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H Baba

Publications and source records attributed to H Baba.

At least 73 records · Page 4Linked to original sources
PubMed1998

Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves.

We report an instructive case of a 65-year-old man who presented with a dumb-bell shaped tuberculous abscess across the greater sciatic notch bilaterally compressing both sciatic nerves. Clinical symptoms progressed slowly and mimicked lumbar radiculopathy, thus delaying an accurate diagnosis. Anterolateral retroperitoneal and posterolateral gluteal approaches of the greater sciatic notch as well as the acetabulum on both sides were followed in order to provide safe viewing and resection of the abscess. The abscess wall was adherent to the sciatic nerve and surrounding blood vessels. The symptoms completely disappeared after resection of the abscess.

Abscess↗
PubMed1998

Solitary plasmacytoma of the spine associated with neurological complications.

We report eight patients with a solitary plasmacytoma of the spine associated with neurological complications. The patients included five men and three women with an average age at presentation of 59 years (range, 47 to 73 years). The tumour was confined to the thoracic spine in six cases, cervical spine in one and lumbar spine in one. Duration of symptoms ranged from 2.5 to 22 months. Treatment consisted of a combination of radiotherapy, melphalan and surgery. One patient progressed to multiple myeloma 7 years after surgery. Surgical treatment (anterior surgery in three cases and posterior surgery in five) produced neurological improvement in all patients. We stress the importance of an early diagnosis followed by appropriate treatment including surgery for this clinical entity and long-term follow-up to detect a disseminated disease.

Aged↗
PubMed1998

Relationship between gait and clinical results after high tibial osteotomy.

Thirty-two patients with primary osteoarthritis of the medial compartment of the knee were studied prospectively to assess the relationship between clinical results, limb alignment, and adduction moment of the knee. Clinical and radiographic examination and gait analyses were performed preoperatively and repeated at 6 months and at 1, 3, and 6 years after high tibial osteotomy. The preoperative peak adduction moment was high in 25 patients and low in seven. In both groups, the adduction moment of the knee decreased at 6 months after surgery but increased after that period. Alignment of the affected knee in both groups remained valgus after surgery (average femorotibial angle, 167 degrees-169 degrees). Clinical outcome in both groups improved after surgery and remained unchanged after 1 year. The peak adduction moment of the knee for the whole group significantly correlated with alignment and foot angle before and 6 years after surgery but did not correlate with stride length and walking velocity. In addition, only alignment was associated significantly with clinical results at 6 years. These results suggest that the preoperative peak adduction moment of the knee does not correlate with clinical or radiographic outcomes of high tibial osteotomy, provided sufficient valgus alignment is achieved at surgery.

Aged↗
PubMed1998

Effects of boron neutron capture therapy using borocaptate sodium in combination with a tumor-selective vasoactive agent in mice.

Boron neutron capture therapy (BNCT) destroys tumor cells by means of alpha particles and recoil protons emitted by 10B(n, alpha)7Li reaction. For BNCT to be effective, the tumor/normal tissue concentration ratio of 10B must be larger than 1.0, because neutron distribution is not selective. We examined the combination of 10B-enriched borocaptate sodium (BSH) with flavone acetic acid (FAA) as a model compound which causes vascular collapse in squamous cell carcinoma in mice (SCCVII tumors) and would increase the tumor/normal tissue concentration ratio of 10B. FAA (200 mg/kg, i.p.) was injected, and 5 min later BSH (75 mg/kg, i.v.) was administered, followed 15 to 180 min later by irradiation with thermal neutrons. The 10B concentrations were measured by prompt gamma ray spectrometry. Without FAA, tumor 10B concentrations were less than or equal to normal tissue concentrations at all time intervals, except that the concentrations were 1.7- to 2.7-fold greater in tumor than muscle at 15 and 180 min after injection of BSH. With FAA, 10B concentrations 2.1- to 6.9-fold greater in tumor than in muscle were achieved at all intervals tested. For blood and skin, significant differential accumulations were found in tumors at 120 and 180 min. Tumor/liver ratios were less than 1 at all times. Cell survival was determined by in vivo/in vitro colony assay, and increasing radiosensitization correlated with increasing tumor 10B concentrations, whether or not they were achieved with FAA. Tumor control rates, determined at 180 days after BNCT, similarly appeared to depend only on 10B levels at the time of irradiation. Because 10B levels correlate with the radiation response of tissues, a therapeutic gain would be expected whenever the tumor levels exceed normal tissue levels, such as in tumors located in muscle irradiated at 15-180 min after FAA + BSH, or in those in skin irradiated at 120 and 180 min.

Animals↗
PubMed1998

Treatment of advanced gastric cancer with 5-fluorouracil and cisplatin in combination with dipyridamole.

We investigated the efficacy of combination chemo-therapy using 5-fluorouracil (5-FU), cisplatin (CDDP), and dipyridamole (DP), which is based on the concept of double biochemical modulation. Twenty-eight patients with advanced gastric cancer were treated with the simultaneous continuous intravenous (i.v.) infusion of 5-FU (800 mg/m2/day) and DP (4 mg/kg/day), and i.v. infusion of CDDP (20 mg/m2/day) for 5 days. The cycles were repeated every 4 weeks. Twelve patients (43%) had a partial response (PR), while stable disease (NC) occurred in 13 patients (46%), and progression (PD) in 3 patients (11%). An improved performance status was observed in 20 patients (71%). The carcinoembryonic antigen (CEA) level was markedly decreased in 75% of the CEA-positive patients. Toxicity was acceptable. The mean steady state plasma concentration of total DP was 6.40.5 microM, which thus seemed adequate to potentiate the cytotoxicity of 5-FU. The treatment regimen described herein thus appears to be effective, safe and well tolerated by patients with advanced gastric cancer.

Adult↗
PubMed1997

Phosphodiesterase I, a novel adhesion molecule and/or cytokine involved in oligodendrocyte function.

One of the more complex developmental processes occurring postnatally in the CNS is the formation of the myelin sheath by oligodendrocytes. To examine the molecular events that take place during myelination, we isolated oligodendrocyte-derived cDNA clones, one of which (p421.HB) represents a putative alternatively spliced isoform of rat brain-specific phosphodiesterase I (PD-Ialpha) and a species homolog of the human cytokine autotaxin. Analysis of the structural composition of the p421.HB/PD-Ialpha protein suggests a transmembrane-bound ectoenzyme, which, in addition to the phosphodiesterase-active site contains presumed cell recognition and Ca2+-binding domains. Consequently, it may be involved in extracellular signaling events. Expression of p421.HB/PD-Ialpha is enriched in brain and spinal cord, where its mRNA can be detected in oligodendrocytes and in cells of the choroid plexus. Expression in the brain increases during development with an intermediate peak of expression around the time of active myelination and maximal expression in the adult. We have identified four presumably alternatively spliced isoforms, two of which appear to be CNS-specific. Decreased levels of p421.HB/PD-Ialpha mRNA in the dysmyelinating mouse mutant jimpy, but not shiverer, suggest a role for p421.HB/PD-Ialpha during active myelination and/or late stages of oligodendrocyte differentiation. Furthermore, p421.HB/PD-Ialpha mRNA levels were reduced in the CNS at onset of clinical symptoms in experimental autoimmune encephalomyelitis. These data together implicate the importance of p421.HB/PD-Ialpha in oligodendrocyte function, possibly through cell-cell and/or cell-extracellular matrix recognition.

Animals↗
PubMed1997

Transcription effect of nm23-M2/NDP kinase on c-myc oncogene.

Transactivating factor PuF which interacts with a nuclease hypersensitive element locates upstream from the c-myc gene. PuF was recently identified as being encoded by nm23-H2/ NDP kinase gene [Postel, E. H., Berberich, S. J., Flint, S. J., and Ferrone, C. A. (1993) Science 261, 428-429]. Here we have studied the correlation of expression between c-myc and nm23 genes in vitro. By a comparative study of the expression of 2 genes in cell lines, no direct correlation of kinetics was found. A plasmid containing the human c-myc fragment (c-myc CAT) was cloned upstream from the bacterial chloramphenicol acetyltransferase (CAT) gene. When the murine melanoma cell line was cotransfected with a nm23-M2/ NDP kinase expression vector and c-myc CAT, CAT activity was elevated. In addition, cell cycle phases in the murine cell lines transfected with nm23/NDP kinase were estimated; an alteration of the cell cycle, prolonged S-phase was found in the cell lines transfected with nm23-M2/NDP kinase, whereas human nm23-H2/NDP kinase did not play a role in transactivating the c-myc gene or in S-phase prolongation in murine cell lines. From these results we conclude that the murine nm23-M2 gene transactivates the c-myc gene and controls the cell cycle, S-phase, indirectly via a cellular cofactor in the murine cell line, which does not work with the human nm23-H2 gene.

Animals↗
PubMed1997

Prior brain injury protects death from local anaesthetic-induced convulsion.

Minor brain injury was inflicted with a small hypodermic needle at four sites from the scalp 7 days before the production of convulsion by i.p. injection of 100 mg/kg lidocaine in mice. The latency to convulsion and survival rate were significantly longer and higher, respectively, in the brain-injured group than in the sham-operated one. Thus, the results suggest that a protective mechanism develops in the injured brain against asphyxia caused by lidocaine convulsion.

Anesthetics, Local↗
PubMed1997

Local spread of metastatic vertebral tumors. A histologic study.

STUDY DESIGN: Nineteen solitary metastatic vertebral tumors obtained by total en bloc spondylectomy were analyzed histologically. OBJECTIVES: To determine the mechanisms of local spread of vertebral tumors and identity barrier tissues to tumor progression in the vertebra. SUMMARY OF BACKGROUND DATA: Histologic studies of specimens resected at amputation or en bloc excision have determined the pattern of local spread of bone and soft tissue tumors in the extremities and identified barrier tissues to tumor spread. However, a similar assessment of vertebral malignancies is difficult. The development of total en bloc spondylectomy for primary vertebral malignancy and solitary has allowed the collection of tissue samples sufficient to analyze the pattern of local spread of tumors, using the concept of compartment and barrier. METHODS: Histologic sections of all vertebral elements were prepared from specimens collected after en bloc spondylectomy. Serial 5-mm sections in the sagittal plane were also prepared and examined. RESULTS: Analysis of tumor location showed that metastatic tumors reached the vertebral column by invading the bone marrow of the dorsal region of the vertebral body. The anterior longitudinal ligament, posterior longitudinal ligament, periosteum abutting the spinal canal, ligamentum flavum, periosteum of the lamina and spinous process, interspinous ligament, supraspinous ligament, cartilaginous endplate and the anulus fibrosus served as barriers to tumor progression. The posterior longitudinal ligament was the weakest barrier tissue and was gradually destroyed by the tumor at the point of perforating vessels. Even after destruction of the barrier tissue, tumor cells were covered with a thin, fibrous reactive membrane. Two pathways allowed tumor spread to the adjacent vertebrae: 1) from the edge of the vertebral body to the adjacent vertebral body beneath the longitudinal ligament, and 2) through the paravertebral muscles to the neighboring lamina. CONCLUSIONS: Each vertebra can be represented by a compartment surrounded by several barriers. The most common path for tumor spread is through the posterior longitudinal ligament to the epidural space.

Aged↗
PubMed1997

Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors.

STUDY DESIGN: The study of seven patients with primary malignant or benign aggressive tumors who underwent a new aggressive surgical technique termed "total en bloc spondylectomy" is reported. OBJECTIVES: To report a new surgical technique of total en bloc spondylectomy for complete, resection of primary spinal malignancy and for oncologic curability. SUMMARY OF BACKGROUND DATA: The conventional approach for primary spinal malignancy is via intralesional piecemeal resection, and very few reports have described en bloc extralesional resectioning with histopathologically wide or marginal surgical margins. METHODS: Total en bloc spondylectomy, consisting of en bloc laminectomy and en bloc corpectomy followed by anterior instrumentation with spacer grafting and posterior spinal instrumentation, was performed in five patients with primary malignant tumors and two patients with giant cell tumors. Patients were observed for 2 years to 6.5 years, except for one patient who died 7 months after surgery because of a mediastinal metastasis. RESULTS: All patients, except one, attained significant clinical improvement after surgery with no major complications. Histologically, the margins were wide or marginal except for the pedicles, and occasionally the spinal canal and the posterior, where they were accepted to be intralesional. One patient died of metastasis that was not directly related to surgery itself. There was no local recurrence. CONCLUSIONS: The advantages of total en bloc spondylectomy include resection of the involved vertebra(e) in two major blocs, rather than in a piecemeal pattern, and completion of the procedure during one surgical session posteriorly. The "total en bloc spondylectomy" offers one of the most aggressive modes of therapy for primary spinal malignancy.

Adolescent↗
PubMed1997

Vertebral lesions associated with palmoplantar pustulosis.

Spinal lesions were reviewed in 9 patients (3 men and 6 women) who presented with palmoplantar pustulosis. Cervical lesions were found in 3 patients and lumbosacral involvement in 7. The duration of disease averaged 4.8 years. Seven patients had associated sterno-costo-clavicular hyperostotic lesions, and all showed abnormalities in blood tests which suggested chronic inflammation. Vertebral lesions were assessed as a spondylodiscitis type in 4, single level syndesmophyte-forming type in 1, multiple hyperostosis type in 4, and an ivory vertebra type in 1. Five patients were treated conservatively, and 4 with progressive spondylodiscitis type lesions underwent curettage and anterior interbody fusions. At follow-up, all patients improved in both spinal and cutaneous presentations, and 4 who underwent surgery and 1 with tonsillectomy attained complete cure. The vertebral manifestations of palmoplantar pustulosis may vary, but rapidly progressive lesions need surgery for favourable early improvement from the vertebro-cutaneous symptom complex.

Female↗
PubMed1997

Stress fracture of the femoral component in total knee replacement: a report of 3 cases.

We report 3 cases of stress fracture of the femoral component (small size Whiteside Ortholoc II) in total knee replacements which occurred at 32, 52, and 73 months after operation. The site was at the junction between the medial posterior bevelled surface and the posterior flange. The most likely cause of failure is due to the thinness of the metal at this point.

Aged↗
PubMed1997

The tarsal tunnel syndrome: evaluation of surgical results using multivariate analysis.

Thirty-four patients with the tarsal tunnel syndrome were treated by decompression of the posterior tibial nerve. The condition was bilateral in 3 cases. There were 9 men and 25 women with an average age at operation of 41 years. The average follow up was for 3.8 years. Multivariate analysis showed that the outcome is influenced, in order of importance, by fibrosis around the nerve, the preoperative severity of the condition, a history of sprained ankle, worker's compensation, a long history, and heavy work. The results were favourable when there was a short history, the presence of a ganglion, no sprains, and light work. Measurement of the terminal latency of the medial plantar nerve was valuable in assessing recovery. The precise cause of the syndrome and its effect on treatment should be considered before operation.

Adolescent↗
PubMed1997

Three-dimensional topographic analysis of spinal accessory motoneurons under chronic mechanical compression: an experimental study in the mouse.

We investigated the effect of chronic mechanical compression of the cervical spinal cord on the number of spinal accessory motoneurons in 25 tiptoe-walking Yoshimura mice. The animals had calcified deposits in the atlantoaxial membrane at the C1-C2 vertebral level, compressing the spinal cord posterolaterally. Motoneurons of the spinal accessory nerve between C1 and C5 segments were labelled using wheat germ agglutinin-horseradish peroxidase (WGA-HRP) injected into the sternocleidomastoid muscles. The counted cells were processed into a three-dimensional computer display to analyse the cytoarchitectonic changes caused by external cord compression. The number of WGA-HRP-labelled spinal accessory motoneurons was significantly reduced on the affected side. The number of motoneurons in compromised C2 and C3 cord segments correlated linearly with the extent of mechanical compression, but no such relationship was present on the contralateral side. There was an increase in the number of WGA-HRP-labelled spinal accessory motoneurons in the medial cell pools of the anterior grey horn at a level most rostral to the compression, and in the ventrolateral cell pools at levels immediately rostral to the compression. Our findings suggest that the spinal accessory motoneurons translocate rostral to the area of external compression in order to avoid mechanical injury.

Animals↗
PubMed1997

Plasticity of the spinal cord contributes to neurological improvement after treatment by cervical decompression. A magnetic resonance imaging study.

To investigate the relationship between morphological plasticity of the spinal cord and neurological outcome after surgery for compressive lesions, we correlated the transverse area of the cervical spinal cord measured by transaxial magnetic resonance imaging (MRI) obtained during the early postoperative period (1-6 months) with neurological function assessed at a median postoperative follow-up period of 2.5 years. Measurements on MRI in 56 patients (35 men and 21 women) included evaluation of the cross-sectional area of the cervical cord and the subarachnoidal space at the level of decompression. The transverse area of the cervical cord increased by 30 to 62% postoperatively and that of the subarachnoidal space by 57 to 95%. Neurological improvement was noted in all patients and averaged 63% in our assessment scale. Expansion of the cervical cord during the early postoperative period correlated significantly with the late postoperative neurological status (P = 0.009). Our results suggest that an increase in the cross-sectional area of the cervical spinal cord, representing spinal cord morphological plasticity, is a significant factor in determining the late neurological improvement following decompressive surgery.

Adult↗
PubMed1997

Surgical treatment and outcome for node-negative gastric cancer.

BACKGROUND: The clinicopathologic characteristics and prognosis for patients with node-negative gastric cancer have heretofore remained to be determined. METHODS: We analyzed data on 730 of our patients with node-negative gastric cancer who underwent curative gastric resection in the Department of Surgery II, Kyushu University Hospital, between 1965 and 1990, with reference to prognostic factors. The presence of lymph node metastasis was determined by means of routine hematoxylin-eosin staining of excised tissues. RESULTS: The 5-year survival rate was 91.7% and the 10-year rate was 88.5%; thus the prognosis was good for patients with node-negative gastric cancer. When the prognosis was analyzed by stratification of each clinicopathologic factor, the survival time was shorter for older patients when the size of the tumor was larger, when the tumor involved the entire stomach, and when-tissues revealed infiltrative growth, serosal invasion, and lymphatic invasion. Extensive lymph node dissection was performed for 86.6% of the patients, and for these patients the prognosis was better, with a statistical difference. In a multivariate analysis, tumor size, serosal invasion, and extensive lymph node dissection proved to be independent prognostic factors for patients with node-negative gastric cancer. CONCLUSIONS: Prophylactic lymph node dissection for patients with gastric cancer will prolong the survival time.

Adult↗
PubMed1997

Regulation of vasomotion of arterioles and capillaries in the cat spinal cord: role of alpha actin and endothelin-1.

Ring-shaped vasoconstrictions of arterioles at their branching sites have often been reported in vascular corrosion casts of the brain and spinal cord in rats and cats. It is surmised that smooth muscle cells in arteriolar walls could regulate the blood flow by changing the diameter of the lumen (ie vasomotion). However, few reports have described vasomotion at the capillary (capillaries have no smooth muscle cells). Also, there have been no reports on endothelin-1 in the arterioles and capillaries of the spinal cord. This study was designed to determine (1) the electron microscopic architecture of vasomotion; (2) the immunohistochemical identification of alpha actin and endothelin-1 in the arterioles and capillaries of the spinal cord. Twenty-seven adult mongrel cats were used to study vascular corrosion casts at the lumbosacral spinal cord segments immunohistologically and through scanning electron microscopic observations. Sections of the spinal cord were stained with monoclonal anti-alpha actin and endothelin-1 antibodies. Vascular corrosion casts demonstrated two types of vasomotion: a sausage-like peristalsis and a ring-shaped vasoconstriction at the arteriole and capillary levels. In the immunohistological study, alpha actin and endothelin-1 were identifiable in the vascular wall at the bifurcation, and pericytes were found to contain microfilaments of alpha actin. The ring-shaped vasoconstriction might be regulated by smooth muscle cells in arterioles and by pericytes in capillaries by releasing endothelin-1.

Actins↗