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Biomedical subjects

T Fukushima

Publications and source records attributed to T Fukushima.

At least 163 records · Page 9Linked to original sources

Peripheral blood stem cell collection and transplantation using the Haemonetics Multi Component System.

AIM: To assess clinical usefulness of an intermittent-flow blood cell separator in peripheral blood stem cell (PBSC) collection and transplantation. RESULTS: The Haemonetics Multi Component System (Multi) was used to collect PBSC (52 aphereses in 17 patients). The mean processing blood volume and the mean PBSC yield were 7407 ml and 2.16 x 10(6) CD34+ cells/kg, respectively. When CD34+ cells exceeded 0.3% of the peripheral WBC, more than 2.0 x 10(6) CD34+ cells/kg could be collected by a single apheresis. Eight patients underwent PBSC transplantation after high-dose chemotherapy. Hematopoietic recovery was achieved in a median period of 10 days. CONCLUSIONS: (1) A single-arm, light-weight machine has sufficient capability to collect PBSC. (2) The percentage of CD34+ cells in the peripheral WBC is a good predictor of the CD34+ cell yield of the collection.

Adult↗

Reciprocal modulation of somatosensory evoked N20m primary response and high-frequency oscillations by interference stimulation.

OBJECTIVES: We examined whether the inverse relation between somatic evoked N20m primary response and high-frequency oscillations during a wake-sleep cycle (Hashimoto, I., Mashiko, T., Imada, T., Somatic evoked high-frequency magnetic oscillations reflect activity of inhibitory interneurons in the human somatosensory cortex, Electroenceph clin Neurophysiol 1996;100:189-203) holds for interference stimulation. METHODS: Somatosensory evoked fields (SEFs) from 14 subjects were measured following electric median nerve stimulation at the wrist with, and without, concurrent brushing of the palm and fingers. SEFs were recorded with a wide bandpass (0.1-1200 Hz) and then N20m and high-frequency oscillations were separated by subsequent low-pass (< 300 Hz) and high-pass (> 300 Hz) filtering. RESULTS: The N20m decreased dramatically in amplitude during interference stimulation. In contrast, the high-frequency oscillations moderately increased in number of peaks. CONCLUSIONS: These results demonstrate the presence of an inverse relation between N20m and high-frequency oscillations for interference stimulation. We speculate that the high-frequency oscillations represent a localized activity of GABAergic inhibitory interneurons of layer 4, characterized by a high-frequency spike burst (200-1000 Hz) without adaptation, and that the continuous interference stimulation induces tonic excitation of the interneurons, leading to a facilitation of responses to the coherent afferent volley elicited by the median nerve stimulation (bottom-up mechanism). On the other hand, refractoriness of the pyramidal neurons caused directly by interference stimulation along with an enhanced feed-forward inhibition from the interneurons will lead to a decrease of N20m amplitude.

Adult↗

Poor outcome of autologous stem cell transplantation for adult T cell leukemia/lymphoma: a case report and review of the literature.

A limited number of patients with adult T cell leukemia/lymphoma (ATL) who received autologous stem cell transplantation (ASCT) have been reported. We report here a case of fatal systemic Candida krusei infection in a female patient with ATL undergoing ASCT. All of the eight patients (including seven patients in the literature) with ATL who received ASCT developed relapse of ATL or death due to ASCT complication, irrespective of subtype or remission state of ATL, source or selection of SCT or conditioning regimen. At present, ASCT appears to provide little benefit for ATL in contrast to that for other types of aggressive non-Hodgkin's lymphoma.

Adult↗

Food intake, serum lipids and amino acids of school children in agricultural communities in Japan.

OBJECTIVE: To investigate the correlation among serum lipids, amino acids and diet of children in Japan where the mortality of ischemic heart disease is still very low. DESIGN: Cross-sectional study. SETTING: Two towns in Shimane prefecture, typical mountainous agricultural communities in the western part of the mainland of Japan. SUBJECTS: 514 children (10-15 y) in the communities were recruited. RESULTS: The mean cholesterol levels ranged from 3.9 to 4.4 mmol/l for boys and from 4.3 to 4.5 mmol/l for girls, and serum cholesterol level fell with age in boys. Serum cholesterol level of girls rose once between 11 and 13 y and fell gradually. Fish intake was positively correlated with serum omega-3 series fatty acids. Milk intake was negatively and soybean intake was positively correlated with omega-3/omega-6 series fatty acids ratio. Serum branched-chain amino acids were correlated negatively with serum polyunsaturated/saturated fatty acids ratio. CONCLUSIONS: Serum cholesterol level of children in agricultural communities in Japan has risen, and is probably affected by the change of food intake. Promoting the intake of soybean and fish, which are traditional Japanese foods, will be important in preventing atherosclerosis and ischemic heart disease. Attention should be paid to the relationship between branched-chain amino acids level in blood and fatty acids metabolism to verify the mechanism of the progress of atherosclerosis.

Adolescent↗

Effect of contamination and etching on enamel bond strength of new light-cured glass ionomer cements.

The effect of water and saliva contamination on the bond strength of metal orthodontic brackets cemented to etched (10% polyacrylic acid) and unetched human premolar enamel was investigated. Two bonding agents were used: one commercially available product (LC) and one experimental (EX) light-cured glass ionomer. Shear bond strength was measured after aging for 5 minutes, 15 minutes, and 24 hours. The results were compared by ANOVA and Scheffe's tests at p = 0.05. For LC, the bond strength of brackets bonded to etched enamel, with and without contamination, was statistically higher than that of brackets bonded to unetched enamel for all aging times. An exception was the bond strength to unetched enamel with saliva contamination after 24 hours; for EX, this value was statistically higher than that measured on unetched enamel with water contamination. Contamination by saliva did not reduce bond strength to unetched enamel. For both etched and unetched enamel, there was no significant difference between LC and EX after 24 hours for all contamination conditions.

Acid Etching, Dental↗

Medical education in China for the 21st century.

Drastic changes are occurring in medical education around the world. Medicine and medical technologies are developing rapidly and expanding beyond the multidisciplinary area. The needs of medical care and medical education are different even from those of several years ago. In order to cope with these increasing social needs, the innovation of medical education in China has become an urgent and important problem. This study is an attempt to answer the question of how to develop medical education in China for the 21st century, based on a historical review of the development of medical education. This development might be divided into three periods: (1) before the Cultural Revolution; (2) the Cultural Revolution (1966-76); and (3) post-Cultural Revolution (1977-present) in modern China, and based on problem analysis of the curriculum, teaching methods, education evaluation, systems and policies and the balance between educational needs and supplies. We concentrate on the discussion of how to solve these problems, and have designed a new strategy for the further development of medical education in China. This discussion and newly developing strategy focuses on the main targets and priorities and adoption of suitable measures according to the conditions of the country. The purposes are to elevate the quality of medical education, to train qualified doctors to meet continuously increasing needs and to maintain the development of medical education for the 21st century in China.

China↗

Widespread occurrence of alpha-synuclein/NACP-immunoreactive neuronal inclusions in juvenile and adult-onset Hallervorden-Spatz disease with Lewy bodies.

Alpha-Synuclein (originally called precursor of the non-Abeta component of Alzheimer's disease amyloid-NACP) is a presynaptic nerve terminal protein and is now known to be a major component of Lewy bodies (LBs) in Parkinson's disease. Previous studies have shown that LBs are occasionally found in patients with Hallervorden-Spatz disease (HSD), a hereditary or sporadic neuroaxonal dystrophy. Therefore, an immunocytochemical examination of the brain tissues from two patients with HSD for alpha-synuclein/NACP was performed. In both cases, LBs were observed in the substantia nigra, locus ceruleus and other subcortical nuclei. These LBs were strongly immunolabelled with anti-alpha-synuclein/NACP. Moreover, abnormal alpha-synuclein/NACP-immunoreactive structures in the neuronal somata and processes were found in the cerebral neocortex, hippocampus, basal ganglia, thalamus, pontine and inferior olivary nuclei, spinal grey matter, and peripheral sympathetic ganglia. Although numerous dystrophic axons (spheroids) were found throughout the brain, either none or only a few were positive for alpha-synuclein/NACP. These findings suggest that widespread accumulation of alpha-synuclein/NACP is a pathological feature in patients suffering from HSD with LBs, and that this phenomenon is unrelated to axonal spheroid formation.

Adult↗

A lateral transzygomatic-transtemporal approach to the infratemporal fossa: technical note for mobilization of the second and third branches of the trigeminal nerve.

This report describes an alternative approach to the infratemporal fossa lesions through a lateral zygomato-temporal craniotemy, which modifies the extradural temporopolar technique for cavernous sinus surgery. First, an L-shaped osteotomy of the zygoma from the frontozygomatic suture attaching the zygomatre arch and low positioned temporal cramotomy are made. Through this zygomato-temporal craniotomy and orbitotemporal drilling, leaving the lateral orbital rim and orbital roof intact, skeletonization of the foramens rotundum and ovale are carried out. The key element of this infratemporal exposure is the dissection and mobilization of the trigeminal nerve, trigeminal second branch rostrally, and the third branch caudally, which facilitates a wide exposure of the infratemporal fossa with preserving trigeminal function. The corridor between the mobilized trigeminal branches provides direct access to the lateral and medial pterygoid plate, internal maxillary artery, sphenoid and maxillary sinuses, maxilla and, finally, the parapharyngeal area. Our experiences have demonstrated that this lateral transzygomatic-transtemporal exposure is satisfactory for use with infratemporal fossa tumors. This approach has an advantage for cranial-base exposure with decreased risks of cosmetic deformity and of trigeminal nerve dysfunction.

Journal Article↗

Extended transbasal approach: anatomy, technique, and indications.

Appropriate indications for the transbasal approach have not been clearly established. The focus of this study is to determine the feasibility of maximal exposure of the clivus and surrounding regions via this strategy. Further, we sought to determine the key anatomical landmarks and morphometric data necessary for safe, radical exposure. In 20 injected cadaveric specimens, anatomical observations were made grossly and microscopically with 4-40 x magnification. The three basic variations of the transbasal craniotomy were compared with regard to surgical exposure. Maximum exposure of the ventral clivus could be obtained by total ethmoidectomy and sphenoidectomy through the extensive transbasal craniotomy. The lateral limits of exposure were found to be the optic nerves, intracavernous carotid arteries, and hypoglossal canals. Inferiorly, the foramen magnum is the limit of exposure. Morphometric measurements were determined between the key landmarks and were found helpful in subsequent dissections due to the lack of bony structures in relation to neural and vascular structures within the bone. The keys to optimizing the transbasal approach are beyond the simple initial steps of the craniotomy. Maximal exposure from the suprasellar compartment to the foramen magnum is possible via the extended transbasal approach.

Journal Article↗

Extended Transsphenoidal Approach with Sigma-shape Osteotomy of the Maxilla: Technical Note.

The traditional sublabial transsphenoidal approach offers a limited operative field. This report describes a simple surgical technique to widen the sublabial transsphenoidal window to access the midline lesions from the planum sphenoidale to the lower clivus. This technique was developed on the basis of clinical experience and on data obtained by cadaveric dissection study. Following a sublabial incision and separation of the bilateral septal mucosa, a small Sigma-shape osteotomy of the maxilla, including the anterior nasal spine, was performed with a surgical saw. The width of the entrance to the nasal cavity ranged from 32 to 38 mm. Although the plexus of the anterior superior alveolar nerve was partially cut, our clinical experience revealed no significant sensory loss of the incisors after the Sigma-shape osteotomy. The nasal orests of the maxilla and palatine bone were drilled out, and the roof of the nasopharynx was then incised to expose the lower clival bone. Although extradural sellar or clival lesions were the focus of this approach, the intradural anatomical structures examined by cadaveric study were presented. The extended transsphenoidal approach with Sigma-shape osteotomy of the maxilla is a simple technique and provides widened access to the sellar and clival regions.

Journal Article↗

Immunohistochemical study of insulin-like growth factor II (IGF-II) and insulin-like growth factor binding protein-2 (IGFBP-2) in choroid plexus papilloma.

Insulin-like growth factor-II (IGF-II), a mitogen for various kinds of cells, has been shown to be secreted from the choroid plexus in animals. Insulin-like growth factor binding protein-2 (IGFBP-2), one of the six carrier proteins for IGFs, is also thought to be released from the choroid plexus, bind to IGF-II in the cerebrospinal fluid (CSF) and modulate the action of this growth factor. Little is known about the expression and localization of these substances in human choroid plexus and choroid plexus papillomas. The present immunohistochemical study demonstrated all six choroid plexus papillomas were positive for IGF-II, whereas normal choroid plexuses were negative for IGF-II. On the other hand, IGFBP-2 was positive in the endothelium and vascular media in the normal choroid plexus, while it was weakly positive in four and negative in two out of six choroid plexus papillomas. These results suggest that the alterations in the IGF-II/IGFBP-2 axis might be involved in the tumorigenesis of choroid plexus papilloma.

Brain Neoplasms↗

Development of a handpiece and probes for a microsurgical ultrasonic aspirator: instrumentation and application.

OBJECTIVE: To address the several disadvantages of currently available ultrasonic aspirators used in microsurgery, new instruments were designed for neurosurgical use under a microscope. DESCRIPTION OF INSTRUMENTATION: The weight of the handpiece was reduced to 90 g. Two types of angled probes were constructed. Keyhole-type probes have 93- and 112-mm lengths, a 2.2-mm tip diameter, and 9.5- and 11.2-mm sheath diameters at the most proximal site and produce a tip amplitude of 300 microm (supplied by 23.5-kHz ultrasonic power). Needle-type probes have 89- and 171-mm lengths, a 1.9-mm tip diameter, and 3.5- and 3.3-mm sheath diameters at the proximal site and produce a tip amplitude of 70 microm. All of these instruments are compatible with magnetic resonance imaging. METHODS: The newly developed handpiece and probes were used in an experimental model. The 119 mass lesions treated included giant thrombosed aneurysms, various gliomas, vestibular schwannomas, deep-seated meningiomas, clival tumors, and suprasellar tumors. EXPERIENCE AND RESULTS: The handpiece and probes were safely used in regions that are difficult to access, such as the third ventricle and the cerebellopontine angle. It was possible to manipulate the needle-type probe in the suprasellar region through the transsphenoidal route, and the probe was very efficient for thrombectomy in giant aneurysms. The ultrasonic power of keyhole-type probes was sufficient to remove meningiomas. CONCLUSION: This newly developed neurosurgical handpiece with angled probes has great utility for microscopic dissections, because of its small size and light weight.

Brain Neoplasms↗

Diversity of leukaemic cell morphology in ATL correlates with prognostic factors, aberrant immunophenotype and defective HTLV-1 genotype.

To investigate the diversity of morphology in adult T-cell leukaemia/lymphoma (ATL) and its possible association with the pathophysiology of ATL, we selected 36 acute cases and 14 chronic cases phenotypically confirmed to have >90% ATL cells in peripheral blood mononuclear cells. Prototype ATL cells were observed in all cases, although the percentage of all lymphoid cells varied considerably (48.9 +/- 23.8 in acute type, 29.6 +/- 18.9 in chronic type; P = 0.015). Chronic lymphocytic leukaemia (CLL)-like morphology with round nuclei was more frequent in chronic type than in acute type (52.0 +/- 24.9% v 16.6 +/- 13.1%; P < 0.0001). Unusual morphology (UM; lymphoblastic, vacuolated, granular pleomorphic or large cells) was more frequent in acute type than in chronic type (20.1 +/- 18.7% v 2.7 +/- 3.2%; P < 0.0001). Furthermore, there were significant negative and positive correlations of % CLL-like cells and % UM cells respectively, with serum LDH level, hypercalcaemia, performance status, and total number of involved lesions. Cases with aberrant immunophenotype (n = 6) or defective HTLV-1 integration (n = 22) showed lower % CLL-like cells and higher % UM cells than other cases, respectively. Cases with >50% CLL-like cells (n = 7; all chronic type) were younger (53.1 +/- 12.2 v 66.9 +/- 10.6 years; P = 0.038) and showed longer acute-crisis free survival (mean: 16.7 v 3. 0 years; P = 0.012) than chronic cases with <50% CLL-like cells. These results suggest that diversity in genotype, phenotype, morphology and behaviour of ATL are closely associated, and that CLL-like morphology is a good prognostic factor for chronic type.

Adult↗

Counteracting moment device for reduction of earthquake-induced excursions of multi-level buildings.

A vibration-control mechanism for beams and columns was presented in our previous report in which the earthquake force was transformed into a vibration-control force by using a gear train mechanism. In our previous report, however, only the principle of transforming the earthquake force into the control force was presented; the discussion for real structures and the design method were not presented. The present article provides a theoretical analysis of the column which is used in multi-layered buildings. Experimental tests were carried out for a model of multi-layered buildings in the frequency range of a principal earthquake wave. Theoretical results are compared to the experimental data. The optimal design of the control mechanism, which is of importance in the column design, is presented. Numerical calculations are carried out for the optimal design. It is shown that vibrations of the column involving the mechanism are suppressed remarkably. The optimal design method and the analytical results are applicable to the design of the column.

Architecture↗

A case report of caudal regression syndrome associated with an intraspinal arachnoid cyst.

We report here a rare case of caudal regression syndrome associated with an intraspinal arachnoid cyst. The patient was a 6-month-old baby girl with multicomplex congenital abnormalities: sacrococcygeal dysgenesis and ventral curvature, large terminal cyst (myelocystocele), spinal arachnoid cyst, cerebellar hypertrophy (suspected), high imperforate anus, partial dysgenesis of the large intestine, omphalocele, atresia of the vagina, bilateral incomplete ureter duplication, incomplete pseudoduplicated bladder and bilateral talipes equinovarus. We performed plastic repair of the myelocystocele and perineal lesion for caudal regression syndrome and partial removal of the cyst wall for the intraspinal arachnoid cyst. She has been well for 3 years postoperatively, and her mental development is normal.

Abnormalities, Multiple↗

Glucocorticoid-induced secondary osteopenia in female rats: a time course study as compared with ovariectomy-induced osteopenia and response to salmon calcitonin.

Previously we reported that 8-week treatment with methylprednisolone acetate (MPA: 0.1 mg/kg, s.c., 3 days a week) of male rats caused a novel type of osteopenia whose development was prevented by salmon calcitonin (SCT) in a dose-dependent manner. In this study, to compare the MPA-inducible osteopenia with the ovariectomy (OVX)-inducible one, female rats were used instead of male rats and a time-course study of development was made. MPA treatments for 1, 2, 4 and 8 weeks histologically induced characteristic osteopenic changes in a time-dependent manner that were histomorphometrically detectable in tibiae within 4 weeks as reduced bone mass, accelerated bone resorption, and suppressed bone formation and mineralization. Node-strut analysis revealed that the connectivity of the trabecular structure remained unaffected. Such MPA-induced changes in the trabecular structure, to be defined as thinned-but-uncut, is in a good contrast with OVX-induced unthinned-but-cut structure, although the latter osteopenic changes became detectable 2 weeks earlier. Another previous finding confirmed herein was that MPA-induced osteopenia in female rats was also completely masked by SCT (10 U/kg, s.c., 5 days a week). The results indicate that the MPA-inducible secondary osteopenic model in either sex of rats would be usable for testing anti-osteopenic drugs.

Analgesics↗