Biomedical subjects

K Sugimura

Publications and source records attributed to K Sugimura.

355 records · Page 20Linked to original sources

PubMedDate not supplied

Magnetic resonance imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism.

PURPOSE: Percutaneous ethanol injection therapy (PEIT) of the abnormal parathyroid gland is an effective treatment in patients with chronic renal failure with dialysis that tends to be unresponsive to medication. To evaluate the efficacy of PEIT, we investigated the correlation between serum intact PTH (iPTH), and the findings of MR imaging and 99mTc-MIBI scintigraphy. MATERIALS AND METHODS: PEIT was performed 32 times in 24 patients with secondary hyperparathyroidism. Both MR imaging and MIBI scintigraphy were performed before and after PEIT. The detectability of parathyroid lesions was evaluated by MRI and MIBI scintigraphy with reference to ultrasound (B-mode) findings (as a standard) and the comparison of each treatment was done between imaging changes and serum iPTH levels. RESULTS: In the small parathyroid glands (< 0.5 ml with US), MR images detected abnormal glands in 74.0% (20/27), and MIBI accumulation was observed in 40.7% of the cases. Whereas, MR images and MIBI showed similar detectability (95.0% vs. 90.0%) to large parathyroid glands (> or = 0.5 ml with US). After PEIT, glands in which ethanol was successfully injected showed decreased signal intensity on T2-weighted images and decreased accumulation of MIBI. MR imaging and MIBI scintigraphy showed almost equivalent high sensitivity in evaluating therapeutic changes (73.3% vs. 76.4%) according to our evaluation category of more than 30% reduction of iPTH as effective. However, the specificity of MR imaging was much higher (100%) than that of MIBI scintigraphy in evaluating therapeutic effects. CONCLUSION: In conclusion, MRI provided better detectability of abnormal parathyroid glands than 99mTc-MIBI scintigraphy. The reduction of high signal intensity area after PEIT on T2-weighted MR images is considered an useful therapeutic evaluation guideline than the reduction of MIBI accumulation on scintigraphy.

Adult↗

PubMedDate not supplied

Squamous cell carcinoma of the external auditory canal: two cases treated with high dose rate 192Ir remote afterloading system (RALS).

We report two cases of early-stage external auditory canal cancer treated by intracavitary irradiation with a high dose rate (HDR) 192Ir remote afterloading system (RALS) for preoperative treatment. A 6-Fr catheter for the HDR 192Ir remote afterloader, fixed by a plastic earplug, was inserted into the external auditory canal in two cases (case 1, T2N0M0; case 2, T1N0M0). The total intracavitary radiation dosages were 50 Gy (10 Gy/2 Fr/wk for 5 wks) for case 1, and 42 Gy (15 Gy/5 Fr/wk for 3 wks) for case 2. No external irradiation was given in either case. Surgical resection was performed in both cases, three to four weeks after irradiation. Histopathological examination confirmed the post-irradiation changes of necrosis, hyalinosis, and calcification, although vivid cancer cells remained. In preoperative irradiation of external auditory cancer, this method, although limited to treating early-stage cancers, may be a modality of choice for its efficacy and less severe side effects.

Brachytherapy↗

PubMedDate not supplied

TNF alpha, IL-1 beta and IL-6 production by peripheral blood monocytes in patients with renal cell carcinoma.

Renal cell carcinoma (RCC) has been shown to be immunologically more labile than other types of cancer. In this study, we examined tumor necrosis factor alpha (TNF alpha), interleukin-1 beta (IL-1 beta) and interleukin-6 (IL-6) production of peripheral blood monocytes in 38 RCC patients. Monocytes were isolated from peripheral blood mononuclear cells by adherence to a plastic dish and cultured with lipopolysaccharide for 24 hours. The culture supernatant was obtained, and the production of TNF alpha, IL-1 beta and IL-6 was measured by ELISA. As a result, TNF alpha and IL-1 beta production was significantly higher in the high stage patients compared to the control subjects and low stage patients. When the patients were divided according to serum C-reactive protein (CRP), TNF alpha, IL-1 beta and IL-6 production was significantly higher in the CRP-positive patients compared to the control subjects and the CRP-negative patients. Overexpression of these cytokines may therefore induce a hypermetabolic status that may be a cause of malnutrition and cancer cachexia.

Blood Cell Count↗

PubMedDate not supplied

Detection of minute pleural fluid in the pleural retracted space associated with peripheral lung cancer: evaluation with MR imaging.

PURPOSE: To evaluate the efficacy of magnetic resonance imaging (MRI) in detecting minute pleural fluid in the pleural retracted space (PRS) associated with peripheral lung cancer. MATERIALS AND METHODS: Our subjects were 20 patients with peripheral lung cancer in whom thin-section CT in the lung window setting demonstrated lesions adjacent to the pleural surface, and who were referred for MR imaging. The imaging findings were retrospectively evaluated and correlated with the histopathologic specimens. Pleural fluid was aspirated for cytology under ultrasound (US) guidance in six patients. RESULTS: STIR MR images revealed water SI areas beneath the chest wall associated with the lung cancer, whereas, on CT images, lung cancer and minute pleural fluid in the PRS showed similar soft-tissue density without enabling easy differentiation. Two of the six patients who underwent aspiration cytology showed malignancy. All histopathologic specimens obtained from 18 patients who underwent surgery showed pleural retraction corresponding to the water SI areas on STIR images. Histopathological study revealed that the fibrotic focus of the tumor tended to occur more intensively when the shape of pleural retraction was thinner and deeper. CONCLUSION: Water SI areas on STIR images were thought to suggest pleural fluid retention in the PRS. MRI was sensitive in detecting minute pleural fluid in the PRS and may help to avoid overdiagnosis of chest wall invasion induced from peripheral lung cancers.

Adult↗

PubMedDate not supplied

Comparison of MR imaging and urodynamic findings in benign prostatic hyperplasia.

OBJECTIVE: In benign prostatic hyperplasia (BPH), it is uncertain whether the size of the prostate is related to the degree of urodynamically demonstrated bladder outlet obstruction. We compared MR imaging findings and urodynamic data in patients with surgically confirmed BPH. MATERIALS AND METHODS: We prospectively studied 43 benign prostatic hyperplasia (BPH) patients in whom transurethral resection of the prostate (TURP) was planned. We obtained T1- and T2-weighted images in the transverse and sagittal planes with a 1.5 Tesla superconducting unit. The predicted volume of the inner gland and the peripheral zone were obtained on T2-weighted transverse images. Prostatic protrusion into the urinary bladder (IB protrusion) and the inner gland ratio (IG ratio: inner gland volume/total prostatic volume) were determined. RESULTS: IB protrusion and inner IG ratio were significantly greater in patients with severe stenosis than in those without. A surgical capsule (SC) was seen in 20 of 25 patients (80%) with severe stenosis and 8 of 18 (44%) of those without it. The accuracy of IB protrusion + IG ratio, IB protrusion + surgical capsule, and IB protrusion + IG ratio + surgical capsule was 89%, and that of IG ratio + surgical capsule was 86%. CONCLUSION: The inner gland ratio, protrusion into the bladder, and presence of surgical capsule were the most important factors in bladder outlet obstruction. The probability of outlet stenosis increases in patients with more than two of these criteria.

Aged↗

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

Diagnosis of chest wall invasion by lung cancer: useful criteria for exclusion of the possibility of chest wall invasion with MR imaging.

PURPOSE: To compare the accuracy of thin-section CT, conventional static MR imaging (conventional MRI), and breathing dynamic echo planar magnetic resonance imaging (BDEPI) in evaluating lung cancer invasion to the chest wall. MATERIALS AND METHODS: Thin-section CT, conventional MRI, and BDEPI were performed preoperatively in 20 patients suspected of having primary lung cancers adjacent to the chest wall on conventional CT. The results of imaging findings were compared with those of surgical and histopathological findings. RESULTS: All patients were confirmed to have no chest wall invasion after surgery. By thin-section CT, 10 of 20 patients were correctly diagnosed as having no chest wall invasion (50% specificity). Two of the 20 patients were incorrectly diagnosed as having chest wall invasion by conventional MRI and BDEPI (90% specificity). CONCLUSION: When chest wall invasion is suspected on CT scans, static and breathing dynamic MRI are recommended to avoid false positive interpretations.

Adenocarcinoma↗

PubMedDate not supplied

Topical contrast-enhanced magnetic resonance dacryocystography.

PURPOSE: To evaluate the usefulness of magnetic resonance dacryocystography (MRD) with topical administration of normal saline solution and diluted Gd-DTPA solution for the assessment of lacrimal outflow disorders. MATERIALS AND METHODS: Two T2-weighted sequences and two T1-weighted sequences were evaluated in this study. The 1:100 diluted Gd solution was prepared by diluting Gd-DTPA (Magnevist) with normal saline solution. A phantom study using tube phantoms of various diameters filled with normal saline solution and 1:100 diluted Gd solution was performed. A preliminary study was performed in ten normal volunteers. Eighteen patients with lacrimal outflow disorders underwent clinical MRD, and 14 also underwent conventional dacryocystography (CDG). MRD images were evaluated and compared with clinical symptoms and CDG images. RESULTS: In all sequences, MRD could visualize the full length of 0.7 to 1.7 mm diameter tube phantoms and could show all of the normal lacrimal sacs and nasolacrimal ducts. In the clinical study, MRD findings were compatible with the symptoms in 14 patients but were not compatible with CDG findings in half of the cases. CONCLUSION: Topical contrast-enhanced MRD provided a simple, non-invasive means of obtaining detailed morphological and functional information on the lacrimal drainage apparatus.

Aged↗

PubMedDate not supplied

Cell type-specific expression of the human renin gene.

We have previously produced transgenic mice carrying the human renin gene, whose expression is regulated in a tissue-specific manner. In the present study, we further characterized expression of the transgene. Northern blot analysis showed that the human renin gene is expressed in the kidney but not in the liver of two lines of transgenic mice with 10 and 50 copies of the transgene, suggesting that the integrated copy number of the human renin gene does not influence the dominant-renal expression pattern. Immunohistochemical study using a monoclonal antibody specific for human renin demonstrated that expression of human renin in the transgenic mouse kidney is confined to the epithelioid juxtaglomerular cells. Transfection experiments indicated that the chloramphenicol acetyltransferase fusion gene containing the 3-kb upstream sequences of the renin gene is activated only in human epithelioid embryonic 293 cells derived from kidney but not in human HepG2 cells from liver. These findings suggest that transfer of the cloned renin gene into mice and in vitro cultured cell lines can give rise to cell type-specific expression.

Animals↗

PubMedDate not supplied

Use of the C64 quantitative tuning fork and the effect of niceritrol in diabetic neuropathy.

We investigated the usefulness of the C64 quantitative tuning fork in assessing vibratory sensation in patients with diabetic neuropathy. The vibratory sensation scores determined by using the C64 quantitative tuning fork were significantly correlated with severity of subjective symptoms of numbness, cold, desensitization, spontaneous pain in the upper and lower extremities, and vertigo, as well as measurements of neurologic function (threshold of vibratory sensation, the coefficients of variation of the R-R intervals of the electrocardiogram at rest, and the motor nerve conduction velocity [MNCV] of the lower extremities; P < 0.05 to 0.01). Subsequently, we evaluated the effects of niceritrol on neurologic function in the same patients by using the C64 quantitative tuning fork, other neurologic function tests, and the change in severity of subjective symptoms before and after therapy. Niceritrol significantly improved measures of neurologic function (vibratory sensation scores, MNCV of the upper extremities, and sensory nerve conduction velocity of the lower extremities; P < 0.05 to 0.001), and subjective symptoms (numbness, cold, desensitization, and spontaneous pain in the lower extremities; P < 0.01 to 0.001). Our results suggest that the C64 quantitative tuning fork is a convenient and objective tool for assessing the severity of diabetic neuropathy and that niceritrol is useful for the treatment of this disease.

Blood Glucose↗

PubMedDate not supplied

Histopathology of uterine cervical carcinoma: diagnostic comparison of endorectal surface coil and standard body coil MRI.

OBJECTIVE: We compared body coil (BC) MR images and endorectal surface coil (ERC) images with respect to the visualization of the cervix and adjacent tissues and the histopathologic correlations of the imaging findings. MATERIALS AND METHODS: Twenty-one patients with cervical carcinoma underwent MRI using both coils for evaluation of the cervix and adjacent tissues. In all patients, surgical confirmation of the diagnosis was obtained after imaging. RESULTS: The ERC images were superior to BC images for visualization of the cervix, parametrium, anterior vaginal wall, and posterior bladder wall (p < 0.005). The accuracy of detecting parametrial invasion by ERC and BC imaging was, respectively, 95 and 79% (p < 0.05), while the differences of accuracy between BC and ERC imaging were not statistically significant in staging or in assessing for invasion to corpus, vagina, bladder, and rectum. All the false-positive sites of parametrial invasion on BC images were diagnosed correctly on ERC images. CONCLUSION: Endorectal surface coil imaging is useful in assessing the extent of cervical carcinoma, especially parametrial invasion, because it can delineate the tumor and the normal tissues in detail.

Adult↗

PubMedDate not supplied

A simple and efficacious criterion based on serum LH levels to time hCG administration for human in vitro fertilization.

OBJECTIVE: To test the efficacy of a simple criterion--LH level--for administration of hCG in an IVF program. DESIGN: Prospective, with retrospective analysis of other criteria for hCG administration. SETTING: University hospital IVF program. PATIENTS AND INTERVENTIONS: Eighty-four patients, in 110 cycles, were given 150-300 IU at 10-11 A.M. daily beginning on day 3 of the cycle. Serum LH measured daily 8:30-9:30 A.M., hCG administered on night of day LH level first exceeded J, defined as minimum value + (day 3 value-minimum) x 1/3. OUTCOME MEASURES: Pregnancy (after IVF + ET); serum concentrations of estradiol and LH. RESULTS: Total and ongoing pregnancy per cycle: 35% and 27% respectively. If hCG is administered one day early or late by the J criterion, the pregnancy rate is reduced. CONCLUSIONS: Pregnancies occurred over wide follicle diameter (14-21 mm) and estradiol level (229-2,050 pg/mL) ranges. LH is recommended for timing hCG administration.

Chorionic Gonadotropin↗