Biomedical subjects
Publications and source records attributed to T Sakurai.
The purpose of this study is to compare the cleansing effect of ultrasonic devices with that of hand instrumentation. When ultrasonic instrumentation is used in a curved canal, instruments should be precurved to some degree. The ultrasonic method is superior to the manual method in removal of debris from the root canal.
A patient with Plummer's disease in whom a coexisting nonfunctioning thyroid nodule was detected by TI-201 imaging is presented. I-123 imaging revealed a hot nodule corresponding to the functioning nodule and little uptake in the rest of the thyroid. In contrast, two areas of abnormalities were noted on a TI-201 image: one corresponded to the hot nodule in I-123 imaging and the other was visualized in the suppressed part of the thyroid in the same lobe. This case revealed that TI-201 imaging is clinically useful in detecting coexisting nodules in the suppressed part of the thyroid.
We report the case of a child with acute focal bacterial nephritis and a renal abscess in the right kidney associated with bilateral vesicoureteral reflux. The patient was treated successfully with antibiotics and bilateral ureterocystoneostomy. Urine has remained sterile since the operation, but the affected kidney has developed progressive scarring. This case suggests that acute focal bacterial nephritis and a renal abscess may cause a small kidney, which looks like a hypoplastic kidney, associated with vesicoureteral reflux.
The standard value of serum insulin was determined to be less than 75 microU/ml with ninety-eight female adult cynomolgus monkeys of wild origin. Then, fifteen apparently healthy laboratory-bred female cynomolgus monkeys aged 6-8 years were studied to know the usefulness of the arginine tolerance test (ATT) by measuring blood glucose, insulin and glucagon. Prior to ATT, all animals had been diagnosed as non-diabetic by the intravenous glucose tolerance test (IVGTT). Arginine hydrochloride was infused intravenously at a dose of 0.5 g/kg. BW under anesthesia. According to the standard value of insulin, fifteen animals were divided into two groups, that is, the low (n = 7) and the high (n = 8) value groups. In the low value group, glucose and insulin value did not change significantly after arginine infusion and their responses were similar to those in the control group (saline infused, n = 4). But glucagon markedly increased from 10 to 45 minutes post infusion. In the high value group, glucagon response was similar to that in the low value group, while glucose and insulin values significantly decreased. It is concluded that the pancreatic alpha-cell function (glucagon secretion) can be judged by the ATT in the cynomolgus monkey but the beta-cell function (insulin secretion) can not be diagnosed.
Clinically nonfunctioning pituitary adenomas have been thought to synthesize some pituitary hormones as shown by studies involving cell culture, immunocytochemistry, or measurement of hormone levels in tumor homogenates. Nevertheless, they are not associated with hypersecretion of pituitary hormones. To further clarify hormone synthesis in such pituitary adenomas, the presence of messenger ribonucleic acid (mRNA) of prolactin (PRL) growth hormone, and adrenocorticotropic hormone (ACTH) in the cytoplasm of 16 nonfunctioning adenomas was determined by means of a hybridization technique, and compared to the immunocytochemical findings. In three adenomas (19%) PRL mRNA was detected and in one case (6%) ACTH mRNA was detected. The hybridization technique appears to be more sensitive than immunohistochemistry for detection of specific mRNA's in assigning the hormone synthesis potential to clinically nonfunctioning tumors. The results suggest that PRL and ACTH are synthesized in some cases of clinically nonfunctioning pituitary adenomas and that hybridization techniques are useful to investigate hormone synthesis in pituitary adenomas. The ability to demonstrate PRL mRNA in tumor tissues allowed differentiation between hyperprolactinemia caused by synthesis of PRL in the tumor and that due to hypersecretion from the adjacent normal pituitary.
The absorption of pyridoxine from the intestine of the mouse was studied in whole animals. [3H]Pyridoxine was orally administered and the distribution of isotope between the six recognized forms of vitamin B6 was determined in portal and peripheral blood after the administration. When small doses (1.4 or 14 nmol) were administered, labeled pyridoxine could hardly be found in the portal blood as well as in the peripheral blood, although labeled pyridoxal and pyridoxal phosphate were found both in the portal and peripheral blood. However, when a large amount (46 or 140 nmol) was given, a significant amount of labeled pyridoxine was found with labeled pyridoxal and pyridoxal phosphate both in the portal and peripheral blood. These results suggest that a physiological dose of pyridoxine is transformed to pyridoxal in the intestinal tissues and then is released in the form of pyridoxal into the portal blood.
A case of cystic pheochromocytoma is reported. A 64-year-old man was referred to our hospital because of right flank pain and gross hematuria. Excretory urography showed an inferior displacement of his right kidney, and right suprarenal mass was suspected. CT and ultrasonographic findings suggested that the most likely diagnosis was cystic adrenal tumor. Right adrenal tumor was removed through a transverse abdominal incision on October 15, 1986. During the procedure, the blood pressure rose to 260/100 mmHg at the time of tumor manipulation. The histological diagnosis was pseudocystic pheochromocytoma. Pathogenesis of cystic adrenal tumor is discussed briefly.
A new anti-K562 cell monoclonal antibody, RTF8X, a cytotoxic IgM, recognized a surface antigen on erythroblasts from patients with erythroleukemia and polycythemia vera. RTF8X, which is highly specific to K562 cells, did not react with the other 14 hematopoietic cell lines and the seven nonhematopoietic cell lines. RTF8X antigen was not detected in normal peripheral blood, but was found in less than 1% of normal marrow cells. RTF8X did not inhibit in vitro colony formation of CFU-E and BFU-E in a complement-dependent cytotoxicity assay. Cell-sorting analysis showed that, morphologically, the RTF8X-positive marrow cells from the patients and normal volunteers contained more than 60% erythroblasts and that CFU-E and BFU-E were not demonstrated in cells with RTF8X antigen. Enzyme treatment suggested that RTF8X antigen was a sialoglycolipid. These results indicate that RTF8X may recognize the surface antigen found increasingly in association with tumors of erythroid lineage. RTF8X should be useful for studies of erythroid differentiation and proliferation in patients.
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A case of primary adenocarcinoma of the ureter, associated with severe hypocalcemia in a 73-year-old man is reported. The patient had undergone left nephrectomy for pyonephrosis due to a ureteral stone, 29 years previously. On November 4, 1986, he visited the hospital with dysuria and overflow incontinence as the chief complaints. He was admitted with suspicion of prostatic carcinoma, but prostatic stones and chronic prostatitis were proven. However, urine cytology showed adenocarcinoma cells, and a ureteral tumor was found at the right ureterovesical junction. On December 10, right partial ureterectomy, total cystectomy and right ureterocutaneostomy were performed. Moderately differentiated, invasive adenocarcinoma was found at the right ureteral end, 1.5 cm in length and in part poorly differentiated transitional cell carcinoma was present continuously to the adenocarcinoma. Hypocalcemia was cured easily with activated vitamin D3. The patient, 9 months after the operation, is apparently free of the ureteral tumor.
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To evaluate the usefulness of magnetic resonance imaging (MRI) in measuring regional wall thickness of the left ventricle, 11 patients with hypertrophic cardiomyopathy (HCM) were imaged. The measurements were compared with those obtained by two-dimensional echocardiography (2D-echo) and cineangiography. Regional wall thickness was ascertained at six locations including the base, middle, and apex of the interventricular septum (IVS) and left ventricular posterior wall (LVPW) from the two selected transverse sections. All of these six locations were also measured for the IVS by biventriculography and for the LVPW by left ventriculography with the left anterior oblique view. Only the base was measured for both the IVS and LVPW using 2D-echo because of the difficulty in obtaining good images for the middle and apex of the left ventricle. The measurements by MRI correlated well with those obtained by 2D-echo and cineangiography in the majority of locations. At the base, where the wall thickness was measured by the three methods, the measurements of the IVS correlated well each other (r = 0.63 to 0.81). However, a good correlation was obtained only between 2D-echo and MRI for the LVPW r = 0.75. The correlation between MRI and cineangiography was generally good for the IVS at any levels (r = 0.76 to 0.87), but not for the LVPW. This was partially due to the narrow range of data for the LVPW as well as to the difficulty in determining the epicardial border in left ventriculograms. In conclusion, regional wall thickness can be correctly measured by MRI in any locations of the left ventricle even at the apex, where measurement is difficult by other methods.
Two different irradiation methods for the treatment of esophageal cancer have been compared and analyzed. One group of 146 patients were treated by external irradiation alone at the Aichi Cancer Center Hospital, while another group, consisting of 76 patients, were treated by external irradiation combined with booster intracavitary brachytherapy utilizing Radium-226 tubes at the National Sapporo Hospital. The patients that were treated by the addition of booster intracavitary brachytherapy showed a better response than the patients treated by external irradiation alone, with respect to the local control rate and survival. Booster intracavitary brachytherapy was found to be a more effective method for patients with esophageal smaller lesions and/or patients manifesting the serrated spiral, or funnel type lesions in their X-rays.
In order to identify the characteristics of uterine cervical cancers detected by mass screenings (mass group), these cancers were compared to cancers diagnosed in patients voluntarily visiting medical institutions (voluntary group), and the following results were obtained. 1. The mass group tended to show a higher incidence of cervical cancer, and the voluntary group had a higher incidence of endometrial cancer. 2. In the mass group having cervical cancer, the age was younger than that in the voluntary group. Also the incidence of cancer among relatives within the third generation and the frequency of previous participating in a mass screening were both significantly greater (p less than 0.01), compared to the voluntary group. 3. As compared to the voluntary group, many patients in the mass group having cervical cancer were asymptomatic and were diagnosed at an early stage, and even if symptomatic, there still were more early cancers in the mass group than in the voluntary group (p less than 0.01). 4. The incidence of lymph node metastases in advanced cervical cancer, that is beyond stage I b, was lower in the mass group than in voluntary group (p less than 0.01). 5. Cervical cancers in the mass group were surgically treated in 94.2% of cases, and the rate was higher than that in the voluntary group. In the surgical treatment, 77.4% of cases in the mass group underwent a simple hysterectomy and a semi-radical hysterectomy, and the frequency of surgical treatment was higher than that in the voluntary group (p less than 0.01). There also was a tendency toward a shorter time of operative procedures, less bleeding during operation, and fewer postoperative complications. 6. In the mass group having cervical cancers, the prognosis was favorable (p less than 0.01). By the clinical stage, in early cancers including stage 0 and stage I a, there was no significant difference in the prognosis between the mass group and voluntary group, and in the advanced cancer, the prognosis was more favorable in the mass group compared to the voluntary group (p less than 0.01). Asymptomatic patients had a better prognosis than symptomatic patients, and there was no difference between the two groups, but among symptomatic patients the prognosis was more favorable in the mass group than in the voluntary group.