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Biomedical subjects

E Inoue

Publications and source records attributed to E Inoue.

At least 19 recordsLinked to original sources

Proteolysis by calpain is an underlying mechanism for formation of sugar cataract in rat lens.

To confirm the effect of a new aldose reductase inhibitor (ARI), rat lenses were cultured with xylose. ARI prevented opacities and reduced lens hydration caused by xylose. Next, cataract was produced by feeding a diet containing 50% galactose. ARI was tested for amelioration of cataract. On day 19 after feeding of galactose, nuclear cataracts were visible in 75% of the animals receiving only galactose, while nuclear cataracts were not observed in animals treated with ARI. In galactose cataract, lens hydration and calcium were significantly increased. Calpain in soluble and insoluble fractions was decreased. Alpha- and beta-crystallins were proteolyzed. These changes were inhibited by administration of ARI. These results suggested that proteolysis by calpain is an underlying mechanism in formation of sugar cataract in rat lens.

Aldehyde Reductase

New concept of spinal orthosis for weakened back muscles.

An anterior bending posture of the trunk during walking is often seen among the elderly commonly due to weakened thoraco-lumbar and gluteal muscles. For the management of this debilitating condition, the authors have developed a modified design of thoraco-lumbosacral orthosis (TLSO). Incorporated in this device are pockets for the accommodation of lead weights, which are located posteriorly at the level of the lumbar region and an elasticated anterior abdominal band. The results and level of patient acceptance achieved with the use of this brace have both been excellent.

Equipment Design

[Evaluation of multislice dynamic MR imaging of the whole liver].

In 47 patients with liver cirrhosis, we performed dynamic MRI with a multisection FLASH technique that enabled us to obtain 13 T 1-weighted images of the entire liver within a single breath hold. Computed tomographic arterial portography (CTAP), US, CT, angiography (AOG) and MRI (spin echo [SE] and dynamic MRI) were performed in all 47 patients. Except for cyst, hemangioma and metastatic tumor, 104 focal nodules less than 3 cm in diameter were detected. These 104 focal lesions were divided into three groups according to the pattern of CTAP: 69 portal supply negative, 11 portal supply decreased, and 24 portal supply normal. In the portal supply negative group, 63 lesions (91%) were detected by dynamic MRI, which was superior to other modalities (US 77%, CT 41%, AOG 70%, MRI-SE 61%). The superiority of dynamic MRI resulted from its excellent ability to detect liver lesions less than 1 cm in diameter. We confirmed histologically that dynamic MRI had almost the same ability to detect hepatocellular carcinoma (HCC) as CTAP. Dynamic MRI should be clinically useful as a noninvasive examination for the detection of HCC.

Carcinoma, Hepatocellular

Comparison between conventional and spiral CT in patients with hypervascular hepatocellular carcinoma.

To determine the usefulness of spiral CT in the detection of hypervascular hepatic lesions, we compared conventional contrast enhanced CT (CECT) with whole liver dynamic scanning during the artery-dominant phase by spiral CT (SDCT), using hypervascular hepatocellular carcinoma (HCC) as a model. Twenty-nine patients with 56 hypervascular nodular type HCCs detected by hepatic digital subtraction angiography were examined by both CT techniques. These nodular type HCCs were divided into three groups according to diameter: < 10 mm (n = 7), 10-20 mm (n = 17), and over 20 mm (n = 32). None of seven lesions less than 10 mm in diameter was seen by either technique. Of 17 lesions 10-20 mm in diameter, four (24%) were detected by precontrast CT plus CECT, whereas 14 (82%) were detected by precontrast CT plus SDCT. There were no lesions detected by CECT only, whereas 10 lesions were detected by SDCT only (P < 0.01 by signed test). For 32 lesions over 20 mm in diameter, there was no significant difference in detection rates between the CT techniques. Our results indicate that spiral CT is useful for the detection of relatively small hypervascular hepatic lesions such as hypervascular HCCs.

Adult

In vitro antibacterial activity and beta-lactamase stability of SY5555, a new oral penem antibiotic.

The antibacterial activity of SY5555, a new oral penem antibiotic, was compared with those of cefaclor, cefixime, and cefteram. SY5555 was more active than the comparison agents against methicillin-susceptible Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, Citrobacter freundii, Enterobacter cloacae, Morganella morganii, Acinetobacter calcoaceticus, Clostridium spp., and Bacteroides fragilis. Against Providencia spp., Proteus spp., and Haemophilus influenzae, SY5555 was less active than cefixime or cefteram. SY5555 was inactive against methicillin-resistant S. aureus. Enterococcus faecium, Serratia marcescens, Pseudomonas aeruginosa, and Xanthomonas maltophilia, as were the comparison agents. The bactericidal activities of SY5555, cefixime, and cefteram were at or slightly greater than the MICs for clinical isolates of Escherichia coli and Klebsiella pneumoniae. SY5555 was not hydrolyzed by various types of beta-lactamases. However, SY5555 and the comparison agents were hydrolyzed by X. maltophilia (L-1) and P. aeruginosa/pMS354 beta-lactamases, two Bush group 3 beta-lactamases, SY5555 showed a high affinity, as did cefixime and cefteram, for cephalosporinases from C. freundii GN7391 and E. cloacae GN7471 strains. These results suggest that SY5555 may be more specific than existing beta-lactam antibiotics.

Administration, Oral

Pleural invasion by peripheral bronchogenic carcinoma: assessment with three-dimensional helical CT.

PURPOSE: To evaluate the potential role of three-dimensional (3D) computed tomography (CT) in assessment of pleural invasion by peripheral bronchogenic carcinoma. MATERIALS AND METHODS: Twenty-four-second helical CT scans were obtained during a single breath hold in 42 consecutive patients with peripheral bronchogenic carcinoma. Conventional two-dimensional (2D) images and 3D reconstruction images were reviewed independently by three blinded observers, who reached a decision by consensus. All patients underwent surgical resection of the tumor, and CT findings were correlated with the findings in pathologic specimens. RESULTS: Twelve patients had visceral pleural invasion, five had parietal pleural invasion, and 25 had no evidence of pleural invasion. Visceral pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in 11. Parietal pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in three. CONCLUSION: 3D reconstruction imaging is superior to conventional 2D CT in assessment of pleural invasion by peripheral bronchogenic carcinoma.

Carcinoma, Bronchogenic

[Differentiation of bronchogenic carcinoma from benign nodule by MR imaging: quantitative evaluation].

To distinguish benign from malignant nodules with MR imaging, 39 pulmonary nodules (23 bronchogenic carcinomas, nine tuberculomas and seven other benign lesions) were studied. MR equipment of 1.5 Tesla was used, and relative signal intensities of pulmonary nodules on T 2- and T 1-weighted images before and after administration of gadopentate dimeglumine were evaluated. On T 2-weighted images, the relative signal intensity of bronchogenic carcinomas to subcutaneous fat was 5.48 +/- 1.69, that of tuberculomas was -2.56 +/- 2.22 and that of other benign lesions was -0.88 +/- 3.37; the difference between tuberculomas and bronchogenic carcinomas was statistically significant (p < 0.05). On T 1-weighted images before and after administration of gadopentate dimeglumine, the relative signal enhancement of bronchogenic carcinomas was 17.6 +/- 2.0, that of other benign lesions was 20.0 +/- 5.2 and that of tuberculomas was -0.0074 +/- 0.763; the difference between tuberculomas and bronchogenic carcinomas as well as benign nodules was statistically significant (p < 0.001). The relative signal intensity on T 2-weighted images and the ratio of signal enhancement to noise could differentiate tuberculomas from bronchogenic carcinomas and other benign lesions. However, bronchogenic carcinomas and other benign lesions could not be differentiated by MR imaging.

Aged

MR angiography of meningioma.

The clinical evaluation of three-dimensional time-of-flight MR angiography was prospectively performed in 16 patients with intracranial meningioma. MR angiographic techniques used in this study both with and without gadopentetate dimeglumine made it possible to demonstrate the topographic relationship between the tumors and the neighboring vascular structures. MR angiograms were compared with available conventional angiograms. The three-dimensional enhanced MR angiograms were successful in depicting sinus involvement in greater detail in six patients than conventional angiography. In six patients, the feeding arteries of meningiomas were demonstrated with the unenhanced MR angiograms. However, MR angiograms failed to show small feeding arteries in three patients as delineated with conventional angiography. Arterial displacement was shown in nine patients. Venous drainage and collateral circulations were also visualized in four patients. Our results indicate that multiview MR angiograms noninvasively provide useful information for planning the surgical treatment of patients with meningioma.

Cerebral Angiography

In-vitro evaluation of the four beta-lactamase inhibitors: BRL42715, clavulanic acid, sulbactam, and tazobactam.

The in-vitro synergic activities of BRL42715, a new beta-lactamase inhibitor, clavulanic acid, sulbactam, and tazobactam combined with ampicillin, piperacillin, cephalothin, or cefoperazone were tested against various bacteria producing known types of beta-lactamase. BRL42715 showed the best synergistic activity among the inhibitors tested against strains producing penicillinases of type I, II, III, V, and that from Klebsiella pneumoniae, cephalosporinases, and oxyiminocephalosporinases (except that from Klebsiella oxytoca). Clavulanic acid combined with the beta-lactams tested showed the best synergic activity of the inhibitors against strains producing type IV penicillinase and oxyiminocephalosporinase from K. oxytoca. The 50% inhibitory doses of BRL42715 were superior to those of clavulanic acid against various types of beta-lactamases except for type IV penicillinase and the oxyiminocephalosporinase from K. oxytoca. The inhibitory activity of BRL42715 against cephalosporinases from various bacteria was 10(4) to 10(6)-fold greater than that of clavulanic acid. The synergic effects of BRL42715 and clavulanic acid on the activity of piperacillin were compared against six clinical isolates of bacteria resistant to piperacillin. The synergic activity of BRL42715 was greater than that of clavulanic acid in all six isolates.

Anti-Bacterial Agents

Magnetic resonance imaging-histologic correlation of small hepatocellular carcinomas adenomatous hyperplasias.

RATIONALE AND OBJECTIVES: Hepatocellular carcinomas (HCCs) usually consist of components of different histologic grade. Using surgically resected specimens, the authors obtained high-resolution magnetic resonance (MR) images and studied the relationship between histologic grade of HCCs and MR signal intensity. METHOD: In vitro MRI was performed on 15 small (less than 20-mm diameter) HCCs and 2 patients with adenomatous hyperplasia (AH) within 1 hour of surgical resection. In these 17 lesions, 24 macroscopic nodular components corresponding to MR images were recognized pathologically. The difference in MR signal intensity was examined by using tumor/phantom (T/P) signal-intensity ratio. In addition, the correlations between signal intensity on MRI and histologic criteria for grading HCC were studied. RESULTS: On T2-weighted images, grade II HCCs had significantly greater T/P values than grade I HCCs (P < .01). There is the correlation (r = .88, P < .001) between nucleocytoplasmic (N/C) ratio and signal intensity of small HCCs and AHs on T2-weighted images. CONCLUSION: The N/C ratio is an important factor relating the signal intensity to the histologic grade of these lesions on T2-weighted images.

Aged

In vitro antibacterial activity and beta-lactamase stability of CP-70,429 a new penem antibiotic.

In in vitro susceptibility tests, the new penem CP-70,429 showed potent antibacterial activity against gram-positive and gram-negative bacteria except Pseudomonas aeruginosa and Xanthomonas maltophilia. CP-70,429 was stable to various types of beta-lactamases except for the enzyme from X. maltophilia and was 16- to 128-fold more active than the other compounds against beta-lactamase-producing strains of Enterobacter cloacae and Citrobacter freundii.

Anti-Bacterial Agents

Bladder tumors: staging with gadolinium-enhanced oblique MR imaging.

To clarify the importance of imaging plane in evaluation of invasion by tumor into muscle, 50 patients with bladder tumors underwent examination with magnetic resonance (MR) imaging performed with an oblique plane and the early phase of contrast enhancement. After the ideal oblique plane was selected, an oblique T2-weighted image was obtained. Gadopentetate dimeglumine was then administered, and an oblique T1-weighted image was obtained. The staging based on oblique T2-weighted and oblique contrast material-enhanced T1-weighted MR images was then correlated with histopathologic staging. The respective accuracies of oblique contrast-enhanced T1-weighted and oblique T2-weighted images were 78% and 60% for overall staging (P < .05), 90% and 74% for differentiation between (a) stage T1 and lower-stage tumors and (b) stage T2 and higher-stage tumors (P < .05), and 92% and 88% for differentiation between (a) stage T2 and lower-stage tumors and (b) stage T3a and higher-stage tumors (P > .05). Oblique MR imaging performed in conjunction with the early phase of contrast enhancement showed significantly high staging accuracy, especially in differentiation between superficial tumors and tumors with superficial muscle invasion.

Adult

Bladder wall morphology: in vitro MR imaging-histopathologic correlation.

To study the morphology of the normal and inflamed bladder wall, the findings of magnetic resonance imaging and histopathologic examination of 13 in vitro specimens were correlated. Normal bladder wall appeared as a band of intermediate signal intensity on T1-weighted images and as bands of low (inner) and intermediate (outer) signal intensity on T2-weighted images. Inflamed bladder walls demonstrated two additional inner bands of intermediate (inner) and high (innermost) signal intensity on T1-weighted images and high (inner) and low (innermost) signal intensity on T2-weighted images. The mean histopathologic percentages of muscle bundles in inner and outer bands that appeared on T2-weighted images were 92.5% +/- 4.9 and 78.3% +/- 8.2, respectively. The authors conclude that the total thickness of the two bands of differing intensity that appeared on the T2-weighted images of the normal bladder wall correlated well morphometrically with the muscle layers in the histopathologic specimens, and that the different signal intensities in the muscle layer represent a compact inner and looser outer arrangement of smooth muscle bundles.

Aged

In vitro activity of E1040 against imipenem-resistant Pseudomonas aeruginosa strains.

E1040 showed the most potent activity (MIC for 90% of strains, 6.25 micrograms/ml) among beta-lactams tested against 70 strains of imipenem-resistant Pseudomonas aeruginosa. Two strains showed high-level resistance to E1040; one strain produced a type II oxyiminocephalosporin-hydrolyzing beta-lactamase (group 3), and the other produced an enzyme similar to a type II penicillinase (OXA-1). Both beta-lactamases contributed to resistance to E1040.

Anti-Bacterial Agents

Production of phytochelatins in Polygonum cuspidatum on exposure to copper but not to zinc.

We studied cellular resistance to copper of plant cells Polygonum cuspidatum. When callus of P. cuspidatum was incubated on medium containing 100 microM cupric sulfate, the callus grew as well as the control callus did. The copper content of the callus, however, was elevated to a similar level of the medium. When cell extracts of callus exposed to 100 microM cupric sulfate were fractionated by gel filtration chromatography, a specific copper peak was eluted at the region of molecular weights between 4000 and 1000. Since an appearance of the copper-containing materials was inhibited by buthionine sulfoximine and the partially purified copper-containing materials contained only three amino acids: glutamic acid, glycine and cystine, the materials were supposed to be gamma-glutamyl peptides phytochelatins. Callus of P. cuspidatum synthesized phytochelatins from 50 microM cupric sulfate and maximally at 100-150 microM cupric sulfate. When induction of phytochelatins by another heavy metal, zinc, was analyzed, the callus, however, did not synthesize phytochelatins on exposure to zinc sulfate up to 1 mM. These findings suggested that phytochelatins were required for resistance to copper but probably not to zinc in the plant cells.

Cells, Cultured

Hepatic arterial embolization in cases of extensive celiac arterial stenosis.

Transarterial hepatic embolization was attempted in 10 and succeeded in nine patients with hepatocellular carcinoma accompanied by extensive celiac arterial stenosis. All catheterization was done through the femoral artery. In six cases, the tip of the catheter (2.5-F ball-tip microcatheter in three cases, 4-F ball-tip supple catheter in three cases) was placed in the proper hepatic artery through the pancreaticoduodenal collaterals. In three cases, a ball-tip microcatheter was injected from the guiding catheter, which was placed in a pinhole of the celiac trunk. These techniques involving flow-guided ball-tip catheters are of great value for hepatic arterial catheterization in cases of extensive celiac arterial stenosis.

Arterial Occlusive Diseases

Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images.

Sixteen patients with cirrhosis of the liver underwent cranial magnetic resonance (MR) imaging and transarterial portography to evaluate the relationship between basal ganglia lesions and portal-systemic collateral vessels. No neuropsychiatric disturbance was observed in any of the patients at the time of the MR examination, but four patients with portal-systemic encephalopathy were included in the study. Basal ganglia lesions, characterized by increased signal intensity on T1-weighted MR images, were observed in nine of the 16 patients, including the four with portal-systemic encephalopathy. These nine patients had large portal-systemic collateral vessels that were more than 10 mm in diameter. These collateral vessels were receiving blood from the superior mesenteric vein (SMV) in all nine patients. The lesions involved the globus pallidus and portions of internal capsules in a bilateral and symmetric fashion and did not exhibit mass effect. The authors conclude that there may be a significant relationship between high-intensity basal ganglia lesions and large portal-systemic collateral vessels receiving blood from the SMV.

Aged

Prevalence of air bronchograms in small peripheral carcinomas of the lung on thin-section CT: comparison with benign tumors.

Despite improved techniques--such as bronchoscopy and percutaneous needle biopsy--to evaluate pulmonary nodules, there are still many cases in which surgical resection is necessary before carcinoma can be differentiated from benign lesions. The present study was undertaken to determine if the presence of an air bronchogram or air bronchiologram (patent visible bronchus or bronchiole) is useful in distinguishing small lung cancers from benign nodules. Thin-section chest CT scans were obtained in patients with 20 peripheral lung cancers less than 2 cm in diameter (18 adenocarcinomas, one squamous cell carcinoma, and one large cell carcinoma) and 20 small benign nodules (eight hamartomas, seven tuberculomas, two foci of aspergillosis, one focus of cryptococcosis, one chronic focal interstitial pneumonitis, and one plasma cell granuloma). The images were compared with regard to the patency of any bronchus or bronchiole within the lesions. After surgical resection, the specimens were inflated with agar and sectioned transversely to correlate gross morphology and low-power histologic sections with the CT appearance. An air bronchogram or air bronchiologram was seen in the tumors on 65% of CT scans and 70% of histologic sections. Benign nodules had a patent bronchus or bronchiole on CT scans and histologic sections in only one case (5%). These findings suggest that the presence of an air bronchogram in a lung nodule is a useful finding to help differentiate adenocarcinomas from benign lesions.

Adenocarcinoma