectrum, which is assumed to comprise of 1 Bq kg(-1) of 137Cs and 60 Bq kg(-1) of 40K, was evaluated in order to determine the optimum measuring conditions. An optimum eta value of 0.0353 was obtained for the leg phantom, of bone diameter 30 mm, covered by a 1 mm layer of soft tissue. Combining the present calculations with the conventional measurements, a new and simpler method for evaluating the body burden activity of a beta emitter, such as 90Sr, is proposed.

Beta Particles↗
PubMed1998

Childhood bacterial meningitis in Japan.

Haemophilus influenzae type b (Hib) vaccines currently are not used in Japan, but interest in preventing H. influenzae disease by immunization has grown. We performed a retrospective survey for bacterial meningitis in 6 prefectures of Japan. Questionnaires requested the age, sex, clinical outcome and identity of the etiologic organism, if known, of all patients with meningitis younger than 16 years of age who were admitted during calendar year 1994. Of 876 hospitals within the 6 study prefectures, 363 (41.4%) returned a completed questionnaire. There were 1769 cases of meningitis reported, of which 160 (9%) were considered bacterial in origin. H. influenzae was the most common cause of bacterial meningitis, accounting for 68 cases (43%). Sixty-six cases (97%) of H. influenzae meningitis occurred in children 4 years of age or younger, and 27 (40%) occurred in children <1 year of age. Calculated incidence rates based on the population of children 4 years of age or less for each prefecture ranged from 3.4 to 9.9 cases per 100000 (mean, 4.7 cases/100000). H. influenzae is the most common cause of meningitis in Japan, and the estimated incidence rates from this study are very similar to those previously reported from Japan. More comprehensive, prospective surveillance studies will be needed to define better the incidence of Hib meningitis and to aid in making rational decisions regarding the use of Hib vaccination in Japan.

Adolescent↗
PubMed1998

Time-frequency analysis of fetal heartbeat fluctuation using wavelet transform.

We examined whether the nonlinear control mechanism of the fetal autonomic nervous system would change in various fetal states. Eight thousand or more fetal heartbeats were detected from normal, hypoxemic, and acidemic fetuses. Fetal heart Doppler-signal intervals were determined in a high-precision autocorrelation method, and a time series of fetal heart rate fluctuation was obtained. The distribution of the amplitude of temporal fluctuation in the low-frequency component of fetal heart rate frequency was studied using a method of time-frequency analysis called wavelet transform. Spline 4 was used as the mother wavelet function. A gamma distribution was observed from 17 wk of gestation onward. The value of the parameter nu of this gamma distribution was approximately 1.6 and remained constant regardless of the gestational age or the time of day. The value of nu decreased significantly to 0.77 when the fetus developed acidemia and was 1.51 in hypoxemia and 1.54 in a normal condition. This study elucidates a nonlinear structure of the time series of heart rate fluctuation of the gamma distribution in the human fetus. This technique may provide a new quantitative index of fetal monitoring to diagnose fetal acidemia.

Female↗
PubMed1998

Pathologic characterization of hypotensive C57BL/6J-agt: angiotensinogen-deficient C57BL/6J mice.

a fpreviously produced angiotensinogen-deficient mice, i.e. mice with deleted renin-angiotensin system (RAS), with a genetic background on C57BL/6J - C57BL/6J-agt (-/-) -, but no C57BL/6J-agt (-/-) which survived long enough to be weaned. In the present study, we attempted to prevent neonatal death and analyzed pathological development in C57BL/6J-agt (-/-). We indicate that mortality in C57BL/6J-agt (-/-) derived from C57BL/6J-agt (+/-) can be reduced by hypodermic saline injection in the 7 days following birth, that hydronephrosis developed by day 14 in association with polydiplasia and polyuria by day 30, and that chronic hypotension occurs. Hydronephrosis is less damaging to electrolyte resorption in younger mice, but not in adults. We also observed that C57BL/6J-agt (-/-) derived from C57BL/6J-agt (-/-) frequently develop fetal hydronephrosis and die of respiratory failure at birth. These results suggest that maternal RAS is associated with structural maturation of kidney and lung in late fetus and that postnatal RAS plays important roles in structural and functional maintenance of the kidneys.

Angiotensinogen↗
PubMed1998

Analysis of clonality in human endometriotic cysts based on evaluation of X chromosome inactivation in archival formalin-fixed, paraffin-embedded tissue.

The clonality of epithelial cells in ovarian endometriotic cysts was evaluated on the basis of a polymorphism of the X-linked phosphoglycerate kinase gene (PGK). The problems associated with clonality analysis of DNA samples extracted from archival formalin-fixed, paraffin-embedded tissue were addressed with the use of newly designed primers and a modified stepdown program for PCR amplification. The method relies on digestion of DNA with the methylation-sensitive restriction enzyme SnaBI, PCR amplification of PGK, and detection of a BstXI polymorphism. With this approach, only the inactive (methylated) PGK allele is selectively amplified by PCR. A total of 25 epithelial cells in endometriotic cysts and 25 matched normal ovarian stromal tissue specimens were analyzed. All of the control tissue samples yielded PCR products, with 11 of the 25 samples found to be heterozygous for the BstXI polymorphism. Ten of the 25 epithelial cells in endometriosis specimens were informative at this locus, and all of these 10 were shown to be monoclonal on the basis of PGK methylation. The results indicate that this new method of clonal analysis with archival formalin-fixed tissue is reliable and confirm that endometriotic cysts are monoclonal in origin.

Base Sequence↗
PubMed1998

[Outpatient chemotherapy with weekly high-dose infusional 5-fluorouracil (weekly HD-FU) in advanced gastrointestinal cancer].

This study was designed to evaluate the efficacy, toxicity, and quality of life (QOL) of outpatient chemotherapy with weekly HD-FU in advanced gastrointestinal cancer. Treatment consisted of weekly 24-h infusion of 5-FU 2,600 mg/m2, 5-FU was administered using the Groshong catheter and the Baxter infusor LV 5 (5 ml/hr). Eight patients (pts) with advanced gastrointestinal cancer were treated 64 times (mean 8.0 times), and 21 pts were treated 168 times (mean 8.0 times) with adjuvant chemotherapy. Grade 3 or 4 toxicities were not observed. Catheter occlusions and balloon rupture were observed in 1 case each. Responses were PR 2 and NC 6. Mean times to progression were 2.0 and 3.5 months, respectively. Mean scores of QOL were: 70.5 +/- 8.2 before treatment, 78.0 +/- 13.0 after 3 weeks, 79.8 +/- 7.9 after 5 weeks, and 75.8 +/- 11.3 after treatment completion. In adjuvant cases, these scores were 80.6 +/- 11.4, 83.1 +/- 10.7, 85.1 +/- 11.5, and 91.8 +/- 6.9, respectively. In conclusion, a schedule of 5-FU is feasible for outpatient chemotherapy in advanced gastrointestinal cancer.

Adult↗
PubMed1997

Primary non-Hodgkin's lymphoma of the lacrimal sac: a case report and a review of the literature.

BACKGROUND: Primary non-Hodgkin's lymphoma of the lacrimal sac is extremely rare, with most reported cases representing secondary involvement of a systemic malignancy. METHODS: The clinical record of a 70-year-old female who presented with epiphora and swelling of the lacrimal sac area is described. A review of the literature of patients with primary lacrimal sac lymphoma also is presented. RESULTS: Computed tomography demonstrated a lacrimal sac mass involving the nasolacrimal canal. Histopathologic examination of a biopsy specimen revealed a diffuse large cell lymphoma. Using immunohistologic staining, the tumor was a B-cell type, similar to those described in the literature. The patient was treated with 50 gray of irradiation and chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone. The patient remained free of lymphoma 26 months after initial treatment. An ocular examination was unremarkable except for epiphora. CONCLUSIONS: Radiotherapy and/or chemotherapy can treat localized lymphoma of the lacrimal sac successfully.

Aged↗
PubMed1997

A critical role of Lyn and Fyn for B cell responses to CD38 ligation and interleukin 5.

CD38 ligation on mouse B cells by CS/2, an anti-mouse CD38 mAb, induced proliferation, interleukin 5 (IL-5) receptor alpha chain expression, and tyrosine phosphorylation of Bruton tyrosine kinase (Btk) from wild-type, but not from X chromosome-linked, immunodeficient mice. B cells from fyn-deficient (Fyn-/-) and lyn-deficient (Lyn-/-) mice showed an impaired response to mAb CS/2 for proliferation and IL-5 receptor alpha chain expression, and B cells from fyn/lyn double-deficient (Fyn/Lyn-/-) mice did not respond at all to mAb CS/2. The Btk activation by CD38 ligation was observed in B cells from Fyn-/- mice, and it was severely impaired in B cells from Lyn-/- and Fyn/Lyn-/- mice. CD38 expression on B cells from three mutant strains was comparable to that on control B cells. We infer from these results that both Fyn and Lyn are required and that their signals are synergistic for B cell triggering after CD38 ligation. Lyn is upstream of Btk activation in the CD38 signaling. Stimulation of B cells with IL-5 together with CD38 ligation induces not only IgM but also IgG1 secretion. Analysis of the synergistic effects of IL-5 and CD38 ligation on IgG1 secretion revealed the impaired IgG1 secretion of B cells from Lyn-/- and Fyn/Lyn-/- mice. These data imply that Lyn is involved in B cell triggering by CD38 ligation plus IL-5 for isotype switching.

ADP-ribosyl Cyclase↗
PubMed1997

A Turner syndrome woman with a ring X chromosome [45,X/46,X,r(X)(p22.3q27)] whose child also had a ring X chromosome.

OBJECTIVE: To describe a woman with Turner syndrome with ring X chromosome mosaicism who had a child who possessed the same ring X chromosome. DESIGN: Polymorphisms of genes located on the X chromosome from genomic DNA of the mother, father, and the child were evaluated. PATIENT(S): The mother's karyotype was 45,X [48]/46,X,r(X)(p22.3q27) [2], and the child's karyotype was 45,X[33]/46,X,r(X)(p22.3q27) [17]. INTERVENTION(S): Polymerase chain reaction was used to amplify short tandem repeats from the loci of the hypoxanthine phosphoribosyltransferase gene and the androgen receptor gene. RESULT(S): Alleles for both genes in the child originated from both parents in a heterozygous fashion. The alleles originating from the mother originated from the ring X chromosome. However, the amount of amplified DNA was less than that of a normal X chromosome. CONCLUSION(S): The ring X chromosome of the mother was most likely transmitted to the newborn. Thus, an ovum with the ring X chromosome can be fertile and can produce a viable zygote.

Adult↗
PubMed1997

Magnetic stimulation of motor cortex in children: maturity of corticospinal pathway and problem of clinical application.

The developmental profile of the electromyographic responses to transcranial magnetic stimulation (TMS) was studied in 46 neurologically normal children aged from one to 14 years, compared with data in 10 normal control adults. To obtain motor evoked potentials (MEPs) from the first dorsal interosseous muscle in the resting state, the motor cortex was stimulated through a circular coil with the stimulus intensity set at 10% above the threshold intensity for eliciting MEPs. Reproducible MEPs were obtained in all but the children aged below 2 years, and the threshold intensity and central motor conduction time (CMCT) showed a linear decrease with maturation. The MEP amplitude changed little until 9 years of age, but it tended to increase between 10 years and adulthood. The MEP duration, which was not influenced by age, was less than 16 ms over the ages studied. The present data suggest that maturity of the corticospinal motor pathway that controls the intrinsic hand muscles is electrophysiologically complete at 13 years of age. Among the parameters of MEPs, CMCT and MEP duration may be useful for evaluating impairment of the corticospinal tracts in children aged 2 years and older.

Adolescent↗