CAG repeats in the androgen receptor: a case of spinal and bulbar muscular atrophy associated with prostate cancer.
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Adenocarcinoma↗
Biomedical subjects
T Yasui
Publications and source records attributed to T Yasui.
Gamma knife surgery for skull base meningiomas. The effectiveness of low-dose treatment.
BACKGROUND: The surgical removal of skull base meningiomas has a high morbidity rate, even by modern microsurgical standards. We evaluated the results of gamma knife surgery for skull base meningiomas using a relatively low radiation dose for the tumor margins. METHODS: We reviewed 24 cases of skull base meningiomas during a 30-month period. The locations of the tumors were the petroclival region in 11 cases, the cavernous sinus region in 9 cases, and the cerebellopontine angle region in 4 cases. Eight patients (33%) had been operated on previously and fourteen patients (67%) had been treated by neuroimaging. The marginal doses for the tumors were 8 Gy to 15 Gy (median, 10.6 Gy). A large petroclival tumor 58 mm in diameter was treated with a staged treatment protocol with a 6-month interval between treatments. RESULTS: Tumor regression was observed in 46% of the patients imaged during the follow-up period (median, 17.1 months). No patients revealed tumor growth in the follow-up period (100% tumor control rate). Eleven patients (46%) had improved clinically by the time of the follow-up examinations. Preexisting cranial nerve deficit in one patient worsened because of radiation injury. CONCLUSION: Although a longer follow-up period is required, the relatively low minimum tumor radiation dose treatment for skull base meningiomas using a gamma knife seems to be an effective treatment with low morbidity.
Adult↗
Brachial plexus and supraclavicular nerve injury caused by manual carotid compression for spontaneous carotid-cavernous sinus fistula.
BACKGROUND: Manual carotid compression is an established treatment for a spontaneous carotid-cavernous sinus fistula unless emergency treatment is required for it. CASE REPORT: A 63-year-old woman presented with a spontaneous carotid-cavernous sinus fistula. Manual carotid compression of 5 minutes duration, twice a day, for 10 days resulted in injury to the upper trunk (C 5-6) of the brachial plexus and the supraclavicular nerve (C 3-4), which subsequently resolved within a month after cessation of the procedure. CONCLUSION: It is important to know the possible neurological complications of manual carotid compression.
Arteriovenous Fistula↗
Adult leigh syndrome: treatment with intravenous soybean oil for acute central respiratory failure.
This study reports a 38-year-old woman with adult Leigh syndrome associated with partial deficiency of the pyruvate dehydrogenase complex. The patient had intermittent diplopia, loss of vision, dystonia, central respiratory failure and unconsciousness with lactic acidosis. Treatment with an intravenous ketogenic emulsion resulted in rapid clinical and biochemical improvement. In patients with acute respiratory failure under these circumstances, intravenous ketogenic emulsion therapy is worth consideration.
Acute Disease↗
Venous angiomas with arteriovenous shunts: report of three cases and review of the literature
OBJECTIVE AND IMPORTANCE: In spite of recent recognition of the benign nature of venous angioma (VA), only limited information is available on the clinical features of VA with arteriovenous shunt (AVS). The purpose of this study was to elucidate the clinical profile of VA with AVS. CLINICAL PRESENTATION AND INTERVENTION: We describe three patients having a VA with AVS and review the clinical features of 31 patients reported in the literature, including our three patients. The patients included 12 women and 19 men, ranging in age from 18 to 54 years. Seven patients (22.6%) presented with intracranial hemorrhage, and none of 16 patients developed a new or recurrent hemorrhage (mean follow-up period, 11 months). Treatment was conservative in 14 patients, lobectomy or partial resection of the VA in 6, removal of hematoma in 4, operation only for coexisting aneurysm or arteriovenous malformation in 4, and not known in 3. The outcome was reported as good recovery in 19 patients, persistent neurological deficits in 2, death or deterioration not related to the VA in 3, and not known in 7. CONCLUSION: Although there remains some uncertainty as to the clinical features of VA with AVS, its prognosis seems to be essentially as benign as that of VA without AVS. Thus, conservative treatment is recommend except for patients with a large hematoma or with a coexisting arteriovenous malformation or a symptomatic, accessible cavernous angioma, which may be treated by surgical intervention. Further collection of data is required to establish definite treatment guidelines.
Journal Article↗
Metabolic and morphologic characteristics of adipose tissue associated with the growth of malignant tumors.
Changes in total body fat and the metabolic and morphologic characteristics of adipose tissue were sequentially investigated in individual rabbits implanted with VX2 tumors to elucidate the pathology of the fat reduction in animals with malignant tumors as compared with that of diet-restricted rabbits. Lipogenesis in normal, VX2-implanted, and diet-restricted rabbit groups on day 40 after the start of the experiments was 19.1 +/- 2.9, 13.3 +/- 3.5, and 41.7 +/- 6.0 x 10(5) cpm/g/h, respectively, and glycerol liberation by their adipose tissue was 199 +/- 21, 528 +/- 94, and 301 +/- 45 nmol/g/h, respectively. In addition, apoptotic cells were noted in the adipose tissue of VX2-implanted rabbits on days 20-30 after implantation, but not in diet-restricted rabbits. The results showed clear differences between the total body fat reduction profiles of VX2-implanted rabbits and diet-restricted rabbits, suggesting a characteristic lipid metabolism with enhanced lipolysis and diminished lipogenesis in VX2-implanted rabbits. The results strongly suggest that adipocyte apoptosis might be involved in these phenomena.
Adipose Tissue↗
Expression of nerve growth factor in hepatolithiasis.
AIMS/BACKGROUND: Nerve growth factor (NGF) has recently been shown to influence the survival and function of non-neuronal inflammatory cells, possibly through its activity as a colony-stimulating factor. It may also play an important role in acute inflammation and tissue repair. However, no prior report has focused on NGF in chronic inflammatory diseases of the gastrointestinal and biliary tracts. The aim of this study was to examine the expression of NGF in hepatolithiasis. METHODS: Twenty-six liver specimens resected from 22 patients with intrahepatic calcium bilirubinate stones and from 4 patients with intrahepatic cholesterol stones were examined immunohistochemically. RESULTS: The 22 patients with calcium bilirubinate stones demonstrated NGF immunoreactivity associated with surrounding inflammatory cells that was localized to the epithelia of proliferative peribiliary glands in the ductal wall. However, neither the surface lining of the bile duct nor hepatocytes expressed detectable NGF immunoreactivity. In the cholesterol stones cases in contrast, peribiliary glandular elements and inflammatory cell infiltration were less extensive than those observed in cases of calcium bilirubinate stones, and NGF immunoreactivity was not noted. CONCLUSIONS: These observations suggest that proliferative peribiliary glands express NGF protein in chronic proliferative cholangitis. This is characteristic of intrahepatic calcium bilirubinate stones.
Adult↗
Rhabdomyosarcoma of the bladder in an adult.
We report a case of rhabdomyosarcoma of the bladder in an adult. A 73-year-old male was referred to our hospital due to macrohematuria. Ultrasonography, CT and MRI revealed a bladder tumor, and cystoscopic biopsy of the tumor pathologically revealed rhabdomyosarcoma. Total cystectomy with ileal conduit urinary diversion was performed.
Aged↗
Gamma Knife radiosurgery for metastatic brain tumor: the usefulness of repeated Gamma Knife radiosurgery for recurrent cases.
Forty-one patients with a total of 193 metastatic brain tumors were treated because of new lesions or in a few cases because of tumor regrowth. The management involved two to four treatments with Gamma Knife radiosurgery (GKRS). The overall median survival was 15 months. The local control rate of tumors was 89% for the first treatment and 93% for repeated treatments. Symptomatic radiation-induced edema appeared in only two cases (4.9%). Patients with metastatic brain tumors who developed new lesions after GKRS were treated with GKRS alone for subsequent lesions. It was possible to control tumors for a long period with minimal side effects. As a result, we were able to maintain the quality of life of these patients, but, the effect of GKRS in controlling tumor regrowth seemed temporary.
Actuarial Analysis↗
Lipolytic activity of anemia-inducing substance from tumor-bearing rabbits.
Anemia-inducing substance (AIS) is a protein of approximately 50,000 molecular weight secreted by malignant tumor tissue that depresses erythrocyte and immuno-competent cell functions; in this study, its biological effects on adipocytes were examined. Changes in body weight, total body fat, and food intake were investigated in rabbits after VX2 carcinoma transplantation, and the results showed reductions of 11%, 24%, and 30%, respectively, at 40 days after transplantation compared with baseline values (before transplantation). The values were even more markedly reduced 70 days after transplantation. When cyclic plasma perfusion (2 times/wk) was started at 40 days after transplantation, the values at 70 days after transplantation (30 days after beginning plasma perfusion) recovered to 91%, 84%, and 87%, respectively, of the baseline values. AIS fractions were isolated from rabbit plasma by using a phenyl-Sepharose column before transplantation, 40 and 70 days after transplantation, and 30 days after start of plasma perfusion, and AIS activity and lipolytic activity were measured. The results showed enhancement of AIS activity and lipolytic activity as the tumors grew. Lipolytic activity also returned to baseline value as AIS was removed by adsorption by plasma perfusion, and there was a high correlation between lipolytic activity and AIS kinetics. These results strongly suggest that AIS might be one of the substances involved in the enhanced lipolytic activity in advanced tumor-bearing subjects.
Adipose Tissue↗
Involvement of gonadal steroid hormone disturbance in altered prolactin receptor gene expression in the liver of diabetic mice.
The levels of mRNA for long and three short forms of prolactin receptor (PRLR) were examined in the livers of normal (db+/db-) and insulin-resistant diabetic (db+/db+) mice to assess the role of gonadal steroid hormones in the regulation of PRLR gene expression in diabetes mellitus. In females, plasma levels of testosterone in diabetic mice were higher, and those of 17beta-estradiol were lower when compared with levels in normal mice. By contrast, diabetic male mice had lower plasma levels of testosterone than normal males and showed no significant difference in the low circulating level of 17beta-estradiol compared with normal males. The short 3 form of PRLR (PRLR3) mRNA was the most abundant in the liver of both normal and diabetic mice. In addition, the level of PRLR3 mRNA in normal females was 8-fold higher than in normal males. The level of PRLR3 mRNA in diabetic females was approximately a quarter lower than in normal females, whereas the level of PRLR3 mRNA in diabetic males was approximately 2-fold higher than in normal males. During postnatal development, the level of PRLR3 mRNA increased during puberty in normal females, while the level in diabetic females decreased to a nadir at 7 weeks of age followed by a progressive rise. On the other hand, the levels of PRLR3 mRNA in both normal and diabetic males decreased gradually during 5 to 14 weeks of age. Testosterone treatment of diabetic males and females resulted in a 49.1 and 49.8% decrease of PRLR3 mRNA respectively. 17beta-Estradiol treatment slightly (18%) increased levels of PRLR3 mRNA in diabetic males. These results suggest that the hepatic level of PRLR mRNA is regulated by the inhibitory effect of testosterone and the stimulatory effect of estrogen in both normal and diabetic mice.
Animals↗
An adult-onset case of argininosuccinate synthetase deficiency presenting with atypical citrullinemia.
A 52-year-old heavy drinker presented with repeated episodes of disturbance of consciousness and an increase in serum ammonia level, triggered by excessive alcohol intake. He was diagnosed as having adult-onset citrullinemia with deficiency of hepatic argininosuccinate synthetase (ASS) activity. Cranial magnetic resonance imaging (MRI) showed high-intensity lesions in the central pons and the bilateral middle cerebellar peduncles on T2-weighted images. Although almost all cases of adult-onset citrullinemia have been reported to be enzymologically classified as type II, the serum amino acid pattern and serum level of human pancreatic secretory trypsin inhibitor (hPSTI) were atypical for type II in the present case.
Adult↗
Stereotactic radiosurgery for cavernous sinus cavernous hemangioma--case report.
A 40-year-old female presented with cavernous sinus cavernous hemangioma manifesting as left abducens and trigeminal nerve pareses. Magnetic resonance imaging revealed a left cavernous sinus tumor. The tumor was partially removed. Histological examination of the specimen confirmed cavernous hemangioma. Radiosurgery was performed using the gamma knife. The tumor markedly decreased in size after radiosurgery and morbidity was avoided. Cavernous sinus cavernous hemangiomas may be difficult to treat surgically due to intraoperative bleeding and cranial nerve injury. Stereotactic radiosurgery can be used either as an adjunct treatment to craniotomy, or as the primary treatment for small cavernous sinus cavernous hemangioma.
Abducens Nerve↗
High incidence of persistent primitive arteries in moyamoya and quasi-moyamoya diseases.
This study investigated the incidences of persistent primitive arteries in patients with moyamoya disease, unilateral moyamoya disease, and quasi-moyamoya disease. Cerebral angiograms of 50 patients (39 moyamoya disease patients, 6 unilateral moyamoya disease patients, and 5 quasi-moyamoya disease patients) were retrospectively reviewed. There were 35 females and 15 males, aged from 3 to 63 years (mean 27.4 years). Persistent primitive carotid-basilar artery anastomoses were observed in three patients: primitive hypoglossal artery in one moyamoya disease patient, primitive trigeminal artery variant in one unilateral moyamoya disease patient, and an anastomosis between the accessory meningeal artery and the anterosuperior cerebellar artery in one quasi-moyamoya disease patient. The ophthalmic artery originated from the middle meningeal artery in three moyamoya and two quasi-moyamoya disease patients. The incidence of the persistent primitive arteries is significantly higher in patients with moyamoya disease (10.7%) and quasi-moyamoya disease (60%) than in patients with other disease (0.67%) (p < 0.001), so congenital factors may be important in the pathogenesis of moyamoya disease.
Adolescent↗
Fusiform vertebral artery aneurysms as a cause of dissecting aneurysms. Report of two autopsy cases and a review of the literature.
Two autopsy cases of angiographically determined fusiform aneurysms of the vertebral arteries (VAs) are reported and the appropriate literature is reviewed to investigate the pathological characteristics of both fusiform and dissecting VA aneurysms and the pathogenesis of dissecting aneurysms. One patient had suffered a subarachnoid hemorrhage (SAH) due to dissection of a previously documented incidental fusiform aneurysm. The other patient had harbored incidental fusiform aneurysms coexistent with a ruptured aneurysm of the posterior inferior cerebellar artery. The location and pathological features of the aneurysms were similar in the two cases. The aneurysms in both cases displayed intimal thickening, disruption of the internal elastic lamina, and degeneration of the media. A mural hemorrhage and patchy calcification were also found in the case that included SAH. Based on their pathological investigation of these two cases and a review of reported cases, the authors propose that incidental fusiform aneurysms in the VAs are characterized by weakness in the internal elastic lamina and, therefore, have the potential to become dissecting aneurysms, resulting in a fatal prognosis. This suggests that long-term control of blood pressure is mandatory in patients with incidental fusiform aneurysms in the VAs.
Adult↗
[Metastatic tumor of the epididymis from pancreatic carcinoma: a case report].
A 58-year-old male who complained of painful left scrotal swelling consulted a local clinic in August 1998. Because his symptoms did not improve after antibiotic therapy, he was transferred and admitted to Jyouhoku City Hospital on September 14, 1998. Pelvic computed tomography (CT) was performed, and revealed left epididymitis. However, antibiotic treatment did not improve the condition. Then, because carcinoma of the epididymis was suspected, left inguinal orchiectomy was performed. We found a tumor in the spermatic cord and another tumor in the epididymis. The pathological diagnosis was adenocarcinoma, and metastatic carcinoma from the digestive tract was suspected. Therefore, examinations were performed to detect the primary cancer. CT and magnetic resonance imaging (MRI) demonstrated an invasive irregular tumor from the pancreas to the left kidney. Irregular mucosa was observed by gastrointestinal fiberscopy. A biopsy was performed and the pathological diagnosis was adenocarcinoma. Based on these findings, the patient was diagnosed as having a metastatic tumor of the epididymis and spermatic cord caused by pancreatic carcinoma. This is the 3rd case of adenocarcinoma of the pancreas that presented as an epididymal nodule, and this is the 12th case of adenocarcinoma of the pancreas that presented as a spermatic cord nodule.
Adenocarcinoma↗
Combination of automatic HPLC-RIA method for determination of estrone and estradiol in serum.
We developed a highly sensitive assay for estrone and 17 beta-estradiol in serum. Estrone and 17 beta-estradiol, obtained by solid-phase extraction using a Sep pak tC18 cartridge, were purified by high-performance liquid chromatography (HPLC). Quantitation of estrone and 17 beta-estradiol were carried out by radioimmunoassay. Not insignificantly, this automatic system of extraction and HPLC succeeded in analyzing 80 samples a week. Intra-assay coefficients of variation (CV) for estrone and 17 beta-estradiol ranged from 19.5 to 28.7%, and from 8.5 to 13.7%, respectively. The minimum detectable dose for estrone and 17 beta-estradiol were 1.04 pg/ml and 0.64 pg/ml, respectively. The serum levels of 17 beta-estradiol using our method strongly correlated with those by Gas chromatography mass spectrometry (GC-MS). The serum levels of estrone and 17 beta-estradiol in 154 peri- and postmenopausal women were estimated to be between 15 and 27 pg/ml and between 3.5 and 24.0 pg/ml, respectively, while the serum level of 17 beta-estradiol in postmenopausal women, in particular, was estimated to be from 3.5 to 6.3 pg/ml. For postmenopausal women who suffered from vasomotor symptoms, the mean levels of estrone and 17 beta-estradiol at 12 to 18 hours after treatment with daily 0.625 mg conjugated equine estrogen (CEE) and 2.5 mg medroxyprogesterone acetate (MPA) were 135.0 and 21.3 pg/ml at 12 months, respectively. On the other hand, levels of estrone and 17 beta-estradiol at 12 to 18 hours after treatment with CEE and MPA every other day, were 73.4 and 15.3 pg/ml, respectively. These highly sensitive assays for estrone and 17 beta-estradiol are useful in measuring low levels of estrogen in postmenopausal women, and monitoring estrogen levels in women receiving CEE as hormone replacement therapy.
Adult↗
Muscle cell apoptosis is responsible for the body weight loss in tumor-bearing rabbits.
In order to elucidate the cause of body weight loss in the early stage of tumor progression, morphological changes of striated muscle were investigated in rabbits every 10 days after VX2 carcinoma implantation. The lean body mass started to decrease in the tumor-bearing rabbits 10 days after implantation, and body fat ratio showed a significant decrease from 30 days, different from the starved rabbits, whose lean body mass and body fat ratio started to decrease from 10 days. Morphological hallmarks of apoptosis in muscle cells were detected in tumor-bearing animals prior to the tumor growth but not in starved animals. These findings suggest that muscle cell apoptosis may be responsible for the body weight loss in the early tumor-bearing.
Animals↗