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Biomedical subjects

T Fujimoto

Publications and source records attributed to T Fujimoto.

At least 919 records · Page 51Linked to original sources
PubMedDate not supplied

Benign convulsions with mild gastroenteritis: a report of 10 recent cases detailing clinical varieties.

To better define the characteristic clinical features of benign convulsions with mild gastroenteritis, recently recognized as a new entity in Japan, we reviewed all the 10 patients we have seen from 1992 to 1994. The clinical features have been previously reported in the literature to be afebrile generalized tonic-clonic seizures occurring between the first and the fifth sick day of mild gastroenteritis. In our series, four of 10 patients had convulsions before the onset of gastroenteritis. Overall, seizures were mostly brief and often repetitive occurring in cluster (19 seizures/10 episodes). Among these, a prolonged or partial seizure was frequently observed. In six of the 10 patients, the seizure type changed during an episode: from generalized to partial seizures (n = 2), from partial to generalized seizures (n = 2), or from partial to another type of partial seizures (n = 2). None in our series experienced a recurrence episode of afebrile convulsion during follow-up. These findings suggest that benign convulsions with mild gastroenteritis exhibit some variations in their clinical manifestation.

Child, Preschool↗
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Imaging studies in patients with malignant melanoma in the female genital tract.

The purpose of this study was to review magnetic resonance imaging (MRI) and pathologic features of primary malignant melanoma (melanoma) in the female genital tract. We retrospectively evaluated MRI in six women with melanoma of the genital tract. The signal intensity of the tumor on T1-weighted images (WI) was compared with the amount of melanin granules in hematoxylin-eosin stained sections of resected specimen. On T1WI, four melanomas showed a high signal intensity, one intermediate, and one low. The four melanomas with a high signal intensity on T1W1 were rich in melanin granules, while the one intermediate tumor had few granules. The other one was amelanotic. We believe that a high signal on T1WI is characteristic of primary melanotic melanoma of the female genital tract. Our findings suggest that it is strongly influenced by the presence of melanin granules.

Diagnostic Imaging↗
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Squamous cell carcinoma of the tongue as a second malignancy in a patient previously treated for osteosarcoma.

A 15-year-old girl was diagnosed with osteosarcoma; limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 2 years. One year after completion of chemotherapy, the patient was readmitted for systemic recurrence. Amputation of the lower extremity and wedge resection of lung metastasis were performed followed by combination chemotherapy. Two years after cessation of chemotherapy, ulcer of the tongue was noted and cervical lymph nodes were detected by palpation. Biopsy of the lesion showed squamous cell carcinoma. The patient underwent a radical partial tongue resection and postoperative irradiation, followed by chemotherapy. Six years after treatment for the second malignancy, the patient remains well without evidence of disease. Squamous cell carcinoma of the tongue as a second malignancy after treatment of osteosarcoma is quite rare. Long-term follow-up, with particular attention to the head and neck, may be warranted in children treated for osteosarcoma.

Adolescent↗
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Osteosarcoma as a second malignancy after treatment for neuroblastoma.

A 4-month old girl was diagnosed as having stage IV neuroblastoma of the right adrenal gland. Preoperative chemotherapy was given, followed by local surgical excision. Postoperatively, irradiation of the tumor bed and adjuvant chemotherapy was given for 11 months. Nine years after cessation of chemotherapy, the patient developed left hip-joint pain. Biopsy of the ischium showed chondroblastic osteosarcoma. Limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 14 months. Twenty-two months after treatment for the secondary osteosarcoma, the patient has been remained in disease-free condition without any evidence of relapse. A second osteosarcoma occurring outside the radiation field after treatment for neuroblastoma is quite rare. This unusual case emphasized the need for close monitoring for development of second malignant neoplasms in survivors of neuroblastoma even in the absence of a known predisposing factor, such as radiation therapy.

Combined Modality Therapy↗
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Unusual late extrapulmonary metastasis in osteosarcoma.

The major site of metastasis from osteosarcoma is the lung, and over 90% of fatalities in patients with this disease die from pulmonary metastases. Extrapulmonary disease is developing in an increasing proportion of patients, usually after pulmonary metastasis. This study reports three cases of patients with osteosarcoma that metastasized to the brain, mediastinum, intramuscular site, and pelvic cavity. The physician must be aware that extrapulmonary metastases may be present at the time a pulmonary metastasis becomes evident.

Adolescent↗
PubMedDate not supplied

Multichannel bed temperature recorder as a monitor of pressure sores.

The objective of this study was the measurement of skin temperature of patients with decubitus ulcers during long-term illness. IC temperature sensors, arranged on the bed sheet, were used to monitor body movement without attaching sensors directly to the skin; the spatial distribution of temperature was measured. The results of these studies showed that decubitus ulcers were caused by reduced body movement; higher temperature distribution was observed in the area of decubitus ulcers than in normal areas. The difference in skin temperature between the decubitus ulcer areas and normal areas varied from 1.6 degrees C to 3.1 degrees C. The temperature in the decubitus ulcer area was found to be higher than the temperature of areas in which decubitus ulcers were either developing or healing.

Aged↗
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Neoadjuvant chemotherapy with cisplatin, aclacinomycin A, and mitomycin C for cervical adenocarcinoma--a preliminary study.

Between 1989 and 2002, 28 patients with locally advanced cervical adenocarcinoma (bulky IB-IIIB) were recruited for a pilot study aimed at evaluation of the effectiveness of neoadjuvant chemotherapy with cisplatin, aclacinomycin-A, and mitomycin-C (PAM), followed by radical surgery. This regimen was administrated intra-arterially or intravenously. In addition to patients treated with PAM, we retrospectively analyzed the prognoses of 26 patients in stage I and II, who had been treated between 1975 and 1981 with radical surgery with/without radiation therapy. Twenty-eight patients received PAM therapy as neoadjuvant chemotherapy, and 75.0% of the 16 intra-arterially infused patients showed a response, as did 66.7% of the 12 intravenously infused patients. There was a significant difference in the 5-year prognosis of stage II (PAM group, 72.9%; without-PAM group, 36.4%). The results suggest that, as the free space in the parametrium is widened by neoadjuvant chemotherapy with PAM, it is possible that the tumor could be completely resected by radical hysterectomy. Thus, neoadjuvant chemotherapy with PAM is expected to improve the survival rate of patients with advanced cervical adenocarcinoma by the preliminary study. However, the survival rates of stage II with lymph node metastasis in the without-PAM group seem low, and we must also consider that the various technologies to evaluate and treat the cervical adenocarcinomas, e.g. computed tomography, magnetic resonance imaging, and surgical equipments, had improved during 1989-2002 than was the scenario during 1975-1981, and these improvements contributed to better prognosis. A prospective-randomized study is needed to assess the value of this approach compared with standard management.

Aclarubicin↗
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Cerebrovascular injuries induced by activation of platelets in vivo.

Intravascular platelet aggregation induced by ADP injection into the carotid artery of rabbits caused ipsilateral cerebrovascular injuries. We have observed the details of these in vivo vascular changes under the electron microscope. Intracytoplasmic vacuole (1.0-2.0 micron in diameter) formation and partial deendothelialization followed by platelet thrombus formation were characteristic changes in the middle cerebral artery. These vacuoles did not contain horseradish peroxidase (HRP) which was used as a marker of vascular permeability change. Compared with these phenomenon, increased vesicular (0.05-0.2 micron in diameter) transport was prominent, and vacuole formation was rarely seen in small vessels, namely, capillaries and arterioles in the cortex. Endothelial cell damage seemed to be more prominent in large arteries, but only the smaller vessels show marked extravasation of HRP-reaction product and perivascular edema. Blood levels of TXB2 and 6-keto PGF1 alpha were significantly increased 3 min after the ADP injection and returned to pre-injection levels at 60 min after. These results suggest that vasoactive substances resulting from platelet activation may play an important role in producing cerebrovascular injuries caused by platelet aggregation induced with ADP.

Adenosine Diphosphate↗
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Clinical pharmacokinetics of methotrexate in children.

Among the few antineoplastic agents investigated pharmacologically in children and adults, methotrexate has been clearly demonstrated to be handled differently in the two age groups. Age has in fact proved to be a major determinant, exerting an effect on both the pharmacokinetics and pharmacodynamics of methotrexate. Its pharmacokinetics, in turn, determine the drug toxicity. The beta-phase of methotrexate clearance, represented by the plasma drug concentration 48 hours from the start of a 6-hour infusion in a high dose treatment regimen, appears to be constant with age. In children, an increasing plasma drug concentration is apparent with increasing age, but whether this trend reflects a potential increase in the area under the plasma concentration-time curve of methotrexate has yet to be defined. Recent investigations have suggested that the drug is more completely distributed in the tissues of children than adults at the same infused dosage. This may explain the increased tissue toxicity caused by methotrexate. However, other observations suggest a faster drug turnover rate in the tissues of children. This may prevent the drug from concentrating in vital organs. Whether the metabolism of methotrexate, particularly the biosynthesis of methotrexate polyglutamates, plays a role in the biological effect of the drug is worthy of further investigation. The high brain tissue concentration after systemic methotrexate infusion and the slower efflux of methotrexate from brain tissues and cerebrospinal fluid make these tissues vulnerable to methotrexate toxicity.

Adolescent↗
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Intracytoplasmic lumina in human oviduct epithelium.

Intracytoplasmic lumina (ICL) in human oviduct epithelium were investigated with transmission electron microscopy. ICL were found in 43 out of 60 cases examined. They were ultrastructurally characterized by microvilli lining the lumina, periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) staining-positive finely granular material in the lumina, and secretory vesicles in the cytoplasm surrounding the lumina. Although ICL were observed at various heights within the epithelium, they were mainly seen in basally located cells that did not face the oviduct lumen. Various stages of formation and development of ICL were observed in the basally located epithelial cells with secretory activities. Primary ICL were originated in the cytoplasm where the secretory granules were aggregated with smooth-surfaced tubular vesicles. Electron microscopic observations after PA-TCH-SP staining revealed that ICL were formed by fusion of the secretory granules with the tubular vesicles. ICL were enlarged into round profiles by further fusion of secretory granules and tubular vesicles, and subsequently opened to the oviduct lumen, or fused to each other to develop into large extracellular cysts within the epithelium.

Adult↗
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A solid-state ambulatory physical activity monitor and its application to measuring daily activity of the elderly.

An ambulatory acceleration monitor was developed and used to evaluate physical activity in the elderly. The ECG and accelerations at the wrist, waist, and ankle were recorded, and the heart rate and frequency and amplitude of accelerations per unit time were evaluated in both working and retired elderly women performing normal daily activities. The heart rate closely paralleled wrist acceleration. The behaviour patterns of the subjects could be differentiated by time interval signals and histogram distributions. This system appears to be an effective method of understanding and describing the characteristic activities of the elderly in a quantitative and objective fashion.

Activities of Daily Living↗
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Clinical significance of childhood acute myeloid leukemias expressing lymphoid-associated antigens.

The clinical significance of the expression of lymphoid-associated antigens in leukemic cells was studied in 66 children with newly diagnosed acute myeloid leukemia (AML). Among 66 AML cases, 17% were CD7-positive, 15% were CD19-positive, 8% were CD2-positive, and 5% were CD10-positive. In 23 (35%) of the 66 AML cases, at least one lymphoid-associated antigen was expressed in the leukemic cells. When the clinical features and laboratory findings were compared at diagnosis between the 23 Ly+ and the 43 Ly- AML cases, no statistically significant difference was found. The expression of CD34 was significantly more frequent in Ly+ AML cases (91%) than in Ly- AML cases (31%). Chromosomal analysis revealed t(8;21) in 6 of the 21 Ly+ AML cases examined. No other specific chromosome aberration was noted. The 3-year event-free survival rates of Ly+ AML cases and Ly- AML cases were 34% +/- 12% and 26% +/- 8%, respectively. There was no statistically significant difference between the two groups. Further studies are required to determine the prognostic significance of lymphoid-associated antigen expression.

Adolescent↗
PubMedDate not supplied

Overview of clinical studies of childhood acute lymphoblastic leukemia for more than ten years by the Japanese Children's Cancer and Leukemia Study Group.

Since 1981, the Children's Cancer and Leukemia Study Group (CCLSG) has developed a series of protocols for treatment of acute lymphoblastic leukemia (ALL) in childhood. In the first randomized controlled study of the 811 protocol (1981-1983) a comparison of conventional daily 6-mercaptopurine and methotrexate with a pulsed regimen of the two drugs was performed. The superiority of the pulsed regimen was shown. In the next 841 protocol (1984-1987) a comparison of two drugs and three drugs during induction therapy was conducted. The three-drug regimen resulted in a significantly higher event-free survival (EFS) rate. In the 874 protocol (1987-1990) two regimens with or without cranial irradiation were randomly compared, and there was no significant difference between the two regimens for the standard-risk group. To further improve the EFS rate a risk group-directed protocol 911 was conducted starting in January 1991. Life-table analysis of serial CCLSG protocols revealed that the outcome of overall ALL has gradually improved with an increase of the EFS rate; 41.4% +/- 3.6% at 14 years for the 811 protocol, 51.3% +/- 3.5% at 11 years for the 841 protocol, 56.7% +/- 3.1% at 8 years for the 874 protocol, and 78.2% +/- 3.1% at 4 years for the more recent 911 protocol.

Antineoplastic Combined Chemotherapy Protocols↗
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Bcl-2 expression and prognosis in childhood acute leukemia. Children's Cancer and Leukemia Study Group.

Bcl-2 expression and its prognostic value were evaluated in 42 children with acute leukemia. The Bcl-2 expression of the leukemic blast cells was measured quantitatively by flow cytometry and was further analyzed by the simultaneous immunostaining of Bcl-2 with the surface membrane antigens, DNA, Ki-67 antigen. All of the cases showed a consistent expression of Bcl-2 protein; virtually all leukemic lymphoblasts were Bcl-2 positive. Although the expression of Bcl-2 varied widely from 7 to 80 x 10(3) MESF units, no significant difference was found in the mean value between the patients with acute lymphoblastic leukemia and those with acute myeloblastic leukemia. In more than half of the patients with AML, intraclonal heterogeneity of Bcl-2 expression was observed. The expression of Bcl-2 showed no apparent fluctuations during the different phases of the cell cycle. However, the proportion of Bcl-2-positive and -negative cells during the cell cycle was different between ALL and AML patients. In the ALL patients, few Bcl-2-negative cells were detected only in the GI phase, whereas in the AML patients Bcl-2-negative cells were detected in the S and G2/M phases, as well as in the G1 phase. No apparent difference was found in Bcl-2 expression between the Ki-67-negative noncycling population and the Ki-67-positive cycling population. Of the clinical features of these patients, only CD34 expression in the ALL patients was associated with high levels of Bcl-2 expression. In the 28 untreated cases of ALL, high expression of Bcl-2 was not an unfavorable factor for the outcome of this disease.

Adolescent↗
PubMedDate not supplied

The power of product integrity.

In the dictionary, integrity means wholeness, completeness, soundness. In products, integrity is the source of sustainable competitive advantage. Products with integrity perform superbly, provide good value, and satisfy customers' expectations in every respect, including such intangibles as their look and feel. Consider this example from the auto industry. In 1987, Mazda put a racy four-wheel steering system in a five-door family hatchback. Honda introduced a comparable system in the Prelude, a sporty, two-door coupe. Most of Honda's customers installed the new technology; Mazda's system sold poorly. Potential customers felt the fit--or misfit--between the car and the new component, and they responded accordingly. Companies that consistently develop products with integrity are coherent, integrated organizations. This internal integrity is visible at the level of strategy and structure, in management and organization, and in the skills, attitudes, and behavior of individual designers, engineers, and operators. Moreover, these companies are integrated externally: customers become part of the development organization. Integrity starts with a product concept that describes the new product from the potential customer's perspective--"pocket rocket" for a sporty, subcompact car, for example. Whether the final product has integrity will depend on two things: how well the concept satisfies potential customers' wants and needs and how completely the concept has been embodied in the product's details. In the most successful development organizations, "heavyweight" product managers are responsible for leading both tasks, as well as for guiding the creation of a strong product concept.

Consumer Behavior↗
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Streptococcal preparation OK-432 enhances the antitumor activity of CPT-11 by increasing Th1-cytokine production in mice.

BACKGROUND: The streptococcal preparation OK-432 is an immunomodulator widely used for cancer therapy in Japan. The purpose of this study was to evaluate the efficacy of the combined treatment of OK-432 and CPT-11. MATERIALS AND METHODS: In C57BL/6 mice inoculated with B16 melanoma, the antitumor mechanism of this combined therapy was investigated through an analysis of cytokine production by the splenocytes. RESULTS: SN-38, the active metabolite of CPT-11, exerted dose-dependent inhibition of interferon (IFN)-gamma production induced by OK-432 in mouse splenocytes. In contrast, the optimum concentration of SN-38 increased interleukin (IL)-6 and IL-12 production by OK-432-activated splenocytes. In tumor-bearing mice, CPT-11 inhibited tumor growth and OK-432 had an additive antitumor effect with CPT-11. Investigation of cytokine production showed that CPT-11 treatment principally inhibited IL-12 and IFN-gamma production, which was improved by the combined administration with OK-432. CONCLUSION: These results indicate that CPT-11 inhibits type-1 T helper (Th1) cells despite its potential to stimulate macrophages and that OK-432 enhances the antitumor activity of CPT-11 by increasing Th1-cytokine production.

Animals↗