Biomedical subjects

K Sugimoto

Publications and source records attributed to K Sugimoto.

736 records · Page 41Linked to original sources

PubMedDate not supplied

Natural course of cavernous hepatic hemangioma.

Cavernous hepatic hemangiomas are benign liver tumors and present as incidental findings on sonographic examinations, but little is known concerning their natural course. Therefore, we performed a clinical and imaging follow-up of 64 cases of cavernous hepatic hemangioma in 50 patients during an average 18.8 month period. One case presented a symptom of slightly right upper quadrant pain and two cases showed thrombocytopenia. In one of the thrombocytopenia cases, cavernous hepatic hemangioma was resected because of Kasabach-Merrit syndrome. No case increased in size during follow-up, but one case decreased and disappeared. These results suggested that prolonged clinical and imaging follow-up of cavernous hepatic hemangiomas may be needed.

Adult↗

PubMedDate not supplied

Disappearance of gastric antral vascular ectasia after percutaneous transhepatic obliteration.

We report on a patient with severe iron deficiency anemia due to gastric antral vascular ectasia (GAVE), complicating hepatocellular carcinoma (HCC) and esophageal varices. Esophago-gastro-duodenoscopy (EGDS) 6 months after transarterial embolization (TAE) for the HCC and percutaneous transhepatic obliteration (PTO) for esophageal varices, showed the absence of GAVE. As GAVE did not recur in spite of the recurrence of the tumor thrombus later, lowered antral congestion by PTO might be the main cause of disappearance of GAVE. This case suggests that PTO may be an effective treatment against GAVE with portal hypertension with uncontrollable bleeding.

Aged↗

PubMedDate not supplied

Geriatric trauma patients at a suburban level-I trauma center in Japan.

BACKGROUND: Despite the increases in the aged population in Japan, there are little data on geriatric patients with traumatic injuries. A prospective clinical study was carried out to evaluate the use of the emergency medical services (EMS) system, mechanisms of injury, and prehospital assessment and triage of elderly victims of trauma. PATIENTS AND METHODS: From July 1996 through June 1997, a group of geriatric trauma (Group G, n = 22) and a control group of younger trauma patients (n = 173) were compared with respect to transfer method to an Emergency Center (direct or indirect), Revised Trauma Scores on the scene of the accident (RTS-1) and on admission to the Emergency Center (RTS-2), and outcome (survival). RESULTS: The mean values for RTS-1 in the Control Group (Group C) were not different from those in Group G, but RTS-2 of the indirect-transfer patients (IP) in Group G were significantly lower than were those for Group C. Group G mortality rates were significantly higher than were the control rates (p = 0.0001). The mortality rate of the IP subgroup was significantly lower than that of the direct transfer subgroup (DP) (30/68 vs. 5/70, p < 0.0001) in the Group C, but mortality rate of the IP subgroup exceeded that of the DP subgroup of Group G (8/14 vs. 5/8). CONCLUSION: The data suggest that in geriatric-age patients, direct transfer patients have a lower mortality rate than do indirect transfer patients when controlled for ISS. Therefore, it seems that a different set of triage criteria should be developed and implemented for geriatric-age victims with trauma-induced injuries and that those who meet these more stringent criteria should be transferred directly to a Trauma Center.

Accidents, Traffic↗

PubMedDate not supplied

Application of self-expanding metallic stents to malignant stricture following mechanically stapled esophagojejunostomy: report of two cases.

Several types of self-expanding metallic stents (SEMS) were placed in two patients suffering from severe malignant stricture at the site of a mechanically stapled esophagojejunostomy used for the treatment of recurrent gastric cancer. Following modified Gianturco stent placement with limited success in one of the patients, an additional Ultraflex stent (Boston Scientific Co., Boston, USA) failed to expand satisfactorily at the outlet of the second stent. In the other patient, since the proximal end of an additional covered Ultraflex stent (Boston Scientific Co.) inserted through the first one failed to expand satisfactorily at the level of severe stenosis because of the extreme rigidity caused by the mechanical staples, a spiral Z-stent was inserted to dilate it. The cases reported here raise some problems associated with the treatment of severely malignant stricture accompanied by extreme rigidity following mechanically stapled esophagojejunostomy with SEMS.

Anastomosis, Surgical↗

PubMedDate not supplied

Cystic hamartoma of the renal pelvis: imaging features.

We report a case of a 50-year-old woman with histologically proven cystic hamartoma of the renal pelvis, focusing on the imaging findings and pathologic features. A large multicystic tumor with solid components in the left kidney was enhanced on both contrast-enhanced CT and gadolinium-enhanced MR images. Angiographic images showed irregular tumor vessels with moderate tumor stain.

Diagnosis, Differential↗

PubMedDate not supplied

Reduced expression of ICE/caspase1 and CPP32/caspase3 in human hepatocellular carcinoma.

The interleukin-1(-converting enzymes (ICE)/caspase1 and the CPP32/caspase3, cysteine proteases, play an important role in the maintenance of homeostasis by inducing apoptosis. Since human hepatocellular carcinomas (HCCs) demonstrate strong resistance to apoptosis, we investigated the expression of ICE and CPP32 in human HCCs. Reverse transcription PCR analysis revealed that one out of five HCC tissues showed no band of ICE mRNA and two out of five HCC tissues showed no band of CPP32 mRNA. An immunohistochemical study of 20 cases of HCC tissues and non-tumor parts revealed that immunoreactivity of ICE and CPP32 was preferentially observed in the cytoplasm, appearing as a diffuse and homogeneous pattern. Some nuclei also stained with anti-ICE antibody or anti-CPP32 antibody and demonstrated apoptotic features. Overall, the expression of ICE and CPP32 were significantly down-regulated in the HCCs compared to nontumor cells. In situ nick end labeling method (TUNEL) labeling index significantly decreased according to the decreasing staining intensity of CPP32. However, there was no tendency for the TUNEL labeling index to decrease with decreasing ICE staining intensity. Our results suggested that the expression of ICE and CPP32 were down-regulated and that especially reduced expression of CPP32 may contribute to resistance against apoptosis in human HCCs.

Apoptosis↗

PubMedDate not supplied

Histological features of cirrhosis with hepatitis C virus for prediction of hepatocellular carcinoma development; a prospective study.

The histological features of pre-neoplastic lesions in HCV-associated cirrhosis remain uncertain. The aim of this prospective study was to elucidate histological features for predicting the development of hepatocellular carcinoma (HCC). A cohort of 72 consecutive patients with hepatitis C-associated cirrhosis, which was diagnosed by histology investigated for development of HCC. Seven histological features including small cell dysplasia (SCD) and large cell dysplasia (LCD) of liver cirrhosis were evaluated with regard to the development of HCC. In addition, proliferation and apoptosis were investigated using immunohistochemistry by proliferating cell nuclear antigen and TUNEL method, respectively. At enrollment, SCD was observed in the biopsy specimens of 18 out of 72 (25.0%) patients and LCD was observed in 20 out of 72 (27.8%). Twenty eight out of 72 patients (38.9%) developed HCC during a mean follow-up period of 72.4 months. Among the histological parameters, SCD, active inflammation and complete nodule were statistically significant factors for the cumulative probability of developing HCC. However, LCD did not appear to be important for HCC development. In multivariate analysis, SCD was the highest independent risk factor for HCC. Samples with SCD demonstrated a higher proliferative rate and a lower apoptotic rate than normal hepatocytes or samples with LCD. These results indicate that SCD is a major risk factor for HCC. Careful assessment of liver histology may be important in order to predict HCC development in patients with HCV-related cirrhosis.

Adult↗

PubMedDate not supplied

The overexpression of cyclin-dependent kinase (CDK) 2 in laryngeal squamous cell carcinomas.

We examined the expression of CDK2 using immunohistochemistry in 102 cases of laryngeal squamous cell carcinomas (LSCCs). The results showed that a total of 63.73% (65/102) patients revealed a CDK2 overexpression pattern and the CDK2 overexpression was correlated significantly with the tumor site, tumor size and advanced stage. A positive correlation between the CDK2 expression and proliferative activity of tumor cells measured by proliferating cell nuclear antigen was found (r = 0.894, p < 0.0001). The Kaplan-Meier's analysis showed that shorter disease-free survival was significantly associated with tumor grade, tumor size, lymph node metastasis and advanced stage. Overall survival was significantly associated with tumor grade, tumor size, lymph node metastasis, advanced stage and CDK2 overexpression. When CDK2 and PCNA were combined, the patients with both CDK2 overexpression and PCNA overexpression had a poorer overall survival. We concluded that the CDK2 overexpression may be associated with the malignant biological behavior of LSCCs.

Biomarkers, Tumor↗

PubMedDate not supplied

Splenectomy enhances liver regeneration through tumor necrosis factor (TNF)-alpha following dimethylnitrosamine-induced cirrhotic rat model.

BACKGROUND/AIMS: We demonstrated that partial splenic embolization for hematological disorders in cirrhotic patients also improved liver function. Therefore, we investigated the mechanism of the beneficial effects of splenectomy on a rat cirrhotic model. METHODOLOGY: 1) Rats were administered DMN (dimethylnitrosamine) after splenectomy (splenectomized DMN rats) or a sham operation (DMN rats). 2) After completion of DMN administration, a tumor necrosis factor-alpha inhibitor (E3330) was administered on the same day as the splenectomy. Histological examination and cytokine expressions were analyzed. RESULTS: The splenectomy apparently reduced liver damage. This may be partially due to the enhancement of liver regeneration since the proliferating cell nuclear antigen labeling index in the DMN-treated liver was significantly increased by splenectomy. Tumor necrosis factor-alpha was down-regulated in the DMN rats, whereas its expression was preserved in the splenectomized DMN rats. There were no apparent differences in the number of Kupffer cells between the splenectomized DMN and the DMN rats, suggesting that the down-regulation of tumor necrosis factor-alpha may contribute to the reduction of Kupffer cells' function. In addition, a tumor necrosis factor-alpha production inhibitor (E3330) significantly reduced the proliferating cell nuclear antigen labeling index after splenectomy. CONCLUSIONS: Splenectomy, in this model, may promote liver regeneration by preserving Kupffer cell function, especially the secretion of tumor necrosis factor-alpha.

Animals↗

PubMedDate not supplied

Comparison of screening methods for hepatocellular carcinomas in patients with cirrhosis.

To determine the most suitable screening methods for hepatocellular carcinomas (HCCs), we investigated 45 cases with HCCs. Ultrasonography, computed tomography (CT) scan and measurement of alpha-fetoprotein (AFP) were regularly performed. Thirty-two cases (72%) were detected initially by ultrasonography. Fourteen out of 23 cases (61%) with tumors 20 mm or less in diameter and 11 out of 12 cases (91%) with 21-30 mm tumors were detected initially by.ultrasonography. For the initial detection of tumors sized 20 mm or less, the mean interval of ultrasonography was 3.54 months, unlike the 5.67 months for tumors sized over 21 mm. There was no significant difference between tumor size and measurement interval in AFP levels or CT scan examinations. From these results, we suggest that a suitable screening schedule would be every three months by ultrasonography.

Aged↗

PubMedDate not supplied

Extraction methods for quantitation of gentamicin residues from tissues using fluorescence polarization immunoassay.

Sodium hydroxide digestion of unhomogenized kidney and skeletal muscle for 20 min at 70 degrees C was a superior method for extracting gentamicin from tissues, compared with simple homogenization, trichloroacetic acid precipitation of homogenized tissue, and sodium hydroxide digestion of homogenized tissue. Fluorescence polarization immunoassay was used to quantitate gentamicin. Sodium hydroxide digestion of unhomogenized tissue allowed for the recovery of 90.0 +/- 5.9% (means +/- SD) from renal cortex and 79.9 +/- 3.5% from skeletal muscle. The limit of sensitivity was 17.4 ng/g kidney tissue, 15.8 ng/g digested muscle, and 39.0 ng/g digested heart. The within-assay coefficient of variation (CV) at 100 ng/g kidney was 9.2%; at 500 ng/g kidney, the CV was 2.5%; and at 2000 ng/g kidney, the CV was 1.5%. The between-assay coefficient of variation was less than 7.5% for all concentrations from kidney, and the 99% confidence interval at 100 ng/g kidney was 71.7-112.4 ng gentamicin/g kidney. The within-assay coefficient of variation (CV) at 100 ng/g muscle was 15%; at 500 ng/g muscle, the CV was 2.6%; and at 2000 ng/g muscle, the CV was 2.3%. The between-assay coefficient of variation was less than 15% for all concentrations from muscle, and the 99% confidence interval at 100 ng/g muscle was 72.5-136.8 ng gentamicin/g muscle. Gentamicin-free milk could be distinguished from milk containing gentamicin concentrations of 10 ng/mL milk with 95% confidence, and from milk containing concentrations of 30 ng gentamicin/mL milk with 99% confidence. Quantitative results at or below the tolerance level can be obtained within 90 min of sample acquisition using these extraction and assay methods.

Animals↗

PubMedDate not supplied

New measurement of patellar height in the knees of children using the epiphyseal line midpoint.

The height of the patella was reevaluated by the ratio of the distance from the center of the patella to the epiphyseal line midpoint in the proximal tibia (PT) to that between the distances of the distal femur and of the proximal tibia (FT) on 59 knees of 36 normal children whose ages ranged from 3 to 18 years (average 10.6 years). The averaged ratio of PT to FT was 1.31 +/- 0.9 at full extension and gradually decreased to 0.99 +/- 0.06 at 90 degrees flexion. Changes in value were minimal within the range of 0.99-1.20 in the range of knee flexion from 30 to 90 degrees.

Adolescent↗

PubMedDate not supplied

A neurophysiological study among Chinese CS2-exposed workers.

A neurophysiological study was carried out to examine peripheral neurotoxicity of extremely low levels of CS2, that is, less than 2 ppm (TWA-8hr) among Chinese viscose rayon workers. From the subjects who participated in a 1981 cross-sectional medical survey, 70 male workers exposed to CS2 and age-matched unexposed workers were randomly selected for the present neurophysiological examination. The conduction velocities of motor, sensory and slower motor fibres of the right ulnar nerve were measured using the same methods as those in the study by Seppäläinen (1974). Skin temperature was measured at the middle of the volar surface of the right forearm with a Thermistor thermometer. According to an earlier occupational hygiene survey in the plant, current personal exposures determined by a passive dosimeter method were very low; the average of daily exposure of 7 jobs studied was 1.45 ppm (range 0.2-5.0). Past and current area sampling data also suggested that occupational hygiene conditions regarding CS2 exposure in the plant had been extremely good for the previous 6 years. The present neurophysiological study clearly showed that significant reduction in the conduction velocities of motor and slower motor fibres of the ulnar nerve was detected as a consequence of chronic exposure to low levels of CS2. In the previous cross-sectional medical survey, no retinopathy was found among Chinese workers exposed to CS2 at this level. These results suggested that an effect of CS2 on the peripheral nerve would appear earlier than that on the retina.

Adult↗

PubMedDate not supplied

MRI finding of chronic hemorrhagic empyema: a case report.

We report a case of 64-year-old man with chronic hemorrhagic empyema. T1- and T2-weighted MR images showed variably hyperintense areas in the tumor that reflected the presence of fresh and old hematoma. Gd-DTPA-enhanced MRI revealed capillary bleeding in the periphery of the mass.

Chronic Disease↗

PubMedDate not supplied

Reirradiation therapy for brain metastases from small cell lung cancer.

Three patients with recurrence of brain metastases from small cell lung cancer were treated with whole brain reirradiation therapy. A total dose of 20 Gy was administered to two patients with hyperfractionation (20 fractions) and to one with conventional fractionation (10 fractions). Two cases achieved PR and the other NC. Survival after reirradiation was four months for all patients. Two patients died of progressive brain metastases and one patient of liver metastases. No radiation injury was observed during follow-up. Whole brain reirradiation at a dose of 20 Gy in 10 or 20 fractions was therefore considered useful and safe for brain recurrence of small cell lung cancer.

Adult↗

PubMedDate not supplied

Long-term effect of prophylactic endoscopic injection sclerotherapy on liver function.

BACKGROUND/AIMS: The aim of this study was to investigate the long term effect of prophylactic endoscopic injection sclerotherapy (EIS) on liver function. METHODOLOGY: This study was a retrospective investigation of seventy-eight patients with liver cirrhosis, whose liver function was classified as Child's A before follow-up. Laboratory data were retrospectively examined before and after follow-up, and a comparison was made between the EIS group (n=21) and the non-treated group (n=57). RESULTS: In the 3 or more years of follow-up, cholinesterase and total cholesterol levels deteriorated in several severe-variceal cases. However, these levels did not deteriorate over the 3 or more years of follow-up in the EIS group. CONCLUSION: Prophylactic endoscopic injection sclerotherapy among patients with early stage LC may prevent the deterioration of liver function.

Aged↗