Networks and Evolution of Molecular Information
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Journal Article↗
Biomedical subjects
T Ohta
Publications and source records attributed to T Ohta.
[Grading of level of consciousness].
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Consciousness↗
[Polysomnography (PSG)].
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Circadian Rhythm↗
[Transcallosal and transcortical approaches for tumors at the anterior part of the lateral ventricle: relations between visualized and ventricular size].
The transcallosal approach has been widely used for tumors located near the midline of the anterior part of the lateral ventricle, while the transcortical approach is known to provide a wide surgical field in cases of hydrocephalus. However, it is not always easy to choose the appropriate approach in individual cases. The size of the visualized field obtained via the surgical approach is one of the most important factors determining the accessibility of the lesion. In this study, we investigated the difference in the sizes of the fields afforded by these two approaches on the basis of our clinical experience and simulation studies. We surgically treated intraventricular pathology located at the anterior part of the lateral ventricle in five patients with tumors and one with a cyst. Tumors with lateral extension of less than 20 mm were approached via the transcallosal route, and those with more than 20 mm of lateral extension via the transcortical route. In the simulation study, the size of the surgical field was measured through a 3-cm incision of either the cerebral cortex or the corpus callosum under various conditions of ventricular enlargement. Two patients treated via the transcortical approach underwent subtotal removal; one of them had a large bilaterally extending tumor measuring 50 mm in its greatest diameter, and the other had tumor involvement of the fornix. The other three tumors and the cyst were totally resected. While postoperative subcortical hematoma developed in two patients, one each treated via the transcortical and the transcallosal approach, no deficits remained at discharge. Since enucleation procedure was insufficient in patients with hard tumors, a wider surgical field than that in patients with soft tumors was considered necessary. When combined approaches are considered indispensable for a patient with a massive tumor, the transcortical approach may be indicated for priority of order to prevent bilaterally residual tumors. The simulation study disclosed that, in either approach, wider surgical field was obtained as the size of ventricle increased. However, the transcallosal approach afforded a wider field than did the transcortical approach not only in ventricules of normal size but also in mild hydrocephalus with cortical thickness of between 30 and 40 mm. The transcortical approach, on the other hand, produced a much wider field in more advanced hydrocephalus with a thickness of less than 30 mm. A wider surgical field can be obtained by certain tactics such as upward retraction of the incised corpus callosum, moving the cortical window, or oblique or transverse cortical incision.
Adult↗
A new surgical technique for the treatment of life-threatening congenital arteriovenous malformation--intraluminal graft implantation.
A new surgical intraluminal graft implantation technique was undertaken in a 27-year-old man with a massive, life-threatening, high-flow congenital arteriovenous malformation (AVM) involving the left lower extremity, which was resistant to such challenges as transarterial embolizations or partial resections. For occlusion of the feeder branches, a composite graft composed of two grafts with different diameters, which matched to the arterial lumen, was surgically inserted into the superficial femoral artery. The implanted graft occluded 2 weeks after the insertion. Although amputation distal to the knee was necessary because of the foot necrosis, the graft was useful in reducing the cardiac output (from 14.3 l/min to 9.8 l/min) and obviating hip joint amputation. A further clinical study is necessary to examine whether or not it is an acceptable treatment modality.
Adult↗
[A case of mediastinal tuberculous lymphadenitis with tracheal stenosis].
68-year-old female was introduced our hospital for productive cough and dyspnea. Chest X ray film showed right upper mediastinal mass and tracheal stenosis. Chest CT showed mediastinal mass with calcifying lesion. ESR at 1 hour was 50 mm and CRP was 1.08 micrograms/ml. Because of progressive dyspnea, the operation was performed without further assessment. We found a mass of adhesive lymph nodes by the side of trachea. We removed it and it turned out to be tuberculous lymphadenitis. Postoperative PPD skin test showed strongly positive reaction. She has taken medication by antituberculous drugs and lives well without complications.
Antitubercular Agents↗
[Radiological anatomy of the vein of Labbé].
The development and radiology of the vein of Labbé (VL) were investigated using the brains of 19 aborted human fetuses and 6 normal adults injected at autopsy with radiopaque material through the venous system. Carotid angiograms taken in stereoscopic pairs (110 cases, 167 hemispheres) were also analyzed in detail. Developmental alterations of the cerebral structures, particularly those of the opercula and cerebral sulci, are reflected in our classification of the pial veins of the lateral cerebral convexity into the superior, middle and inferior groups. The anastomotic veins of Trolard and Labbé were already recognizable at the fetal age of 6 to 7 months, as development of the opercula and resultant depression of the insula became advanced. In our series, superficial draining veins opening into the VL were 14 to 20 mm (average 16.8 mm) in length. Anastomoses among the superior, middle and inferior groups were analyzed angiographically: single anastomosis was found in 23 percent of cases, while double and triple anastomoses were found in 32 and 45 percent, respectively. A majority of the veins at the sites of anastomosis were found to have calibers of less than 1 mm. The VL, therefore, should be considered in most cases as an independent major superficial draining venous channel of the cerebral convexity with insignificant connections with the superior and middle groups.
Adult↗
[Laparoscopic retrieval of a dislocated ventriculoperitoneal shunt catheter: report of three cases and a review of the literature].
Described are 3 cases of a disconnected ventriculoperitoneal shunting system that was successfully retrieved by using a laparoscopic procedure, with a review of the literature. All patients had symptoms of increased intracranial pressure. Roentgenograms showed disconnection of a ventriculoperitoneal shunt catheter at the connecting device and its migration into the peritoneal cavity. A laparoscope was introduced into the peritoneal cavity using the double puncture procedure and the catheter was extracted in less than 15 minutes. The use of a laparoscope enabled exploration of the entire space of the cavity without any large laparotomy incision. Furthermore, the laparoscopic procedure also easily enabled introduction of a replaceable ventriculoperitoneal shunt catheter into the appropriate portion in the cavity and confirmed the CSF flow into the cavity. Because catheters which have migrated into the cavity might cause an acute abdomen, it is important that they should be removed as soon as possible. It should be kept in mind, during the procedures of extracting catheters, that the inner absorptive surface of the peritoneal cavity must be preserved as much as possible. In this regard, laparoscopic retrieval of disconnected shunt catheters is a promising method.
Adult↗
Mosaic pattern of ornithine transcarbamylase expression in spfash mouse liver.
Mosaicism of ornithine transcarbamylase expression was immunohistochemically examined in hepatocytes of spfash heterozygous female mouse livers. An immunohistochemical method using polyclonal antibodies against ornithine transcarbamylase visualized the mosaicism in serial paraffin sections. Very complicated mosaic patterns consisting of positive and negative hepatocytes were obtained in a section of adult liver, but a computer-aided three-dimensional analysis of serial sections demonstrated that patches with complicated shapes and various sizes, which are contiguous groups of positive or negative hepatocytes and are isolated in sections, connected very well with one another. No definite orientation such as portal-central was observed in the three-dimensional images of each patch. In balanced regions of the mosaicism, most individual plates along their straight portal-central lengths did not appear to be composed of only marker-positive or marker-negative hepatocytes. By contrast, in unbalanced regions of the mosaicism, individual plates along their total portal-central lengths often consisted entirely of a major type of hepatocytes. A patch appeared to be present in more than two lobules, but each patch did not constitute a complete lobule. Complicated mosaic patterns of patches were also seen in neonatal and postnatal livers. These results suggest that, although hepatocytes proliferate and migrate extensively during development, they might allocate their daughter cells contiguously and the orientation of their allocation might be random, leading to the formation of three-dimensionally large contiguous quasiclones of hepatocytes, the shapes of which are very complicated.
Animals↗
[Enhancement pattern of hepatic metastases from colorectal cancer on CT arteriography].
The enhancement pattern of hepatic metastases from colorectal cancer on CT arteriography (CTA) was evaluated in 79 cases with 405 lesions. Sixty-two percent of overall lesions irrespective of size showed ring-like enhancement, and 33% of lesions less than 1 cm in diameter showed homogeneous enhancement. In pathological examination of 59 resected lesions, the enhancement pattern on CTA had a good correlation with the extent of tumor cellularity, necrosis or fibrosis in the lesions. And in 8.5% of resected lesions, the extent of enhancement on CTA was larger than that of perfusion defect on CT arterial portography, which was almost equal to the size in the resected specimen. In such lesions, the enhancement on CTA might include enhancement of normal hepatic parenchyma around the lesion.
Adenocarcinoma↗
[An adult case of purulent meningitis secondary to retropharyngeal and deep neck abscess after treatment of odontogenic infection].
Retropharyngeal and deep neck abscess, which may follow odontogenic infection, is uncommon in adults, but can be fatal. Furthermore, bacterial meningitis secondary to this disorder is extremely rare. A 67-year-old man was brought to our hospital because he had developed neck pain, trismus, and disturbance of consciousness over several days. A few days prior to the appearance of neck pain, he had the periodontitis treated. Based on CSF, cervical X-ray and CT findings, he was diagnosed as having bacterial meningitis secondary to deep neck abscess. Culture of the CSF yielded gram-positive cocci, later identified as Gemella species, that is a rare organism for bacterial meningitis. Although the administration of antibiotics and drainage of the abscess resulted in gradual improvement of the infectious process, neurologically he remained with apallic syndrome. We would like to stress the importance of odontogenic and pharyngolaryngogenic sources as potential foci of purulent meningitis.
Abscess↗
Long-term follow-up by coronary angiography in a patient with heterozygous familial hypercholesterolemia: a case report.
A 47-year-old man with heterozygous familial hypercholesterolemia was followed up by coronary angiography for 9 years. During these 9 years, he experienced inferior myocardial infarction twice, at segment 1 of the right coronary artery. A coronary atherosclerotic lesion (50% stenosis) was also present at segment 6 of the left anterior descending coronary artery. This lesion remained unchanged for the first 7 years, but then rapidly progressed to 90% stenosis in the 8th year. While the rate of the progression of coronary atherosclerosis is generally unpredictable, it may progress rapidly in this case of heterozygous familial hypercholesterolemia.
Angioplasty, Balloon, Coronary↗
Does p53 overexpression cause metastases in early invasive colorectal adenocarcinoma?
OBJECTIVE: To find out whether p53 overexpression correlates with metastatic potential and other adverse prognostic factors in early invasive colorectal carcinoma and whether measurement of the expression of p53 protein could be helpful in the choice of treatment (endoscopic/local or radical resection). DESIGN: Retrospective study. SETTING: University hospital, Japan. SUBJECTS: Overexpression of p53 protein in the primary tumour was examined immunohistochemically in 50 patients with early invasive colorectal cancer. MAIN OUTCOME MEASURES: Differences in p53 overexpression between subgroups. RESULTS: Abnormal accumulation of nuclear p53 was detected in the primary tumour of 20 patients (40%) with early invasive colorectal cancer. We found p53-positive cells in 7 (78%) of 9 that had metastasised to regional lymph nodes or distant organs, or both, and in 13 (32%) of 41 that had not metastasised (p = 0.02). p53 Immunoreactivity was also present in 10 (71%) of 14 superficial (type II) lesions compared with 10 (28%) of 36 protruding (type I) ones (p = 0.009) and in 12 (57%) of 21 moderately differentiated adenocarcinomas compared with 8 (28%) of 29 well-differentiated adenocarcinomas (p = 0.045). There was no significant correlation between p53 overexpression and the depth of tumour invasion or angiolymphatic involvement. The p53-positive metastasising tumours had features that corresponded to those of early carcinoma arising de novo. CONCLUSION: Our results seem to support the postulate that p53 overexpression in early invasive colorectal carcinomas is associated with an increase in their metastatic potential.
Adenocarcinoma↗
Discrimination of iron deficiency anemia from other anemia by multiple discriminant analysis of routine blood count and red cell distribution width.
A computer aided diagnostic program, MDA-3 (Multiple Discriminant Analysis) was designed for clinical use. MDA-3 employs CBC data to analyze using a technique of two-group linear discriminant analysis (a type of multivariate analysis) of anemia and polycythemia. MDA-3 is given discriminant knowledge obtained from a database of 7 CBC items and red cell distribution width (RDW) from 14 groups. We collected 851 CBC data of hematologic abnormalities, designed MDA-3 for IDA screening and evaluated the program's efficacy. The number of cases discriminated as IDA group in the first and the second rank by MDA-3 is up to 80.7%. If false negative cases whose degree of probability is similar to the IDA group are considered as the IDA suspicion group, the diagnostic rate becomes 84.9%. This result demonstrates that MDA-3 is useful for screening of IDA.
Anemia, Iron-Deficiency↗
[A case of anaplastic carcinoma of the pancreas, disclosed a hemosuccus pancreaticus].
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Carcinoma↗
[Helical CT for lung-cancer screening: fifth report: evaluation of image quality at low-dose CT using healthy volunteers].
In order to reduce radiation dose in the application of CT for lung-cancer screening, we investigated the potential of low-dose screening helical CT (SHCT) by reducing the tube current and using an additional 10 mm aluminum filter. Six healthy volunteers were scanned at various tube currents (50 mA, 30 mA, 20 mA) with and without the filter. In comparison with the images at 50 mA without the filter, we evaluated the visualization of normal anatomical structures and the detection of simulated nodules at low-dose SHCT. Although a bias toward unclearness in the visualization of small anatomical structures was noted at 20 mA with use of the filter, no structure was assessed as having no visualization at any low-dose scan. Detection of simulated nodules was not degraded significantly by reducing the tube current to 20 mA and using the filter. Further reduction of radiation dose at SHCT may be achieved by the application of small tube current and an additional filter.
Female↗
[Mitochondrial neurogastrointestinal encephalomyopathy presenting with protein-losing gastroenteropathy and serum copper deficiency: a case report].
We report a 56-year old female with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE), presenting with protein-losing gastroenteropathy and serum copper deficiency. There was no neuromuscular disease in her family members. Three years prior to admission, she developed severe gastrointestinal symptoms including diarrhea, nausea, vomiting and ascites, and was diagnosed as having protein-losing gastroenteropathy based on alpha(1)-antitrypsin clearance and other tests. She was referred to our department when neurological symptoms were apparent. Neurological examinations revealed bilateral ptosis, ophthalmoplegia, hearing loss, facial and limb muscle weakness, mild sensory deficit of vibration on her feet and hypoactive deep tendon reflexes. Pigmentary retinopathy, cerebellar ataxia and heart block were not seen. Serum copper level was decreased to 45 micrograms/dl (normal: 83-155). Chronic intestinal pseudo-obstruction was proven by X-ray studies, and diffuse leukoencephalopathy demonstrated on brain MRI. On EMG, motor nerve conduction velocities were prolonged with temporal dispersion. Her muscle biopsy from biceps brachii muscle showed both neuropathic and myopathic changes, scattered ragged-red fibers and focal cytochrome c oxidase deficiency. Southern blot and polymerase chain reaction analysis on mitochondrial DNA showed no deletions nor point mutations. The clinical and pathologic findings of the present patient fulfilled the diagnostic criteria of mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) proposed by Hirano et al. There are few reported patients with MNGIE in Japan, but none presented with protein-losing gastroenteropathy and serum copper deficiency. Since the copper is a cofactor of cytochrome c oxidase, decreased serum copper level may aggravate the respiratory chain enzyme metabolism in mitochondria. Therefore, treatment for gastrointestinal tract disturbance and copper administration may be necessary to prevent disease progression.
Brain↗
Lymphatic flow and neural plexus invasion associated with carcinoma of the body and tail of the pancreas.
BACKGROUND: Lymph node status and neural plexus invasion are the most important prognostic factors that may be amenable to surgery for carcinoma of the body and tail of the pancreas. The pattern of lymphatic spread and neural plexus invasion were evaluated by analysis of various clinicopathologic factors. METHODS: Twenty patients with carcinoma of the body and tail of the pancreas underwent pancreatectomy with systemic regional lymph node dissection at Kanazawa University Hospital. A precise evaluation of their lymph node involvement and neural plexus invasion was determined. RESULTS: Sixteen of 20 patients (80%) had lymph node involvement. The lymph nodes with a high metastatic rate were those along the splenic artery (50%), the inferior body lymph nodes (35%), the lymph nodes around the common hepatic artery (25%), and the paraaortic lymph nodes (20%). There was no relationship between tumor size, histologic type, and lymph node involvement. Plexus invasion was observed in 14 patients (70%). The most frequent site was the splenic plexus, but between 15% and 20% of the patients had celiac or superior mesenteric plexus invasion. There was no relationship between tumor size, histologic type, and neural plexus invasion. CONCLUSIONS: Based on these results, extended lymphadenectomy including the paraaortic lymph nodes, celiac lymph nodes, and superior mesenteric lymph nodes may improve the prognosis for patients with carcinoma of the body and tail of the pancreas. Extrapancreatic neural plexus dissection, especially of the celiac plexus and superior mesenteric plexus, also is necessary.
Adenocarcinoma↗