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Biomedical subjects

Jun Goto

Publications and source records attributed to Jun Goto.

At least 19 recordsLinked to original sources
PubMed2006

Progress of endoscopic ultrasonography and intraductal ultrasonography in the diagnosis of malignant biliary diseases.

In recent years, ultrasound technology has made remarkable strides, and the application of these latest advances to endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS) is crucially important. EUS equipped with electronic scanners (both radial and convex types) has been developed, and now EUS with the function of tissue harmonic imaging (THI) and color/power Doppler is applicable clinically. THI facilitates the acquisition of ultrasound images clearer than those of fundamental imaging, and color/power Doppler sonography demonstrates the precise hemodynamics with the use of a contrast agent. In addition, the progress of image processing technology has realized three-dimensional (3D) images in EUS and IDUS. Reconstruction of 3D images enables us to diagnose more objectively. Here we describe the roles of these new ultrasound technologies in the diagnosis of biliary malignancies.

Biliary Tract Diseases↗
PubMed2006

Usefulness of contrast-enhanced endoscopic ultrasonography in the differentiation between malignant and benign lymphadenopathy.

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is considered the most useful diagnostic modality for regional staging; however, it is still difficult to diagnose lymph node metastasis by EUS images only. In this study, we report the usefulness of contrast-enhanced EUS (CE-EUS) in the evaluation of benign lymph nodes (BLN) or malignant lymph nodes (MLN) based on blood flow patterns. SUBJECTS AND METHODS: In the retrospective study, CE-EUS was performed in 46 patients in whom EUS revealed lymph node in the mediastinum or abdominal cavity. The subjects consisted of 22 patients with BLN and 24 patients with MLN. The lesions were examined by EUS, and the maximal and minimal diameters of lymph nodes were measured. Thereafter, the shape and internal echoes were investigated, and the findings were morphologically classified based on Catalano's report. Enhancement effects and the diagnostic capability of CE-EUS were evaluated. In the prospective study, BLNs were differentiated from MLN using the enhancement patterns on CE-EUS based on the results of the retrospective study, and the diagnostic capability was evaluated. RESULTS: In the retrospective study, there were no significant differences in the maximal diameter and maximal/minimal diameter ratio between MLN and BLN. The morphology was classified into four types. Based on the morphological classification, the sensitivity, specificity, and accuracy rate were 88.2%, 77.3%, and 82.1%, respectively. On CE-EUS, the enhancement pattern was classified into three types. The BLN lesions showed uniform enhancement (19/22). In all patients with MLN, a defect of enhancement was observed (24/24). The sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 86.4%, and 92.3%, respectively. In the prospective study, the sensitivity, specificity, and accuracy rate of CE-EUS were 100%, 81.8%, and 92.0%, respectively. CONCLUSIONS: CE-EUS is useful for differentiating BLN from MLN.

Adult↗
PubMed2006

Morphometric evaluations of the human nervous system.

It is very important to evaluate and accurately understand the various conditions of the human nervous system. In this review article, we introduce several morphometric reports that are proven to be accurate from the view point of various errors (range of tissue shrinkage ratios, microscopic multiple counting, artifacts of microscopic structures, etc.). We review the following aspects of the selected reports: methodology, developmental research, neuronal differences, gender differences, aging process and miscellaneous (nerve fibers, unmyelinated fibers, in relation to neuropathology, clinical image-analysis and immunohistochemistry).

Aging↗
PubMed2006

Morphometric development of the posterior funicular nucleus in the human medulla oblongata.

Using serial sections of 11 human brains of fetuses 18-40 weeks of gestation (WG), 2-month-old infant and 63-year-old adult, we conducted the quantitative analysis of the development of the posterior funicular nucleus (PFN) in the medulla oblongata. The results suggest the following: (1) The cells of the human cuneatus lateralis nucleus are easily distinguished from those of the gracilis nucleus and cuneatus medialis nucleus because the neuronal somatic areas are the largest; the smallest neuronal areas are in the cuneatus medialis nucleus. (2) The development of the PFN occurs at least in four stages characterized by the degree of maturation of the neurons: (a) immature neuronal stage before 20 WG, (b) preparatory stage between (a) and (c), (c) accelerated development stage from 30 to 40 WG, and (d) postnatal stage. The development of the human posterior funicular nucleus accelerates after 30 WG, and postnatal qualitative maturation also occurs. Developmental differences of the three nuclei of the PFN in the medulla oblongata are presented and discussed from the morphological and morphometric point of view.

Humans↗
PubMed2006

[A case of small cell carcinoma of the lung associated with paraneoplastic cerebellar degeneration and Lambert-Eaton myasthenic syndrome].

A 51-year-old male who showed severe ataxia, dysarthria, bilateral blepharoptosis, diplopia and nystagmus with the subacute onset was reported. The chest roentgenogram and CT scan revealed mass lesions at the hilus of the left lung. The tumor markers, NSE and ProGRP, were elevated; 12.8 ng/ml (< or = 10) and 140.7 pg/ml (< or = 46), respectively. The biopsy was performed surgically and the small cell carcinoma of the lung was confirmed pathologically. His cerebellar symptoms were considered to be caused by the paraneoplastc cerebellar degeneration. However, the blepharoptosis was peculiar. The electrophysiological studies were carried out The muscle strength test of the right APB muscle was 5. But the supramaximum stimulation of the right median nerve evoked only 2.0 mV of CMAP of the right APB muscle. The repetitive stimulation tests of the same nerve showed that 3 Hz stimulation resulted in 42% waning but 20 Hz stimulation evoked no waxing. The post-exercise test of the right APB muscle showed 73% increase of the CMAP. These findings indicated that he also suffered from Lambert-Eaton myasthenic syndrome. The titer of the antibody against the P/Q type voltage-gated calcium channel (VGCC) was remarkably elevated, 1,920 pM. None of the following antibodies were detected ; they included antibodies against acetylcholine receptor, Hu, Yo, Ri, Ma-2, CRMP-5, amphiphysin and glutamic acid dehydrogenase. The small cell carcinoma was treated with the combination of irinotecan hydrochloride and cisplatin, leading to the reduction of the mass lesions and the tumor markers. His cerebellar symptoms improved slightly but his blepharoptosis was unchanged. The titer of antibody against the P/Q type VGCC reduced remarkably to 451.8 pM. We reviewed reported cases associated with paraneoplastic cerebellar degeneration and Lambert-Eaton myasthenic syndrome and discussed the relation between the paraneoplastic syndromes and autoantibodies.

Carcinoma, Small Cell↗
PubMed2005

Increased norepinephrine-associated adrenomedullary inclusions in Parkinson's disease.

The association with Parkinson's disease (PD) of adrenomedullary inclusions, known as 'hyaline globules' or 'adrenal bodies', has been reported for over 35 years. However, the common perception has been that adrenomedullary chromaffin cells cannot be recognized as pathological cells in PD. In the present study, we discovered that the number of adrenomedullary inclusions per unit area of the adrenal medulla was larger in PD and other Lewy body disorders (LBD) than in other neurological diseases and controls without any autonomic dysfunctions, and correlated with the duration of LBD. We also showed that the cells with adrenomedullary inclusions are all norepinephrine-secreting chromaffin cells. This was detected by PAS reaction following peroxidase immunohistochemistry of four proteins: chromogranin A, phenylethanolamine N-methyltransferase, S-100 protein and neurofilament protein. We also proved that the components of adrenomedullary inclusions are immunocytochemically different from those of Lewy bodies and Lewy-related neurites, as adrenomedullary inclusions were immunonegative to ubiquitin and alpha-synuclein as well as to the above four proteins. Therefore, contrary to current opinion, the norepinephrine-secreting adrenomedullary chromaffin cell is indeed another type of pathological cell in PD and other LBD.

Adrenal Medulla↗
PubMed2005

A morphological comparison of cervical spondylotic myelopathy: MRI and dissection findings.

The number of people with functional disabilities has been increasing with the rapid changes of age structure in the overall population. One of the major causes of disturbances in daily activities is cervical spondylotic myelopathy (CSM). The transverse area and sagittal diameter of the spinal cord measured by MRI is reported to correlate with the clinical manifestations of CSM, the duration of the disease, and the speed of recovery after surgery in patients with CSM. The purpose of this research is to determine the morphological characteristics of CSM as seen in MRI findings including the spinal cord sagittal diameter, transverse diameter, transverse area and flatness ratio. Twenty-eight of several patients with CSM were treated conservatively after carrying out measurements by MRI. In addition, anatomical studies were carried out on the spinal cords after anatomical dissection of the vertebral column in seven cadavers with CSM. These results, when compared with the morphological analysis of the cervical spinal cord, show that there is a correlation between the transverse areas at C4, C5 and C6 levels, as those at every level of the cervical transverse areas of tissue sections in the dissection cadavers were 10-18% smaller than those in the MRI patients. These results should be taken into account for the treatment of CSM patients.

Aged↗
PubMed2005

Aging process of myelinated nerve fibers in the human Lissauer tract.

We calculated numbers and axonal areas of myelinated nerve fibers in the Lissauer tract of the human lumbar spinal cord (L1) from the viewpoint of the aging process. We examined 20 human spinal cords from 13 males and 7 females, age ranging from 41 to 88 years old. We found that, although the number of nerve fibers showed no significant change in relation to the age of the subject, the axonal area of myelinated nerve fiber in the Lissauer tract did decrease with age.

Adult↗
PubMed2005

Morphometric comparison of human nerve cells: special sensory system.

We compared morphometric data on various nerve cells in the human special sensory system using the modified Klüver-Barrera staining method with an extremely minimized shrinkage ratio and an image-analyzer. According to the measurement data of cell-body sizes, we classified nerve cells of the various nerve nuclei in the special sensory system into three groups. These data are of interest to better understand the process of nerve conduction in the special sensory system.

Afferent Pathways↗
PubMed2005

Morphometric comparison of human nerve cells: pyramidal motor system.

We compared morphological and morphometric data on various motor neurons in the human pyramidal system using the modified Klüver-Barrera staining method with extremely minimized shrinkage ratio and an image-analyzer. We classified motor neurons in the human pyramidal system into three groups according to the measurement data. This report may be of interest to better understand the process of nerve conduction in the human pyramidal system.

Female↗
PubMed2005

Morphometric evaluation of posterior funiculus nerve fibers in relation to aging.

We morphologically evaluated the size of axons in the posterior funiculus in different age groups and examined the changes due to aging. In the past, such studies have been conducted at the cervical spinal cord (C6) level, and a decrease in the size and number of axons due to aging has been noted. The current study was conducted at the lower lumbar spinal cord (L2) level.

Aged↗
PubMed2005

[A case of asymmetric demyelinating neuropathy in a patient with chronic graft-versus-host disease].

A 47-year-old man, who suffered from acute lymphocytic leukemia at 45 years old and was treated with hematopoietic stem cell transplantation at 46 years old after the induction of complete remission by the standard chemotherapy, developed the symptoms of chronic graft-versus-host disease (cGVHD) such as dry eyes, dry mouth, skin thickening, skin scaling, skin pigmentation and impaired liver function. He was admitted to our hospital because of the acute development of diplopia and weakness of his left upper extremity accompanying with the exacerbation of other symptoms of cGVHD. Neurological examinations revealed the right abducens nerve palsy and asymmetric muscular weakness of the extremities; the proximal part of the left upper extremity and the distal part of the right upper extremity were markedly involved. Neurophysiological studies including magnetic motor root stimulation revealed demyelinating neuropathy specifically involving the motor nerves. On the basis of these findings, a diagnosis of peripheral neuropathy associated with cGVHD was made. Nighteen reports are available on peripheral neuropathy in cGVHD patients, but to date little is known about the pathophysiology of this condition. Most of those patients have been diagnosed as having symmetric demyelinating polyneuropathy, such as Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy. In this study, contrary to previous reports, the asymmetric involvement of motor nerves is noteworthy. Accumulation and further analyses of the cases like the present case are necessary to elucidate the pathogenesis of peripheral neuropathy in cGVHD.

Chronic Disease↗
PubMed2004

Development of the human cuneatus medialis nucleus: a morphometric evaluation.

The morphometric features of the development of the human cuneatus medialis nucleus (CMN) were examined using complete serial celloidin sections of 11 brains: nine fetal brains, the brain of a 2-month-old infant and that of a 63-year-old adult. The morphometric analysis revealed at least four stages in the development of the CMN characterized by the maturation of neurons: (1) immature neuronal stage, (2) preparatory stage, (3) accelerated development stage and (4) postnatal stage. The development of the human CMN accelerates after 32 weeks of gestation (WG), and postnatal qualitative maturation also occurs. From the viewpoint of morphometric evaluation, the CMN gradually matures between 18 and 40 WG without a rapid growth phase as far as we have observed.

Female↗
PubMed2004

Morphometric analyses of axons in the human lateral corticospinal tract: cervical/lumbar level comparison and relation to the ageing process.

Myelinated axons in the human lateral corticospinal tract (LCST) at the C6 and L4 levels were examined on 16 male cadavers, with age ranging from 41 to 88 years. The average area of axons in the LCST was measured using a microscopic image-analyzing system. Our data show that the average area of axons at the C6 and L4 levels decreased with age. We also noticed that the average area of axons was larger at the C6 level than at the L4 level in all cases. This decrease may be related to a parallel decrease of conduction velocity in the LCST during the ageing process.

Adult↗
PubMed2004

Plug-in structures at the lacrimal point.

In order to study the precise structures of the human eyelids, we made serial sections, and found a plug-in structure protruding from the lacrimal caruncle and reaching into the lacrimal point. We will show a photo of this plug-in structure, as we believe it plays an important role in the lacrimal drainage system.

Adult↗