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K Sugimura

Publications and source records attributed to K Sugimura.

At least 199 records · Page 11Linked to original sources
PubMed1992

A critical evaluation of transvaginal Doppler studies, transvaginal sonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer.

OBJECTIVE: To evaluate whether transvaginal Doppler ultrasound is more valid than transvaginal sonography, magnetic resonance imaging (MRI), and CA 125 in differentiating malignant from benign ovarian tumors. METHODS: Sixty-three patients with ovarian tumors (36 benign and 27 malignant) were studied with transvaginal Doppler ultrasound before surgery. Blood flow velocity waveforms arising from intratumoral and/or tumor surface arteries were assessed by calculating the resistance index. Transvaginal B-mode sonography and MRI imaging examinations were also conducted. Serum CA 125 levels were measured. RESULTS: There was a significant difference between the resistance index value (0.692 +/- 0.188) in benign tumors and the value (0.503 +/- 0.107) in malignant tumors (P < .05). When 0.72 (mean of the malignant tumor resistance index values + 2 standard deviations) was considered as the cutoff value of the resistance index, the sensitivity and specificity of the resistance index in detecting malignant ovarian tumors were 92.6 and 52.8%, respectively. These values did not differ significantly from those with transvaginal sonography diagnosis (sensitivity 85.2%, specificity 69.4%). The resistance index sensitivity was significantly higher than those with MRI diagnosis (66.7%) and CA 125 levels (59.3%) (P < .05); however, the resistance index specificity was significantly lower than those with MRI diagnosis (97.1%) and CA 125 levels (91.7%) (P < .05). CONCLUSION: Our results suggest that transvaginal Doppler ultrasound does not provide more useful diagnostic information than transvaginal sonography, MRI, and CA 125 for the differentiation of malignant from benign ovarian tumors.

Adult↗
PubMed1992

[An autopsy case of chronic inflammatory demyelinating polyradiculoneuropathy with sever degeneration in the posterior column].

An autopsy case of chronic inflammatory demyelinating polyradiculoneuropathy was reported. It took a progressive course and terminated fatally in eight years. A 41-year-old man noticed motor disturbances when he tried to lift a bath pail and to write on July, 1978. Neurological examination revealed proximal dominant muscle atrophy, weakness of all extremities, and moderately diminished tendon reflex. Sensation was normal. The CSF showed albumin cytologic dissociations. Electromyogram showed neurogenic changes. Histological examination of biopsy specimen obtained from the anterior tibial muscle revealed severe neurogenic changes and showed axonal degeneration on the ventral tibial nerve. The treatment by corticosteroids was not effective, and the disease gradually progressed with repeated improvements and exacerbations. Three years after the onset, he showed vesicorectal dysfunctions. He died of respiratory failure on May, 1986. Neuropathological examination showed severe degeneration of middle root zones in the posterior columns, loss of myelinated fibers in Clarke's columns, demyelination and mild loss of axons accompanied by lymphocytic infiltration in the spinal roots, especially in the anterior roots. The histogram of cervical ventral root, ventral and dorsal roots of thoracic and lumbar regions revealed a decreased number of large myelinated fibers. A characteristic finding of this case was the dissociation of clinical features and neuropathological findings; the clinical features showed a typical motor neuropathy, but neuropathological examination showed severe degeneration on posterior columns of spinal cord like a sensory-ataxic neuropathy. Our observation suggest that the pathway which originates from posterior ganglion cells and runs into Clarke's columns passes through the middle root zones, since severe demyelination in Clarke's columns was observed.

Adult↗
PubMed1992

[Cerebrospinal fluid neuron-specific enolase (NSE) and S-100b protein in Guillain-Barré syndrome--their relations to prognosis].

We measured the cerebrospinal fluid (CSF) levels of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods in 12 patients with Guillain-Barré syndrome (GBS), and 46 control subjects, and evaluated their clinical values in relation to prognosis. The 4 patients with the remarkably elevated level of NSE or S-100b in the acute stage recovered slowly over 1 year after onset, while the 2 patients showed the normal NSE and S-100b levels and recovered within 4 months. In 6 patients, the NSE and/or S-100b were slightly or moderately increased in the acute stage. They recovered from 1.5 to 11 months after onset, and the two patients showing very early recovery have the remarkably increase of S-100b in the recovery stage. These results suggest that CSF NSE and S-100b may be useful biochemical markers for estimation of prognosis in GBS patients.

Adolescent↗
PubMed1992

[Importance of sperm morphology assessment in human in vitro fertilization].

Two hundred eighteen IVF cycles were analyzed in order to clarify the influence of the strictly normal morphology (SNM) of sperm on IVF outcome. SNM was defined according to Kruger et al.'s strict criteria (1988) with our modifications. IVF cycles were divided into 3 groups: %SNM greater than or equal to 40% (69 cycles), 40% less than %SNM greater than or equal to 12% (123 cycles) and %SNM less than 12% (26 cycles). The rates of embryo transfer and pregnancy per cycle and the rate of abortion per pregnancy in the three groups were as follows: 81%, 39%, 19% in %SNM greater than or equal to 40%; 71%, 24%, 30% in 40% greater than %SNM greater than or equal to 12%; and 58%, 7.7%, 50% in %SNM less than 12%. The pregnancy rate per cycle significantly decreased as the %SNM decreased (p less than 0.01), and there was a tendency toward an increase in the abortion rate per pregnancy as the %SNM decreased. The results suggest that %SNM is a useful parameter to use in predicting the IVF outcome.

Abortion, Spontaneous↗
PubMed1991

Ovarian chocolate cyst with markedly elevated serum CA19-9 level: a case report.

We report a patient with ovarian chocolate cyst with an abnormally high serum CA19-9 level (2380 U/ml) in whom MRI (Magnetic Resonance Imaging) was especially useful for the diagnosis. CA19-9 was detected in the epithelium of the chocolate cyst by the immunohistochemical technique, but it was not detected in the endometrium and adenomyotic tissue of the uterus. Twelve weeks were needed for normalization of the serum level of CA19-9 after operation.

Adult↗
PubMed1991

[Low flip-angle spin-echo imaging of the liver. Basic study and its application to hepatic space-occupying lesions].

Dependence on T1 contrast can be reduced by changing the excitation flip angle. Low flip-angle spin-echo imaging can reduce imaging time because repetition time (TR) is reduced. The authors assessed the efficacy of low flip-angle spin-echo images in phantoms and in liver. MR phantoms made from polyvinyl alcohol gel to model the properties of normal liver, HCC, and hemangioma were scanned with various flip angles at TR 2400 and 1200 msec. Measured signal intensities fitted well with theoretical values. The T1 contrast of signal intensity decreased as the flip angle was reduced, accompanied by a decrease in signal-to-noise ratio (S/N). Thirty patients with hepatic space-occupying lesions (23 with HCC, three with metastases and four with hemangioma) were studied by conventional SE (CSE) at 2400/60/2 (TR/TE/NEX [number of excitations]) (10 min 46 sec imaging time) and low flip-angle SE (LFSE) at 1200/60/30 degrees/2 (TR/TE/FA/NEX) (5:20) and/or 1200/60/30 degrees/4 (10:18). The sensitivity of CSE in detecting lesions was 93% (44/47). It was 92% (35/38) for LFSE with two NEX and 94% (34/36) for LFSE with four NEX pulse sequences. The contrast-to-noise ratio (C/N) for images (HCC/liver, hemangioma/liver) obtained by LFSE with four NEX was significantly higher than that for those obtained by CSE (4.8 vs 3.5, p less than 0.01; 13.4 vs 9.7, p less than 0.01, respectively). Although the C/N (lesion/liver) for LFSE with two NEX sequences was lower than that of CSE for any type of lesion (3.0 vs 3.5 for HCC; 5.1 vs 6.3 for metastases; 8.3 vs 9.7 for hemangioma), the difference was not significant. Although reducing the flip angle from 90 degrees to 30 degrees with two NEX resulted in a decrease in S/N (10.7 to 8.9 for HCC; 15.3 to 11.9 for metastases; 20.0 to 18.1 for hemangioma; 7.4 to 6.3 for normal liver; 10.7 to 10.1 for spleen), the difference was not significant. For hepatic space-occupying lesions, low flip-angle spin-echo imaging is useful to obtain T2-weighted images in a shorter imaging time without sacrificing lesion detectability.

Adult↗
PubMed1991

[Normal female urethra and paraurethral structure--evaluation with MR imaging].

The appearance of the normal female urethra on magnetic resonance (MR) images was studied in 40 patients by means of a 1.5 Tesla unit. Morphologic characteristics and anatomic details of the urethra and pubourethral ligament were demonstrated in each patient. MR imaging depicted an outer muscle layer of low signal intensity. Medial to the outer muscle layer, the submucosa was seen as a high-signal-intensity ring, followed by an inner low-signal-intensity ring. In the mid-urethra, a central high-signal-intensity spot was seen in 38% of cases, a finding that may be related to urine and mucus within the mucosal cells. The zonal anatomy of the female urethra was obscure in the over 60 years of age. MR imaging is an excellent tool for demonstrating female urethral anatomy.

Adolescent↗
PubMed1991

Nerve regeneration in rat composite-tissue allografts.

Reinnervation of composite-tissue allografts was examined in a rat hind-limb transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of animals were studied. Group 1 consisted of 10 composite-tissue allografts using inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors. Recipient animals received 15 mg/kg/day CyA subcutaneously for three weeks and then twice weekly for three months. Group 2 consisted of 10 composite-tissue isografts undergoing no immunosuppression, and using F344 as both donors and recipients. Eight months after operation, electromyographic, histologic, and morphometric assessments of nerve regeneration were made. There were no significant electromyographic differences between these two experimental groups in amplitude and conduction velocity, but the levels were lower than in controls. The histologic patterns of nerve regeneration within the composite-tissue transfers were similar in the two groups. However, the fiber population in the regenerated nerves in the two groups was different from that in the normal sciatic nerve. This study confirmed the reinnervation of composite-tissue allografts under CyA immunosuppression. The quality of regeneration in allografts was similar to that in isografts, but the histologic and electromyographic properties of regenerated nerves were different from those of normal sciatic nerves.

Animals↗
PubMed1991

Sperm morphological assessment based on strict criteria and in-vitro fertilization outcome.

One-hundred-and-twenty-three in-vitro fertilization (IVF) cycles were analysed in order to clarify the influence of strictly normal morphology (SNM) of spermatozoa on IVF outcome. SNM was defined using strict criteria according to Kruger with our modifications. The IVF cycles studied were divided into three groups: %SNM less than 12% (13 cycles), 12 less than 40% (68 cycles), greater than or equal to 40% (42 cycles). The cleavage rates per oocyte were higher in the groups with 12-40% and greater than or equal to 40% of %SNM than in the group with %SNM less than 12%. The embryo transfer rate per cycle increased with increasing %SNM. The overall pregnancy rate per cycle increased with increasing %SNM (7.7% in %SNM less than 12%, 22.1% in 12-40% of %SNM, and 40.5% in %SNM greater than or equal to 40%). The ongoing pregnancy rate per cycle also increased with increasing %SNM (7.7% in %SNM less than 12%, 14.7% in 12-40% of %SNM, and 31.0% in %SNM greater than or equal to 40%). The miscarriage rate was lower in %SNM greater than or equal to 40% (23.5%) than in 12-40% of %SNM (33.3%). It was suggested that %SNM is a good predictor of IVF outcome.

Abortion, Spontaneous↗
PubMed1991

Modified PCR-RFLP method for HLA-DPB1 and -DQA1 genotyping.

We previously developed a new technique for HLA class II genotyping by digestion of polymerase chain reaction-amplified genes with restriction endonucleases (PCR-RFLP method). This PCR-RFLP method is an efficient and convenient typing technique for class II alleles. However, small fragments or bands located close to each other on polyacrylamide gels sometimes prevent precise analysis of the RFLP bands. Furthermore, the restriction enzymes we have reported in the previous papers are not sufficient to identify the genotypes of all heterozygous individuals. Here, we report an improved PCR-RFLP method using some informative restriction enzymes which have either a single cleavage site or, alternatively, no cleavage site in the amplified DNA region, depending on the HLA alleles, making reading of RFLP band patterns much easier. Each second exon of the HLA-DQA1 or -DPB1 gene was selectively amplified from genomic DNAs of 70 HLA-homozygous B-cell lines and 100 healthy Japanese by PCR. Amplified DNAs were digested with restriction endonucleases and then subjected to electrophoresis assaying simply for cutting, or no cutting, of the DNA. ApaLI, HphI, BsaJI, FokI, MboII and Mn1I can discriminate eight alleles of the DQA1 gene. Similarly 19 alleles of the DPB1 gene can be discriminated with Bsp1286I, FokI, DdeI, BsaJI, BssHII, Cfr13I, RsaI, EcoNI, and AvaII enzymes. This modified PCR-RFLP method can be successfully applied to heterozygotes. Thus, the method is technically simpler and more practical for routine HLA typing work than our previous PCR-RFLP method.

Alleles↗
PubMed1991

[A family with autosomal dominant hereditary myoedema, muscular irritability, stiffness and hypertrophy].

A familial case with autosomal dominantly transmitted myoedema, muscular irritability, stiffness and hypertrophy was reported. The patient is 54 years old and his father, two sisters and niece had suffered from the similar symptoms. He had noticed a feeling of stiffness and pain in the femoral muscles after several minutes of erect position from the age of 5-6 years. He had observed that light tapping of muscles caused a bulge which persisted for several seconds in the whole body. These symptoms were not progressive. The patients had an athletic appearance, hypertrophy of gastrocnemius muscles, pes cavus and hammer toes. Mild muscular weakness and wasting were noted in the intrinsic hand muscles and the anterior tibial muscles. Myoedema was seen in the muscles of the whole body. His thyroid functions were normal. EMG studies showed no myotonic discharges. Light microscopy of biopsy specimens from the biceps brachii muscle showed unspecific myopathic changes. Electron microscopy showed many vacuoles between myofibrils. The symptoms and signs of this case are very like to those of the cases which Torbergsen described in 1975 and only four families were reported after that. The family presented here is the first report in Japan.

Edema↗
PubMed1991

Role of Ca2+/H+ antiporter in the kidney.

Three different mechanisms for H+ transport mediated by Ca2+ have been reported. First is an ATP-dependent Ca2+/H+ antiporter which is catalyzed by (Ca2+ + Mg2+)-ATPase in plasma membrane. Second is a compensatory Ca2+ movement associated with an ATP-dependent H+ pump catalyzed by H(+)-ATPase in endosome. Third is a mitochondrial Ca2+ movement driven by an electrophoretic H+ driving force. All these processes must play a critical role on transfering messages between Ca2+ and H+. Data indicate that an ATP-dependent Ca2+ pump is an electroneutral Ca2+/H+ antiporter in renal tubular cells as well as in other nonrenal cells. The existence of this process is compatible with the physiological phenomena of Ca2+ and H+ transport in renal tubules, although we still lack direct evidence to comprehend the role of the Ca2+/H+ pump in the kidney.

Acids↗
PubMed1991

[A new criterion for hCG administration in human IVF programs: importance of serum LH levels].

A new, simple criterion for hCG administration to induce ovulation for IVF is described. Serum LH levels were measured daily, and hCG was administered, independent of follicle size or estradiol levels, the night of the day when the LH level first exceeded the J level, defined as the minimum value + (the day 3 value-the minimum value) x 1/3. Based on this hCG criterion, the total and ongoing pregnancy percentages per cycle were 35% and 27%, respectively. It appears that the pregnancy rate decreases when hCG is administered one day before or one day after the criterion is met. Pregnancies resulting from hCG administration based on the criterion had a wide range both of dominant follicle diameter (14-21 mm) and estradiol level (229-2,050 pg/ml). The serum LH level is recommended as a useful parameter in timing hCG administration for IVF.

Chorionic Gonadotropin↗
PubMed1991

[Bone infarction and fat island appearing as local defects in radionuclide bone marrow imaging].

Parallel studies of radionuclide bone marrow imaging and bone scanning are helpful in the early diagnosis of skeletal metastasis. In bone marrow imaging, most lesions are observed as a local defect. We had two cases of nonmetastatic lesions which appeared as local defects in bone marrow imaging. The first case was a male Hodgkin's disease patient, aged 48, who had been treated with frequent chemotherapy, including the administration of a large quantities of steroids. He complained of slight pain in the left shoulder. Without increased uptake in bone scanning, abnormal accumulation of 67Ga-citrate and a local defect in bone marrow imaging appeared, corresponding to localization of the pain. Suspecting bone marrow metastasis, we performed magnetic resonance imaging (MRI). An area of slightly decreased intensity in T1-weighted spin-echo images and lower intensity than fat tissue in T2-weighted images were observed, although it was slightly enhanced by Gd-DTPA. This lesion was diagnosed by biopsy as a bone infarction. The second case was that of a 69-year-old male lung cancer patient. Though no abnormality was revealed by bone scanning or 67Ga-citrate scintigraphy, an apparent defect at the 10th thoracic vertebra was observed in bone marrow imaging. It was not accompanied by pain. MRI was also performed in this case. This was depicted as a clearly defined high intensity area. This was diagnosed as a fat island, and no change has been seen in the seven months of follow up. In conclusion, it is necessary to consider the possibility of nonmetastatic lesions, when local defects appear in bone marrow imaging performed on cancer patients.

Adipose Tissue↗
PubMed1990

[Post radiation changes in the rectum: assessment by MR imaging].

MRI findings of pelvic radiation changes in 42 patients were correlated with the tumor and critical tissue dose, time post treatment, and clinical symptoms. The severity of tissue changes was graded. The ability of MRI to differentiate post radiation tissue changes from residual or recurrent tumor was also correlated. Radiation tissue toxicity increased significantly when the dose exceeded 4,500 cGy, with the incidence of marked rectal changes rising from 8% to 44% with a dose greater than 4,500 cGy. All grades of tissue change were seen in the rectum of time from start of therapy. All patients who exhibited clinical grade 2 or 3 rectal changes showed moderate or severe changes on MRI. Grade 1 MRI changes indicative of mucosal edema were present in 33% of patients with no clinical symptoms. In conclusion, the gradation and sequence of MRI changes following radiation therapy to the pelvis have been documented and correlated with clinical findings. With its potential for distinguishing radiation change from recurrent tumor. MRI should prove to be of value in the assessment of the post-radiation pelvis.

Adult↗