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Biomedical subjects

T Fujimoto

Publications and source records attributed to T Fujimoto.

At least 469 records · Page 26Linked to original sources

[Clinical and epidemiological studies on inpatients with dementia].

We have studied 97 patients with dementia who have been discharged from our hospital and 106 inpatients with dementia who have been admitted during last two years in our hospital. The diagnosis of dementia was done according to the criteria of DSM-III. Based on their clinical course, neurological signs, Hachinski's ischemic score and neuroradiological findings, we divided patients into 4 groups, [senile dementia of the Alzheimer type (SDAT), vascular dementia (VD), unclassified dementia and other dementias which includes dementia with Parkinson's disease or motor neuron disease, etc.]. Concerning 70 demented patients who died during hospitalization, the average age of onset and the duration of illness of SDAT were 80.5 years old and 4.6 years respectively and those of VD were 77.6 years old and 2.7 years respectively. The common causes of death were pneumonia (50%) and cardiac failure (24%). Recurrence of cerebral vascular accident (CVA) was also another frequent cause of death in VD. The most common behavioral problems causing admission in patients of SDAT were aimless wandering, nocturnal delirium, illusion and hallucination. In VD, nocturnal delirium, aimless wandering, violence and abnormal monologue were most common causes of admission. The important causes degrading ADL of inpatients were fracture, especially fracture of the hip joint, pneumonia, intestinal bleeding and CVA. Concerning the increase of the population of over 75 years old, it will be suggested that the care and treatment of demented patients in this age group will become a major social problem.

Aged↗

Widespread thrombosis and necrotizing arteritis of the liver in a 69-year-old woman with symptoms simulating those of temporal arteritis.

Autopsy findings of widespread thrombosis and necrotizing arteritis of the liver in a 69-year-old woman who had clinical symptoms suggesting those of temporal (giant cell) arteritis were presented. The lesion of the temporal artery was not of temporal arteritis but of thrombosis, part of widespread thrombosis, which occurred in the small arteries having hypertensive arteriolopathy. This case also had an arteritis of the liver resembling polyarteritis nodosa (PN). The pathologic processes demonstrated in this case suggested that the temporal arteritis-like symptoms may be brought about by occlusion of the temporal artery. Temporal arteritis is a nonfatal and self-limited disease and little information has been obtained from autopsy material. Accordingly, it is necessary to collect autopsy cases of temporal arteritis to investigate this disease through observations of whole bodies. Recently we examined a case which appeared clinically having symptoms of temporal arteritis, but the autopsy revealed that the symptoms were not brought about by temporal arteritis but by thrombosis of the temporal artery. It is the purpose of this paper to present this case and to discuss some problems concerning genesis of symptoms of temporal arteritis.

Aged↗

[Magnetocardiographic localization of an accessory pathway in patients with WPW syndrome].

The usefulness of magnetocardiography (MCG) in determining the location of an accessory pathway (Kent bundle) was examined by the isomagnetic map at the time of a delta wave, and by gated magnetic resonance imaging (MRI). MCG was performed at 36 points on the anterior chest wall in eight cases with Wolff-Parkinson-White (WPW) syndrome using a SQUID (superconducting quantum interference device) system with the second derivative gradiometer. Based on these records, isomagnetic maps during the QRS and T waves were constructed, and the depth of the accessory pathway from the coil was calculated mathematically. The locations of the accessory pathways were estimated using these data and the MRI findings. The locations of the accessory pathways thus determined were compared with findings obtained by body surface maps. A dipole directed towards the left was deduced, because the maximum was located more superiorly than the minimum in an isomagnetic map 10-40 msec after onset of the delta wave in cases with WPW syndrome, indicating an accessory pathway to be located in the right ventricle. A dipole directed towards the right was deduced, because the maximum was located more superiorly than the minimum in an isomagnetic map 10-40 msec after onset of the delta wave of cases with WPW syndrome indicating an accessory pathway to be located in the left ventricle. Assuming the electric current source is a single dipole, the location of a current dipole might be determined by positions of the maximum and the minimum in the isomagnetic maps. In the present study, the locations as determined by analysis of the isomagnetic map 40 msec after onset of the delta wave and the gated MRI were concordant with the findings obtained by body surface isopotential maps. Furthermore, some cases showed two opposing dipoles on the isomagnetic map at the peak of the T wave in lead II of the standard ECG leads; one directed to the left expressing normal repolarization; the other directed to the right presumably expressing repolarization of the myocardium which was excited by an impulse via the accessory pathway. The location of the current dipole as determined by analysis of the isomagnetic map at the peak of the T wave in lead II was nearly the same as the position of the current dipole as determined by analysis of the isomagnetic map 40 msec after onset of the delta wave.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Long-term arterial infusion chemotherapy to the cancer patients].

Arterial infusion chemotherapy is an effective method for unresectable and recurrent cancer patients. But this method had some problems, in terms of efficacy, side effect and safety. Thus, we studied these problems in 33 patients. We inserted the tube into the proper hepatic artery in 25 cases and into the aorta in 8 cases, and used anticancer drugs, such as MMC, ADM and CDDP. In this study, no serial or severe side effects were noted. On the other hand, the obstruction of catheter and artery was found in a few cases. We encountered 2 cases of CR and 11 cases of PR. The effectiveness of this method is approximately 46.4%. These results suggested that long term arterial infusion chemotherapy for outpatients was a safe and effective method from the view point of quality of life in cancer patients.

Adult↗

[Hepatocellular carcinoma with a complete remission of bone metastasis achieved by arterial chemotherapy].

Reported is the case of a hepatocellular carcinoma with a complete remission of the bone metastasis by arterial chemotherapy. The patient was 60 year old male, with the chief complaint being a tumor at the right side of the chest. The diagnosis was a hepatocellular carcinoma with a bone metastasis at the right 10th rib. The bone tumor showed no decrease in size after an intra-arterial injection of adriamycin, and radiation and or hyperthermia. Therefore, intra-arterial injections of mitomycin C mixed with lipiodol were instituted through the intercostal artery, and no bone tumor was noted after start of this therapy. Although the patient subsequently died, microscopic examination of a specimen obtained at autopsy revealed no malignant cells at the right 10th rib. Intra-arterial injections of anticancer agents mixed with lipiodol therefore are thought to be useful for the treatment of a bone metastasis.

Bone Neoplasms↗

[Histologic characteristics of the pathologic processes in thromboangiitis obliterans (Buerger's disease)].

In order to elucidate histologic characteristics of the pathologic processes in thromboangiitis obliterans (Buerger's disease) a histopathologic study of amputated legs of 9 patients diagnosed as this disease was carried out. The ages of the patients ranged from 27 to 47 years, all male, and the duration of symptoms prior to amputation was between 3 and 11 years. All of the patients had no history of hypertension. The initial stage of the pathologic processes was characterized by contraction of small arteries of legs followed by intimal thickening with laminar elastosis, the subsequent stage by occlusion of arterial lumens by both thrombosis and following organization and recanalization which occurred in the small arteries, and the later stage by lymphocytic infiltration of the arterial walls, suggesting some immunological mechanisms involved in the pathogenesis. Accompanying venules demonstrated similar processes to those of small arteries, which enhanced the local circulatory disturbances.

Adult↗

In vivo T1 measurements of canine brain for deep tissue temperature measurements with MRI.

The possibility of deep tissue temperature imaging with a magnetic resonance (MR) imager was studied in 30 mongrel dogs. The coronary view of the brain of a dog anesthetized with muscle relaxant and pentobarbital and ventilated automatically with air was taken with a special head coil by a 0.1 Tesla MR imager, Asahi Mark-J, driven by a spin warp pulse sequence. T1s in the imaging of the right and left white matter, grey matter, thalamus and caudate nucleus were measured with rectal temperature in group I (10 dogs) for a control study every 30 min until 120 min without intervention, in group II (10 dogs) for hyperthermia with extracorporeal bypass method, before heating, at 41 and 42 degrees C, in group III (10 dogs) for hypothermia, before cooling, at 35 and 30 degrees C and after rewarming, respectively. In groups I, II and III, the T1s at all sites except the white matter at 42 degrees C did not change significantly at any rectal temperature. T1 prolongation in the white matter at 42 degrees C may be due to edema, probably because of biological reaction to hyperthermia. The present study suggests that deep tissue temperature imaging in vivo by T1s measured with the MR imager may be impossible in spite of obvious evidence of T1 dependance on temperature in theoretical, in vitro and ex vivo studies already achieved.

Animals↗

[Factors related to prognosis and relapse in acute myelomonocytic and monocytic leukemias (M4 and M5)].

To analyse the factors which were related to prognosis at first examination and early diagnosis of relapse in complete remission phase, 26 patients with acute myelomonocytic leukemia (M4) and acute monocytic leukemia (M5) were investigated. There was a tight relationship between age and remission rate in patients with M4 and M5. Six of M4 with eosinophilia (M4Eo) patients revealed 83.3% as remission rate with good prognosis in the survival curve. LDH level of them was lower than other patients significantly. In order to diagnose relapse before clinical manifestations, it was useful to follow up number of mature monocytes (over 600/microliters) in the peripheral blood.

Adolescent↗

[Acute leukemia with active hemophagocytosis, positive immunologic markers for the megakaryocyte-platelet lineage, and translocation (16; 21) (p11; q22].

We report a case of infantile acute leukemia with t(16; 21) (p11; q22). The patient was a phenotypically normal one-year-old girl without lymphadenopathy or hepatosplenomegaly. Her peripheral blood at diagnosis showed anemia, thrombocytopenia, and many circulating blasts. Bone marrow blasts were monocytoid with fine reticular nuclear chromatin, abundant grayish-blue cytoplasm with occasional pseudopods or cytoplasmic projections and active hemophagocytosis. Serum levels of lysozyme and ferritin were normal. These blasts were not stained with butyrate esterase and immunologic study showed KOR-P77+ (anti-megakaryocyte monoclonal antibody), MY9+, Ia-. Electron microscopic examination failed to show platelet peroxidase activity. Remission was not induced by mini-COAP or VP-16 and the patient died of measles pneumonitis. The patient's blasts took typical appearance of megakaryoblasts later in the course, although some of them retained the ability of hemophagocytosis observed in the original blasts. This case is considered to be quite atypical since leukemic cells with active hemophagocytosis, megakaryoblastic appearance and t(16; 21) (p11; q22) have not been reported in the literature.

Antigens, Neoplasm↗

[Radiologic diagnosis of pleural mesothelioma].

Five cases of pleural mesothelioma (3 benign and 2 malignant) were evaluated with chest radiograph and CT. A case of benign localized mesothelioma growing within the major fissure, and a case of diffuse malignant mesothelioma encircling the descending thoracic aorta are included among the five cases. Pleural mesotheliomas present a variety of roentgenographic manifestations depending upon the histologic type, the site of origin, and the direction of the extension, and can easily be misdiagnosed as lung tumor, aortic aneurysm, or mediastinal tumor. It is emphasized that pleural mesothelioma should be considered as a differential diagnosis when a mass lesion is found in the mediastinum, hilar region, interlobar fissure, or near the chest wall.

Adult↗

Determination of the aminoglycoside antibiotics sisomicin and netilmicin in dried blood spots on filter discs, by high-performance liquid chromatography with pre-column derivatization and fluorimetric detection.

A simple method for the determination of the aminoglycoside antibiotic sisomicin or its 1-N-ethyl derivative, netilmicin in whole blood, using dried blood spots (DBSs) on filter-paper punched discs has been developed. Sisomicin or netilmicin in the DBSs were recovered most effectively in 0.5 M Na2HPO4 using ultrasonication. The eluates from the DBSs were treated by ultrafiltration for deproteinization and subjected to pre-column fluorescent derivatization using o-phthalaldehyde and beta-mercaptopropionic acid in 0.05 M KH2PO4-borate buffer (pH 9.0), followed by determination by reversed-phase high-performance liquid chromatography. The detection limits of sisomicin and netilmicin in the DBSs on punched discs (10.1 microliters of whole blood) were 0.053 and 0.50 micrograms per ml of whole blood, respectively (signal-to-noise ratio greater than or equal to 2). The method permits a simple collection of blood at the microlitre level and should prove particularly useful for monitoring sisomicin and netilmicin in blood at therapeutic levels in geriatric and paediatric patients.

Chemical Phenomena↗

[Hematopoietic recovery after autologous bone marrow transplantation in high-dose chemotherapy of cancer patients].

In order to evaluate the possible utility of autologous bone marrow transplantation (ABMT), eighteen cancer patients were treated with high-dose combination chemotherapy supported by ABMT. We investigated CFU-GM/kg infused as well as bone marrow nucleated cells/kg to predict for hematopoietic recovery. Although hematopoietic recovery was not related to the nucleated cell number of the transfused bone marrow, CFU-GM infused related significantly to neutrophil recovery to 500/mm3 (correlation coefficient, r = -0.73, p less than 0.001) and platelet recovery to 50,000/mm3 (r = -0.69, p less than 0.001). Furthermore, a significant relationship of CFU-GM infused to the period of neutropenia below 500/mm3 was observed (r = -0.67, p less than 0.001). Taken together, CFU-GM dose can predict for neutrophil and platelet recovery, suggesting that ABMT can shorten the period of bone marrow suppression following high-dose chemotherapy.

Adult↗

Abnormal Ca2+ homeostasis in platelets of patients with myeloproliferative disorders: low levels of Ca2+ influx and efflux across the plasma membrane and increased Ca2+ accumulation into the dense tubular system.

Ca2+ influx and efflux in unstimulated platelets and Ca2+ uptake by simultaneously isolated two membrane fractions of platelets from patients with myeloproliferative disorders (MPD) have been investigated. In MPD, Ca2+ influx and efflux across the plasma membrane in unstimulated platelets were in equilibrium at significantly lower levels than in normals. Ca2+ uptake by external membrane fraction isolated from MPD platelets was lower, whereas, uptake by internal membrane fraction enriched with dense tubular system (DTS) from MPD platelets was significantly higher than that from normal platelets. This corresponded with the membrane associated Ca2+-activated ATPase activity. These abnormalities of calcium ion movement in plasma membrane and dense tubular system illustrates one of the mechanisms of qualitative abnormalities of MPD platelets.

Adenosine Triphosphatases↗

Flow cytometric evidence for minimal residual disease and cytological heterogeneities in acute lymphoblastic leukemia with severe hypodiploidy.

Two subpopulations of small and large leukemia cells and binucleated cells were present in the bone marrow of a 10-year-old girl with acute lymphoblastic leukemia (ALL). Cytogenetic studies showed some cells with a karyotype of 34,X,-X,-2,-3,-4,-5,-7,-9,-13,-15,-16,-17,-20, and others with a karyotype that was exactly double the chromosome set in the cells with 34 chromosomes. Flow cytometric (FCM) examination of surface common ALL antigen (CALLA) and DNA content of the lymphoblasts led to the identification of the primary hypodiploid DNA stemline (DI = 0.72), which corresponds to the small-sized blasts, and the secondary hyperdiploid DNA stemline (DI = 1.44), which corresponds to the large-sized blasts. Sequential bone marrow examinations with FCM and cytogenetics revealed the persistence of the primary hypodiploid clone during remission and their proliferation with chromosomal evolution at full relapse. These results suggest that more rational inductive therapy should be designed to achieve the favorable outcome of ALL with severe hypodiploidy and that FCM is a useful tool to monitor the minimal residual disease of this subgroup in ALL.

Antineoplastic Agents↗

Vector U loop in patients with old myocardial infarction.

The U loop of the vectorcardiogram was examined qualitatively and quantitatively in 100 normal subjects and 67 patients with old myocardial infarction, using a direct-writing vectorcardiograph with memory function. In the control group, the U loop was directed to the left, anteriorly and inferiorly, and it was inscribed counterclockwise in the horizontal plane. In patients with anterior myocardial infarction, the U loop tended to be displaced to the right, and in patients with inferior myocardial infarction to the right and superiorly. The shape of the U loop in patients was also different from that of normal subjects. The maximum U vector was significantly smaller in magnitude both in patients with anterior and inferior myocardial infarction than that of normal subjects (p less than 0.01). In patients with ventricular aneurysm, the magnitude of the maximum U vector was significantly smaller and its direction was displaced more to the right and posteriorly than those without aneurysm (p less than 0.01). In standard 12-lead electrocardiogram (ECG), observation of the U wave in patients with old myocardial infarction was difficult, especially in the limb lead, because of the small size of the U wave. Therefore, vectorcardiographic observation may be more useful than electrocardiographic observation for the analysis of the U wave in patients with old myocardial infarction.

Adult↗

Arterial chemotherapy and transcatheter arterial embolization therapy for non-resectable hepatocellular carcinoma.

An assessment was made on the therapeutic effects of arterial chemotherapy and transcatheter arterial embolization (TAE) therapy on 378 cases with non-resectable hepatocellular carcinoma (HCC). For the 191 cases who had undergone arterial chemotherapy, 22% had a 1-year survival rate, 8.9% survived for 2 years, and 4.0% for 3 years. Of these, for the 128 cases who were compatible with our criteria for patient selection, the three survival rates were 31.4%, 12.2% and 5.9% respectively. However, for the other 63 cases, who were incompatible with our criteria, the 1-year survival rate was 1.6% and it was worse for the cases who had received supportive care alone. For the cases who had undergone arterial chemotherapy, the highest survival rates were obtained by the alternate administration of different anticancer agents, and the three survival rates were 39.0%, 13.1% and 4.9% respectively. For the 187 cases who had undergone TAE therapy, the 1-year survival rate was 66.2%, the 2-year survival rate 36.5%, and the 3-year survival rate 21.9%. For the 124 cases with a tumor progression rate of less than 20% in the liver (E1), the survival rates were 77.8%, 50.1% and 30.8% respectively. The peripheral venous drug concentrations of mitomycin C and adriamycin were lower, but were maintained for a longer period in TAE therapy than in arterial chemotherapy. These results suggest that consideration of the criteria for patient selection and the alternate administration of anticancer agents are necessary in arterial chemotherapy, and that the best therapeutic effects can be obtained by TAE therapy combined with chemotherapy for cases of non-resectable HCC because of the chemotherapeutic and ischemic effects on the tumors.

Carcinoma, Hepatocellular↗

Enhancement by X-ray irradiation of target cell susceptibility to natural killer cells.

The in vitro effect of X-ray irradiation on tumor cell susceptibility to lysis by natural killer (NK) cells was studied in human systems. When relatively NK-resistant T24 bladder transitional carcinoma cells were irradiated with X-rays and cultured for 18 h, they showed increased sensitivity to lysis by blood lymphocytes in a 4-h 51Cr release assay. No enhancement was seen when irradiated target cells were tested immediately after exposure to X-rays. The X-ray-induced augmentation was observed with as little as 1 Gy of irradiation, the level of which was comparable to that observed at higher doses. The doses of X-rays did not influence the viability and spontaneous release of the target cells. Treatment with mitomycin C of target cells did not change their NK sensitivity. On the other hand, irradiation with X-rays of blood lymphocytes resulted in a transient increase in NK activity at 3 h, and then the activity declined and was completely lost by 24 h. However, when irradiated lymphocytes were stimulated with interferon (IFN), they maintained the high activity against untreated T24 cells. These results suggest the possible use of relatively low doses of X-ray irradiation in combination with IFN for treatment of human cancer.

Cytotoxicity Tests, Immunologic↗