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Biomedical subjects

T Fukushima

Publications and source records attributed to T Fukushima.

At least 217 records · Page 12Linked to original sources

Hypothalamic hamartoma associated with multiple congenital abnormalities. Two patients and a review of reported cases.

We report 2 patients with hypothalamic hamartoma associated with multiple congenital abnormalities and analyze 42 (including our own) reported cases, including our 2 cases, of hypothalamic hamartoma or hypothalamic hamartoblastoma with multiple congenital abnormalities, to understand the timing of their occurrence and clarify the prognosis. To this end, we classified them into lethal and nonlethal cases. We found poly- and syndactyly, cleft or high-arched palate and nose abnormalities to be important manifestations of this syndrome. Major organ abnormalities and CNS and endocrine abnormalities occurred frequently among the lethal cases, very likely indicative of a disturbance of embryogenesis between gestational days 34-37 and thus implicated in a negative prognosis.

Abnormalities, Multiple↗

Urinary excretion of D-serine in human: comparison of different ages and species.

The urinary excretion of D-serine (D-Ser) in human, rat and dog of various ages was studied. Great amounts of D-Ser were consistently excreted in human urine throughout life. No age-dependent changes were observed in urinary D-Ser/total-Ser ratios from the newborn to the aged. D-Ser/creatinine ratios in adult human urine were found to be relatively constant in individuals. The constant excretion of D-Ser in human urine was confirmed by analyzing the consecutive 24 h urine of three volunteers. High concentrations of D-Ser and D-alanine (D-Ala) were found in adult dog urine. The urinary D-Ser concentration was high in young rats at unweaned and weaned periods, and then declined with increasing age. In contrast, the urinary D-Ala concentration was very low in suckling rats, and increased rapidly after the weaned state and then declined with increasing age. The species- and age-related excretion of D-Ser in mammalian urine is considered to be due to the differences in the renal handing of D-Ser, because plasma D-Ser concentrations among the groups were not so different. Although free D-Ser has been detected in animal foods and human colostrum, the amount is insufficient to explain the concentration of D-Ser found in urine. These results indicate that urinary D-Ser in mammals may be mainly of endogenous origin.

Adult↗

Age-related weakening of baroreflex-mediated sympathetic activity in spontaneously hypertensive rats in response to blood pressure reduction.

Nicardipine, a dihydropyridine type calcium channel blocker, was infused into 4-, 6-, and 23-wk-old spontaneously hypertensive (SH) and age-matched normotensive Wistar-Kyoto (WKY) rats (under sodium thiobutabarbital anesthesia and ventilation, n = 4) through the left femoral vein, resulting in the reduction of blood pressure. In each rat, mean arterial blood pressure, heart rate, and the concentration of plasma catecholamines (CAs), norepinephrine (NE), and epinephrine (E) were concomitantly determined, and the correlations between these three variables were studied. During the infusion of nicardipine, the plasma concentration of CAs was measured with an automatic detection system in blood samples collected from the right femoral artery of each rat. The reduction in blood pressure induced by nicardipine brought about an increase in plasma CA levels. The blood pressure correlated well with the logarithm of plasma NE or E concentration according to the formula Y= -alpha log (X) + m (Y, blood pressure; X, concentration of plasma NE or E; a, slope; and m, intercept). The slopes (as) of 6-wk-old and 23-wk-old SH rats were significantly greater than those of aged-matched WKY rats, meaning that the increment in plasma CAs in response to a decrease in blood pressure was smaller in SH than in WKY rats of similar ages. However, no significant differences were found between the as of 4-wk-old SH and WKY rats. We conclude that the increment in the baroreflex-mediated sympathetic activity in response to a drop in blood pressure induced by nicardipine is similar or greater in prehypertensive SH than in normotensive WKY 4-wk-old rats, while the increment becomes smaller in SH rats with the onset of hypertension (6-wk-old rats), and is much less in fully hypertensive adult (23-wk-old) SH rats than in age-matched WKY rats. On the basis of these findings and previous data obtained by neurography, we conclude that plasma CAs can be used to evaluate baroreflex-mediated sympathetic activity countering the blood pressure reduction caused by calcium antagonists.

Aging↗

Intramedullary hemangioblastoma of the medulla oblongata--two case reports and review of the literature.

We determined the treatment modality of hemangioblastoma of the brain stem on the bases of our two cases and 31 cases searching from the literature since 1960 which were treated surgically. Hemangioblastomas of the brain stem were categorized according to one of three locations: hemangioblastoma of the fourth ventricle attached to the floor of the ventricle (Type A), hemangioblastoma of the fourth ventricle partially embedded in the floor of the ventricle (Type E), and intramedullary hemangioblastoma of the medulla oblongata (Type I); and were evaluated their clinical features including the operative mortality and morbidity of each location. In our two cases of Type I hemangioblastoma, Case 1, removed partially, died due to sleep apnea and Case 2 lead to normal school life after hemangioblastomas were removed radically. In our review of the 33 surgically-treated cases, radical excision was carried out in 29 cases (87.9%). The mortality was 24.2% overall; that of Type A was 25%, Type E was 28.6%, and Type I was 14.3%. In terms of postoperative mortality, the location of the hemangioblastoma was irrelevant and radical excision was much better than partial removal. Hemangioblastomas of the brain stem could be removed radically by meticulous dissection of the tumor on distinct cleavage, even in cases of intramedullary location. Microsurgical dissection of medullary hemangioblastomas with low morbidity is feasible and prudent postoperative care is mandatory to reduce the operative mortality and morbidity.

Adolescent↗

Prolonged survival in a patient with sinonasal teratocarcinosarcoma with cranial extension. Case report.

Sinonasal teratocarcinosarcoma is a rare malignant neoplasm characterized by the combined histological features of carcinosarcoma and teratoma. The primary symptoms of this tumor are usually nasal obstruction and epistaxis, and a nasal cavity mass is the most common clinical finding. The authors describe an exceptionally rare case in which the patient presented with massive intracranial extension and exhibited confusion as an initial symptom. He subsequently underwent combined radical surgery and radiation therapy and has remained free of disease for 31 months. The surgical approach to the lesion, histological features, and clinical course are detailed.

Aged↗

[Current situation and perspective for treatment of acute myelogenous leukemia in adults].

The current situation and perspectives for the treatment of acute myelogenous leukemia in adults were summarized. Due to the recent progress of chemotherapy, the complete remission (CR) rate is close to 80% in adults with newly diagnosed acute myelogenous leukemia in Japan. On the other hand, the long-term disease-free survival rate is 30-40% in CR cases. The allogeneic bone marrow transplantation (allo BMT) during the first CR has a low relapse rate compared with that of chemo therapy. However, the therapy-related mortality is not inconsiderable, so, the time of allo BMT is controversial. Idarubicin has a superior CR rate as well as long-term disease-free survival in comparison with daunorubicin, and it is becoming the first line treatment for acute myelogenous leukemia in adults.

Adult↗

Technical refinements in retraction for middle fossa surgery.

OBJECTIVE: This report describes an alternative technique for exposure of the floor of the middle fossa. STUDY DESIGN: Descriptive review of alternative middle fossa retraction techniques on a retrospective case series. SETTING: Tertiary referral center. PATIENTS: Patients undergoing middle fossa or combined petrosal craniotomy were studied. INTERVENTIONS: Dural elevation was carried anteriorly past the middle meningeal artery to permit separation of the dura from connective tissue over the Gasserian ganglion. With the dural release, flexible spatula retractors (Fukushima) can be used. RESULTS: The advantages of this technique are 1) this system is "low profile," with the back of the retractor posing no obstruction to vision or angle of instrument manipulation; 2) the anterior dural release permits extensive exposure with less force than is necessary when dural attachments to the trigeminal nerve remain intact; and 3) anterior exposure of the clivus and petrous apex is achieved without the need for transection of V3 (3rd division fifth cranial nerve). CONCLUSIONS: The authors find these refinements of practical benefit for breadth of exposure, visibility, and room for instrumentation during middle fossa surgery.

Brain↗

Rhombencephalosynapsis: cerebellar embryogenesis.

We describe two infants in whom rhombencephalosynapsis was diagnosed with MR imaging in vivo. In contrast to Dandy-Walker malformation, the vermian maldevelopment in this anomaly is characterized by an absence of the anterior vermis and a deficiency of the posterior vermis. The cerebellar hemispheres are fused. In an attempt to identify the pathogenesis of these anatomic manifestations, we question the traditional concept of the embryologic development of the cerebellar primordium.

Brain↗

[Perioperative management of intracranial hemorrhage related to hematological disease].

Six patients with hematological disease complicated by intracranial hemorrhage were surgically treated in the last 2 years. In this study, in order to clarify indication for operation and perioperative management, 6 cases were classified into 2 groups. The details of each group were as follows: Group 1 was defined by the fact that the underlying hematological disease had not yet been controlled. (One case was ITP and the others were 2 AML cases). Group 2 was defined by the fact that the underlying hematological disease was well controlled. (One case was CML, one case was ATL and one case was ITP). A tendency to bleed was corrected in all patients of group 1 in the perioperative period. In the AML cases, prevention of infection was mandatory because both AML cases had been in remission, and no serious postoperative complication had occurred. The outcome of short term treatment was excellent in all but one case, in whom the recurrence of subdural hematoma caused death during the period 1 month after operation. On the other hand, no cases classified in group 2 needed specific hematological perioperative management and the short term treatment outcome was excellent. Since intracranial hemorrhage related to hematological disease has often been fatal, those patients were treated conservatively in most cases. However, from our analyses, we were able to emphasize that most intracranial hemorrhage related to hematological disease might be treated surgically and with good result, if the underlying hematological disease has entered the remission period.

Adult↗

[Use of a CO-oximeter for forensic diagnosis of hypothermia].

Blood samples were collected from the right and left atria separately in 9 cases of hypothermia and 18 cases of non-hypothermia during judicial and consented autopsy between March 1995 and December 1997. The oxyhemoglobin ratio (O2Hb), reduced hemoglobin ratio (RHb) and oxygen saturation (sO2) were measured by oximetric analysis. O2Hb, R-Hb and sO2 were significantly greater in the hypothermic group than the non-hypothermic group. We conclude that the diagnosis of hypothermia can be established in cases where O2Hb and sO2 in the left atrium exceed 80%, irrespective of values in the right atrium.

Adult↗

Unnecessary surgical operation confirmed by individual identification by analyses of several short tandem repeat (STR) loci.

A 60-year-old man who was diagnosed as having hepatic cell carcinoma by needle punch biopsy from the liver, underwent right hepatic lobectomy. However, no malignant components were detected in the removed tissue. It was suspected that he was the wrong patient and had undergone the operation unnecessarily. Individual identification was performed using paraffin blocks of his liver tissue taken by needle punch biopsy, that of liver tissue taken at surgery and his peripheral blood by genotyping several STR loci. All of these specimens had the same genotypes. Histological re-examination revealed that the biopsied sample contained no malignant component. The end result was that the initial biopsied liver specimen was misdiagnosed as hepatic cancer and the patient underwent an unnecessary operation due to misdiagnosis.

Biopsy, Needle↗

Arachidonic acid metabolism to prostaglandin E2, D2, F2alpha, and I2 in the plerocercoid of Spirometra erinaceieuropaei.

Changes in the fatty acid composition of phospholipid and triglyceride fractions in Spirometra erinaceieuropaei plerocercoids were investigated after 0, 0.5, 1, 3, and 6 hr incubation at 10 C and 37 C with physiological saline containing 5 mM arachidonic acid and 10 mg/ml bovine serum albumin, pH 7.0. At 37 C, arachidonic acid was absorbed and incorporated rapidly into the triglyceride fraction (over 14.4% in composition), and decreased after 2-3 hr; at 10 C, the amount of triglyceride increased slowly and continued to a maximum of 12.9% during 6 hr of incubation. We used a simplified method to extract and purify prostaglandins from the plerocercoid of S. erinaceieuropaei. Prostaglandins were quantified using gas chromatography-mass spectrometry. Prostaglandin E2, PGD2, PGF2alpha, and 6-keto-PGF1alpha were detected under different incubation conditions. In the dose-dependent experiment, PGD2 was detected in plerocercoids incubated with 0.5, 1, 2, and 5 mM arachidonic acid, pH 7.0, at 25 C; PGE2 was detected with 2 and 5 mM arachidonic acid. In the time-dependent experiment, where plerocercoids were incubated with 5 mM arachidonic acid, pH 7.0 at 25 C, PGF2alpha was first detected at 15 min; thereafter, 6-keto-PGF1alpha was detected at 30 min and PGD2 and PGE2 were detected at 1 hr. Thromboxane B2 was not detected in either the dose-dependent or time-dependent experiments, and only PGE2 was detected in the incubation medium with 5 mM arachidonic acid at 1 hr. These results reveal that when plerocercoids change from reptilian to mammalian hosts, they are able to absorb and modify arachidonic acid bound to albumin and generate prostaglandins under suitable conditions. Prostaglandins exhibit potent biological functions for immunoresponses that may be relevant to parasitism and the success of larva migrans in S. erinaceieuropaei.

Animals↗

Human identification by genotyping of personal articles.

In cases of personal identification of unknown skeletal remains, forensic scientists normally analyze an individual's genotype or phenotype by comparison with those of other family members such as patients. However, such genotyping does not necessarily provide conclusive proof of identity. In this study, we attempted personal identification by comparison of several short tandem repeat (STR) loci in samples from three corpses in various stages of decomposition with samples from personal articles of the respective individuals. The first victim had been found dead in a burned car. Almost 100% of his body was charred. The genotypes of the iliac bone from the burned body with regard to several STR loci were compared with those from a single hair recovered from the vacuum cleaner from the candidate's home. The second victim was found in a forest after more than 5 years. Several STR loci genotypes of skeletal bone were compared with those of the candidate's mummified umbilical cord kept in his parent's house. In the last case the victim was found in the sea after more than 7 months. The genotypes of the loci in the pubic bone of the corpse were compared with those of a menstrual bloodstain on the candidate's underwear left in the washing machine at her home. We succeeded in identification of the three cases by comparison of several VNTR and STR loci in the corpses with those in personal articles. In conclusion, personal identification can sometimes be performed more precisely by genotyping of personal articles than by comparison with the genotypes of relatives.

Adult↗

D-aspartic acid localization during postnatal development of rat adrenal gland.

Developmental changes in cellular localization of D-aspartic acid (D-Asp) were investigated in rat adrenal gland with polyclonal anti-D-Asp antibody. At 1 and 3 weeks of age, immunoreactivity (IR) toward this amino acid was intense in the cytoplasm of cells in the zona fasciculata (ZF) and zona reticularis (ZR) of the adrenal cortex but was less so in the zona glomerulosa (ZG). Conversely at 8 weeks of age, intense IR was observed in the ZG and less in the ZF and ZR. In the adrenal medulla, IR was evident in large clusters of cells which were identified as adrenaline-storing cells. The emergence of D-Asp in specific types of cells at distinct periods of development of rat adrenal gland suggests that this amino acid may have a physiological role in the maturation of the organ.

Adrenal Cortex↗

The involvement of calmodulin and Ca2+/calmodulin-dependent protein kinase II in the circadian rhythms controlled by the suprachiasmatic nucleus.

We investigated the involvement of calmodulin and Ca2+/calmodulin-dependent protein kinase II (CaMKII) in the photic entrainment of circadian rhythms using calmodulin inhibitors such as calmidazolium (CMZ) and trifluoperazine (TFP), and a CaMKII inhibitor, KN-62, in rats. Fos expression in the suprachiasmatic nucleus (SCN) of rats induced by photic stimulation (300 lux, 1 h) during the early subjective night of the rats was inhibited by treatment with CMZ (10 mg/kg i.p.) or TFP (20 mg/kg i.p.) 30 min before photic stimulation. With respect to the neuronal firing rate in the rat SCN slice, KN-62 and CMZ application during the early subjective night attenuated the glutamate (10 microM)-induced phase shift. The present results suggest that calmodulin and CaMKII are involved in the photic entrainment mechanism in the rodent SCN.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

Amyloid beta protein 42(43) in cerebrospinal fluid of patients with Alzheimer's disease.

To investigate the pathomechanism of amyloid beta protein (A beta) deposition in brains with Alzheimer's disease (AD), cerebrospinal fluid (CSF) levels of A beta species (CSF-A beta) with different carboxy termini, i.e. A betaX-40 and A betaX-42(43) as well as A beta1-40 and A beta1-42(43), were measured in patients with AD and age-matched controls without dementia (CTR) using sandwich enzyme-linked immunosorbent assays (ELISAs). The present study revealed that both CSF-A betaX-42(43) and A beta1-42(43) levels were significantly lower in the AD patients (P<0.005) than in the CTR group, whereas neither CSF-A betaX-40 nor CSF-A beta1-40 levels showed any differences between the two groups. In addition, although there was no difference between the ratios of A betaX-40 to A beta1-40 in the AD and CTR groups, the ratios of A betaX-42(43) to A beta1-42(43) were increased in the AD group compared with those in the CTR group (P<0.05). Therefore, it can be assumed that the ratios of amino terminal truncations and/or modifications of CSF-A beta42(43) with carboxy termini ending at residue 42(43) were more increased in the AD group than in the CTR group. Increased adsorption of A beta42(43) to A beta deposition in AD brains, decreased secretion of A beta42(43) to CSF and/or increased clearance of A beta42(43) from CSF might explain the diminished levels of A beta42(43) in the CSF of AD patients. In addition, CSF-A beta42(43) could reflect increased amino terminal truncations and/or modifications of A beta42(43) in AD brains.

Aged↗

Regional distribution and postnatal changes of D-amino acids in rat brain.

Regional distribution of D-amino acids in rat brain was studied by the modified highly sensitive analytical method which was previously developed. The method includes fluorogenic derivatization of each amino acid, isolation of each amino acid by reverse-phase HPLC, followed by enantiomeric separation with Pirkle-type chiral stationary phases. D-Amino acid contents were determined in the cerebrum, cerebellum, hippocampus, medulla oblongata, pituitary gland and pineal gland. D-Aspartic acid was observed in the pineal gland (3524 +/- 263 nmol/g, data are for male rats of 6 weeks of age) and the pituitary gland (80.5 +/- 9.0 nmol/g). D-Serine was found in various regions of the brain except for the cerebellum and medulla oblongata. D-Alanine was observed exclusively in the pituitary gland (25.9 +/- 4.4 nmol/g), whereas D-leucine was found in the pineal gland (3.4 +/- 0.4 nmol/g) and the hippocampus (1.6 +/- 0.07 nmol/g). No other D-amino acids were detected in the brain. The contents of D-aspartic acid in the pituitary gland and D-serine in the pineal gland were higher in female rats. In contrast the contents of D-alanine in the pituitary gland and D-leucine in the pineal gland and the hippocampus were higher in males. Postnatal changes of D-aspartic acid and D-leucine in the pineal gland and D-alanine in the pituitary gland were also investigated. The results described in this paper suggested that distinct regulatory mechanisms exist for individual D-amino acids in the corresponding region of rat brain.

Amino Acids↗