[Stress fracture].
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Arthritis, Rheumatoid↗
Biomedical subjects
T Tajima
Publications and source records attributed to T Tajima.
A novel weekday-on/weekend-off UFT schedule.
In a step toward a clinical trial, the tumor response and survival of a weekday-on/weekend-off schedule of UFT was compared with its conventional daily schedule in a cancer-bearing rat model. The dose-intensive schedule--600 mg of UFT for 5 days followed by 2 drug-free days--amounts to a weekly dose similar to the conventional schedule of 400 mg/day. The weekday-on/weekend-off schedule provided increased survival and significantly greater antitumor activity than the conventional daily schedule, with no difference in adverse reactions. A study was also conducted in human subjects to measure fluorouracil (5-FU) concentrations that identified the pharmacokinetic activity during the 2 drug-free days of the weekday-on/weekend-off schedule. The plasma 5-FU concentration declined markedly after 24 hours, but the concentration in the tumor remained at a relatively high level after 2 days off the drug. A one-year clinical study evaluated the compliance and toxicity of the weekday-on/weekend-off UFT schedule as adjuvant chemotherapy for colorectal cancer. Based on the findings of all these studies, the weekday-on/weekend-off schedule for UFT as adjuvant chemotherapy for colorectal cancer can be recommended for a clinical trial.
Administration, Oral↗
[Day surgery for pediatric inguinal hernia repair].
Pediatric patients with inguinal hernia can be good candidates for day surgery. Since 1986, 1273 such patients have been treated under our day surgery system. Although 8 patients (0.6%) were unable to go home after surgery due to perioperative complications and 21 (1.6%) visited earlier than scheduled after discharge, no major complications were noted and postoperative complications did not differ from those seen in the inpatient setting. Our questionnaire survey demonstrated that 96% of the families were satisfied with the system. Based on our own experience and a literature review of day surgery for inguinal hernia repair in children, the problems surrounding the day care system are discussed. Patient selection, preoperative assessment, general anesthesia, postoperative care including oral intake and analgesia, and postoperative follow-up are considered the most important issues in the day care system. A team approach including pediatric surgeons, anesthesiologists, and pediatric nurses is considered indispensable for the safe and satisfactory day surgery treatment.
Ambulatory Surgical Procedures↗
Pseudotumors of the spleen.
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Diagnosis, Differential↗
[History of breast cancer surgery and its perspectives].
At the end of the 19th century, surgical treatment of breast cancer was revolutionized by the introduction of the Halsted radical mastectomy. Haagensen, who studied under one of Halsted's students, further strengthened the foundations of the technique, and the Halsted operation became the standard radical breast cancer surgery worldwide. This may have been responsible for the persistence of this operation, particularly in Japan. Some Halstedian surgeons espoused the extended radical mastectomy or super-radical mastectomy. However, breast-conserving surgery is now becoming the most common technique. In the early 1970s breakthroughs in the understanding of the biology of breast cancer led to a new era of adjuvant therapy. Consequently current surgical management of breast cancer is no longer possible without considering other therapeutic modalities. Consistent with this change, it should be realized that the disease is no longer diagnosed at the same stage as it was at the time of Halsted. Although the ultimate patient outcome is not likely to be influenced solely by locoregional treatment, surgery will continue to be employed as the most effective treatment modality, and every effort should be made to prevent locoregional tumor spread.
Breast Neoplasms↗
Evaluation of a surgical gamma probe for detection of 18F-FDG.
Because fluorine-18 fluorodeoxyglucose (18F-FDG) is an excellent tumor-localizing radio-pharmaceutical, a hand-held radiation detection probe capable of localizing an area with high 18F-FDG uptake would make radioguided surgery possible. In this laboratory study, we investigated the capability of a widely used intraoperative gamma probe with a cadmium zinc telluride (CdZnTe) detector for detection of 18F-FDG. For sensitivity tests, an 0.1- ml 18F-FDG preparation was made to act as a point source with radioactivities of 1.0, 2.0, and 3.0micro Ci (37 kBq, 74 kBq, 111 kBq). Relative transmission across the side wall of the probe and sensitivity at each source-to-probe distance were measured. For simulation studies, 2 l of 18F-FDG solution (0.02micro Ci, 0.74 kBq/ml) served as normal background. One ml of 18F-FDG was prepared to simulate tumors with radioactivities of 0.05, 0.1, 0.2, and 0.4micro Ci (1.85 kBq, 3.7 kBq, 17.4 kBq, and 14.8 kBq). The ratios of the radioactive concentration of tumor to that of the background were 2.5, 5, 10, and 20:1, respectively. The tested gamma probe was shown to be sensitive to 18F. The high-energy annihilation radiation was detected from the side wall of the probe despite application of a supplementary collimator. The count rate decreased markedly as the source-to-probe distance increased, owing to the effects of the inverse-square law. In the simulation studies, the probe detected a considerable amount of background activity. However, the measured count rate increased with the increasing source-to-background ratio. In our setting, the probe was capable of distinguishing the 18F-FDG source from the background when the source-to-background ratio was no less than 5:1. To make a surgical application feasible, however, collimation or shielding against high background radiation is necessary.
Fluorodeoxyglucose F18↗
On-line microextraction of metal traces for subsequent determination by plasma atomic emission spectrometry using pH peak focusing countercurrent chromatography.
Metal ions were highly efficiently enriched by pH peak focusing high-speed countercurrent chromatography. The peak intensity for a 10-mL standard sample in the effluent stream was increased over 100-fold compared to conventional plasma atomic emission spectrometry. Ca, Cd, Cu, Mg, Mn, Ni, and Zn are chromatographically extracted in a basic organic stationary phase containing a complex-forming reagent such as bis(2-ethylhexyl) phosphoric acid. After the sample solution is introduced into the column, metal ions remain around the sharp pH border formed between acidic and basic zones, moving toward the column outlet. Enriched metal ions are finally eluted with the sharp pH border as a highly concentrated peak into a volume of less than 100 microL. We evaluated this method for concentration efficiency in trace determination in tap water using different column diameters.
Countercurrent Distribution↗
Breast Cancer Chemotherapy in the 21st Century.
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Journal Article↗
Novel missense mutation (Leu466Arg) of the DAX1 gene in a patient with X-linked congenital adrenal hypoplasia.
We identified a DAX1 missense mutation, a substitution of arginine for leucine at codon 466 (Leu466Arg), in an infant with X-linked congenital adrenal hypoplasia (AHC). A heterozygous substitution, Leu466Arg, was also identified in his mother and sister. Since leucine at position 466 is well conserved among other orphan nuclear hormone receptor superfamilies and Leu466Arg was not detected among 50 normal Japanese control individuals, the mutation is most likely responsible for X-linked AHC. It is interesting to note that Leu466Arg among all mutations ever reported is located at the most C-terminal region of the DAX-1 protein. Most mutations identified previously were located in the C-terminal presumptive ligand binding domain. Hence, the C-terminal end of the DAX-1 protein may play an important role in the biological function, such as in normal adrenal embryogenesis.
Adrenal Insufficiency↗
Impaired differentiation of endocrine and exocrine cells of the pancreas in transgenic mouse expressing the truncated type II activin receptor.
Activin A is expressed in endocrine precursor cells of the fetal pancreatic anlage. To determine the physiological significance of activins in the pancreas, a transgenic mouse line expressing the truncated type II activin receptor under the control of beta-actin promoter was developed. Histological analyses of the pancreas revealed that the pancreatic islets of the transgenic mouse were small in size and were located mainly along the pancreatic ducts. Immunoreactive insulin was detected in islets, some acinar cells, and in some epithelial cells in the duct. In addition, there were abnormal endocrine cells outside the islets. The shape and the size of the endocrine cells varied and some of them were larger than islets. These cells expressed immunoreactive insulin and glucagon. In the exocrine portion, there were morphologically abnormal exocrine cells, which did not form a typical acinar structure. The cells lacked spatial polarity characteristics of acinar cells but expressed immunoreactive amylase, which was distributed diffusely in the cytoplasm. Plasma glucose concentration was normal in the transgenic mouse before and after the administration of glucose. The insulin content of the pancreas in transgenic and normal mice was nearly identical. These results suggest that activins or related ligands regulate the differentiation of the pancreatic endocrine and exocrine cells.
Activin Receptors, Type II↗
Hypogonadotropic hypogonadism in a female caused by an X-linked recessive mutation in the DAX1 gene.
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Adolescent↗
Changes in concentrations of serum amyloid A protein, alpha 1-acid glycoprotein, haptoglobin, and C-reactive protein in feline sera due to induced inflammation and surgery.
To identify candidates for feline acute phase proteins, the concentrations of serum amyloid A protein (SAA), alpha 1-acid glycoprotein (alpha 1-AG), C-reactive protein (CRP), and haptoglobin (Hp) were measured in sera isolated from clinically normal and hospitalized (or diseased) cats, from cats with experimentally induced inflammation, and cats subjected to surgery for urinary diversion. Measurements were made by sandwich enzyme-linked immunosorbent assay and single radial immunodiffusion. The concentrations of SAA, alpha 1-AG, and Hp in sera from hospitalized cats were 7-11 times higher than in clinically normal cats. Similar results were obtained for the concentrations of SAA, alpha 1-AG, and Hp in cats with induced inflammation and cats subjected to surgery. By contrast, the serum concentration of feline CRP did not change significantly between clinically normal cats and hospitalized cats or inflammation-induced or post-surgery cats. Feline SAA concentration was found to increase earliest, with alpha 1-AG and Hp beginning to increase thereafter. From these results, feline SAA is concluded to be an acute phase reactant at the early stage of inflammation.
Animals↗
MR detection of cytoplasmic fat in clear cell renal cell carcinoma utilizing chemical shift gradient-echo imaging.
We attempted to determine whether cytoplasmic fat in clear cell renal cell carcinoma (RCC) can be identified by chemical shift gradient-echo magnetic resonance imaging (CSI). CSI was performed for 22 clear cell RCCs and 30 other renal tumors (including 16 non-clear cell RCCs), all of which were surgically proven. Signal reduction in out-of-phase images of these tumors was retrospectively evaluated and compared. The signal loss ratio (SLR) was defined and calculated. Fat staining of specimens from 16 tumors was performed and correlated with SLR. SLR was significantly higher in clear cell RCCs than in non-clear cell RCCs (P < 0.001). There was a significant correlation between degree of fat staining positivity of the specimens and SLR (P < 0.01). When signal reduction in out-of-phase images suggested the diagnosis of clear cell RCC, correct diagnosis of this entity was made in resected renal tumors with sensitivity, specificity, and accuracy of 82%, 90%, and 87%, respectively. CSI can demonstrate cytoplasmic fat in clear cell RCCs, which helps to differentiate this entity from other RCCs.
Adenocarcinoma, Clear Cell↗
Which technique, circular stapled anastomosis or double stapling anastomosis, provides the optimal size and shape of rectal anastomotic opening?
BACKGROUND: Two types of end-to-end colorectal anastomosis using a circular stapler, circular stapled anastomosis(CSA) and double stapling anastomosis(DSA), have become the standard technique. The possibility of anastomotic openings of the DSA being smaller and somewhat distorted, because of some portion of the stapled rectal stump not being included in the anastomotic opening, was examined. METHODS: Anastomotic openings created by CSA and DSA were photographed through a sigmoidoscope, and the maximal and minimal diameters and the areas of the anastomotic openings were measured and calculated with an image analyzer. They were examined in the swine rectum immediately after surgery and were also examined in the randomized clinical cases 3 or more months after surgery. RESULTS: It was found that larger anastomotic openings could be created as the diameter of the anastomosed intestine and the cartridge size became wider in both methods immediately after surgery. The shape of anastomotic opening created by DSA was observed to be more oval than round immediately after surgery. The anastomotic stenosis occurred in a small number of patients in both methods within 3 months after surgery. The area of the anastomotic opening created by CSA was about 25% larger than that by DSA immediately after surgery and about 30% larger 3 or more months after surgery. CONCLUSION: CSA provides a larger anastomotic opening than DSA. Anastomotic stenosis occurred in a small number of patients in both methods.
Aged↗
Vesicular blood flow after ligation of the internal iliac arteries in low anterior resection or abdominoperineal resection.
PURPOSE: Bilateral ligation of the internal iliac arteries has been reported to be a safe procedure in pelvic surgery because there are five collateral pathways. Some of the five pathways are surgically interrupted after resection of the rectum and two cases in which necrosis developed in the perineum were reported. The aim of the study was to assess the degree of safety and blood flow reducing efficacy of internal iliac artery ligation in rectal cancer surgery. METHODS: The subjects were 23 patients with advanced rectal cancer. Tissue blood flow on the surface of the bladder was measured using a laser Doppler flow meter when unilateral or bilateral internal iliac artery were clamped at a central site or at a peripheral site. RESULTS: Tissue blood flow of the bladder before clamping the internal iliac artery was 6 to 74 ml/min/100 g. Blood flow in the right half of the bladder decreased significantly when the right and both internal iliac arteries were clamped (both, P < 0.01), but it did not decrease significantly when only the left internal iliac artery was clamped. The results were the same whether the central site or peripheral site was clamped. When the central site was clamped, there was no difference between the decrease in blood flow in the right half of the bladder whether the right internal iliac artery was clamped or both internal iliac arteries were clamped. By contrast, when the peripheral site was clamped, the decrease in blood flow in the right half of the bladder was much greater when both internal iliac arteries were clamped than when the right internal iliac artery alone was clamped (P < 0.01). The results in the left half were the same as in the right half. Blood flow became 33 to 110 (mean, 73; median, 75) percent of the value before clamping when both internal iliac arteries were clamped at the central site, and 18 to 114 (mean, 52; median, 47) percent when both internal iliac arteries were clamped at the peripheral site. No changes in the color of the bladder or other pelvic organs were observed while the internal iliac arteries were clamped. CONCLUSION: Our study suggests that bilateral internal iliac artery ligation causes a temporary decrease in blood flow to the pelvic organs, but the reduction is not great enough to induce necrosis histologically. We recommend the ligation of the internal iliac arteries at the point below the takeoff of the superior gluteal artery to gain a considerable blood flow reducing effect on the pelvic organs.
Aged↗
Peritoneal recurrence of colon cancer detected by positron emission tomography: report of a case.
Increased glucose metabolism has been reported to occur in association with colorectal cancer. As positron emission tomography (PET) using [18F]fluorodeoxyglucose is able to depict hypermetabolic sites, it can therefore be used to detect colorectal cancer. A 69-year-old male patient with a recurrent solitary liver metastasis from colon cancer underwent whole-body PET which revealed high [18F]fluorodeoxyglucose uptake in the lesion. Furthermore, PET revealed peritoneal metastases that had not been detected by conventional imaging methods. Consequently, PET proved useful in helping us to avoid performing unnecessary treatment for the liver metastasis. Although it is uncertain whether early identification of recurrence can prolong survival, it may help to prevent unnecessary treatments being carried out. Thus, the application of PET in carefully selected patients could be beneficial to the management of recurrent colorectal cancer.
Aged↗
Deletion of a large genomic segment in tobacco varieties that are resistant to potato virus Y (PVY).
Recessive alleles (va, va1, va2, etc) of the tobacco Va locus confer resistance to potato virus Y (PVY). To elucidate the mechanism underlying this resistance, we attempted to identify randomly amplified polymorphic (RAPD) markers that reveal polymorphism between two nearly isogenic lines (NILs) that differ in their susceptibility to PVY. Using each of 500 primers and 800 pairs of primers, we identified over 100 RAPD fragments that differed between the NILs. We applied these RAPD primers or primer combinations to an F2 population obtained from a cross between the susceptible line BY4 and the resistant va2-bearing NIL, F55. It was found that only 10 RAPD markers were polymorphic between resistant and susceptible plants. Unexpectedly, these markers were all linked to Va. All 10 RAPD markers were present in all 8 susceptible varieties tested. At least one RAPD marker was not detected in 8 out of 10 resistant varieties. Southern analysis revealed that the sequences of markers were not present in the genomes of resistant varieties, and the markers were found in individually distinct positions on the chromosomes of susceptible tobacco varieties. These results strongly suggest that the resistance conferred by va is due to deletions at the Va locus governing susceptibility to PVY.
Base Sequence↗
Evaluation of hemorrhoids with the retroflexed fiberoptic colonoscope
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Journal Article↗