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Biomedical subjects

K Sugimura

Publications and source records attributed to K Sugimura.

At least 145 records · Page 8Linked to original sources

[Prostate and prostatic carcinoma: comparison of gadolinium-enhanced MR images and histopathologic findings].

The purpose of this study was to determine the patterns of enhancement in normal prostate, and to compare them with the enhancement patterns and histopathologic findings in patients with prostatic carcinoma. Seventeen patients who had no urogenital disease and 27 who underwent radical prostatectomy or prostatic biopsy were included in this study. All patients were evaluated with T1-, T2-weighted and gadolinium-enhanced T1-weighted images. With gadolinium enhancement the inner gland showed more enhancement than the peripheral zone in the normal prostate. The carcinoma tissue was enhanced more than the peripheral zone in 13 patients, about the same as the peripheral zone in 11 patients, and less than the peripheral zone in three patients. The three patients whose cancer tissue demonstrated no enhancement had poorly differentiated adenocarcinoma of the solid type. In conclusion, gadolinium-enhanced T1-weighted imaging is not reliable for routine use in MR imaging of the prostate, but may be useful to evaluate histologic types in patients with prostatic carcinoma.

Adolescent↗

Study of cytokines in ulcerative colitis.

We investigated the lymphocyte-activation antigens and the expression of cytokine genes in the mucosa of ulcerative colitis (UC). Fresh colonic mucosal biopsy specimens from patients with UC and controls were fixed for the immunohistochemical study of CD4, HLA-DR, and CD25, and other specimens were prepared for the RNA analysis of cytokines. Gene expression was evaluated by the reverse transcription-polymerase chain reaction, and the radioactivity of dot-blotted amplified cDNA was standardized by co-amplified beta-actin cDNA. The inflamed mucosa of active UC showed increased CD4+DR+ and CD25+ cells in comparison with control subjects. Active UC showed significantly increased mRNA expression of IL-1 beta, IL-2R alpha, IL-6, IL-8, and TNF alpha compared with the controls. We found no significant difference in the mRNA expression for IL-2, IL-4, IL-10, and IFN-gamma between active UC and controls. Increased CD4+DR+ and CD25+ cells in active UC mucosa indicate mucosal CD4(+) T cell activation in the lamina propria, but we did not clarify Th1 or Th2 specific T cell activation from our study of cytokine mRNA expression. The increased mRNA expression for IL-1 beta, IL-6, and TNF alpha in the mucosal lesions of UC indicates that these inflammatory cytokines may play important roles in the pathogenesis of UC.

Biopsy↗

[Role of CT in patients with prostatic disease: usefulness of depiction of prostatic zonal anatomy].

The purpose of this study was to evaluate the role of CT in patients with and without prostatic disease. CT and MR findings were reviewed in 25 patients without known prostatic disease, 11 patients with benign prostatic hyperplasia and 11 patients with prostatic cancer. Differential attenuation allowed for distinction of the peripheral zone and inner gland of the prostate by CT in 72% of normal patients. The distinction rate of prostatic zonal anatomy by CT decreased to 30% in the diseased group. When zonal anatomy of the prostate is not visualized on pelvic enhanced CT, the presence of prostatic disease might be considered.

Adolescent↗

T1-weighted images with ECG gating using partial flip angle spin-echo imaging.

ECG-gated spin-echo imaging can reduce vascular artefacts compared with spin-echo scans without gating. However, this method produces poor T1-weighted images because the repetition time (TR) is limited by the heart rate. We investigated the value of low flip angle spin-echo imaging for increasing T1-dependent contrast when using ECG gating. Using computer simulation, the predicted contrast increased with decreasing the flip angle, and the effect was almost saturated at a flip angle of around 40 degrees. With the application of this flip angle, the identical image contrast as a T1-weighted image (TR = 400 ms) can be obtained within the heart rate range of 65 to 75 beats/min. For clinical evaluation, the tissue contrast index values ((signal intensity in the lesion-signal intensity in the muscle)2 x 100/signal intensity in the muscle) obtained by conventional spin-echo and low flip angle spin-echo imaging were compared in 17 patients. The contrast index of low flip angle spin-echo images (74.0 +/- 52.0) was significantly higher than that of conventional spin-echo images (40.9 +/- 35.9). Thus, ECG-gated low flip angle spin-echo imaging provided better T1-dependent contrast than conventional ECG-gated spin-echo imaging. This method may be especially useful for Gd-DTPA-enhanced magnetic resonance imaging.

Aged↗

Diagnosis of pelvic endometriosis by magnetic resonance imaging using "fat-saturation" technique.

OBJECTIVE: To assess the usefulness of fat-saturated magnetic resonance (MR) imaging for detecting small endometrial implants. DESIGN: Prospective evaluation by conventional and fat-saturated MR imaging. SETTING: Shimane Medical University Hospital, Izumo, Japan. PATIENTS: Fifty-one consecutive patients with clinically suspected pelvic endometriosis. INTERVENTIONS: Magnetic resonance images < 2 weeks before laparoscopy or laparotomy. MAIN OUTCOME MEASURE: The location, number, and size of lesions. RESULTS: Surgery revealed a normal pelvis in 5 patients, endometriosis in 44 (42 with pigmented lesions and 2 with nonpigmented lesions and adhesions), and other cystic lesions in 2. With fat-saturated MR imaging, overall sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 71%, 95%, and 50%, respectively. At surgery, 122 pigmented lesions of endometriosis were detected. Conventional MR images indicated lesions of endometriosis in 74. When fat-saturated images were used, 103 lesions were detected. With conventional MR images, only one of 34 small endometrial implants (2 to 3 mm in diameter) was detected. However, the addition of fat-saturated images increased the detection rate to 15 of 34, and all lesions > 4 mm in diameter. CONCLUSION: Conventional MR imaging for detecting small endometrial implants was improved by addition of the fat-saturation technique. Therefore, fat-saturation MR imaging is an acceptable for detecting small endometriomas.

Adipose Tissue↗

Prediction of effectiveness of intraperitoneal chemotherapy by intraperitoneal scintigraphy in patients with advanced ovarian carcinoma.

Intraperitoneal scintigraphy with Tc-99m MAA was performed in nine patients with carcinomatous peritonitis secondary to ovarian or tubal carcinoma. Tc-99m MAA (370 MBq) and NaCl was delivered through an implantable injection port. For patients with good diffusion on intraperitoneal scintigraphy, intraperitoneal chemotherapy was effective. However, for patients with only local diffusion, intraperitoneal chemotherapy was not effective. Intraperitoneal scintigraphy can predict the effectiveness Intraperitoneal scintigraphy can predict the effectiveness of chemotherapy through the implantable injection port.

Adult↗

Benign prostatic hyperplasia: value of MR imaging for determining histologic type.

PURPOSE: To assess the value of magnetic resonance (MR) imaging for determining the histologic type of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Unenhanced T1- and T2-weighted images and gadolinium-enhanced T1-weighted images were obtained in the transverse plane at 1.5 T in 33 patients with BPH. Hyperphasia was classified as stromal or nonstromal. Nonstromal hyperplasia was diagnosed if (a) the nodules in the inner gland had heterogeneous high signal intensity on T2-weighted images and peripheral enhancement on gadolinium-enhanced images, (b) a surgical capsule was present, or (c) the inner gland volume to total volume ratio was greater than 0.75. RESULTS: A correct diagnosis was made with MR imaging in 23 of 24 patients with nonstromal hyperplasia and eight of nine with stromal hyperplasia (94% accuracy). In nonstromal hyperplasia, nodular lesions were seen in 20 patients and a surgical capsule was seen in 19. Eighteen patients had a transition zone ratio greater than 0.75. CONCLUSION: MR imaging appears to be useful for choosing the type of pharmacotherapy performed because accurate histologic assessment is possible.

Aged↗

Intrapelvic two-dimensional time-of-flight magnetic resonance angiography in healthy and diseased subjects.

We evaluated the use of magnetic resonance angiography (MRA) based on two-dimensional (2D) time-of-flight (TOF) technique in the pelvic vasculature. In the initial phase of this study, MRA was performed in 10 normal subjects for determination of the optimum imaging parameters. Systemically varied scan parameters included flip angle ranging from 20 degrees to 90 degrees by 10 degrees increments and repetition time (TR) of 30, 40, and 50 ms. The optimum imaging parameters for intrapelvic MR angiography were found to be flip angle of 90 degrees, pulse sequence of 30/4.9 (TR ms/TE ms). Using these imaging parameters, 70-100% of the second division branches of the internal iliac artery could be visualized in each subject. In the second phase of this study, we evaluated the use of MR angiography in patients with intrapelvic vascular disease by comparing its accuracy in evaluating the iliac arteries with that of conventional angiography. In patients with atheromatous disease, the MR angiographic determination was consistent with that of conventional angiography in 23 of 28 visualized arterial segments (82%). In eight lesions in patients with non-stenotic vascular disease or hypervascular pelvic tumours, all lesions were demonstrated clearly with MR angiography. 2D TOF technique with high flip angle excitation is suitable for the evaluation of main iliac branches and diseased vessels.

Adult↗

[Evaluation of the results of one session of extracorporeal shock-wave lithotripsy (ESWL) for a single urinary tract stone].

Fourteen hundred seventeen patients with a single stone under either general or epidural anesthesia were treated by one session of ESWL using the Dornier HM3 while 255 cases by one session of ESWL using the Dornier MPL9000 under no anesthesia but only with some analgesics, with 3 months' follow up available in all patients. The ratio of stone location in the kidney vs ureter was 7 to 3 in the Dornier HM3 and 5 vs 6 in the Dornier MPL9000. The overall success rate (stone free and residual stone fragments of less than 4 mm, 3 months after ESWL) was 58% (591 cases/1016 cases) for kidney stones with the Dornier HM3 and 35% (41/117) with the Dornier MPL9000. On the other hand, the overall success rate for ureter stones was 61% (245/401) with the Dornier HM3 and 70% (96/138) with the Dornier MPL9000. The overall success rate for stones of more than 10 mm, was poor when treated by the Dornier MPL9000 compared with the Dornier HM3.

Adolescent↗

Effect of an angiotensin II receptor antagonist, TCV-116, on rat carotid artery neointimal formation after balloon injury.

Arterial injury by a balloon catheter produces marked smooth muscle cell proliferation and the participation of angiotensin II in this response has been suggested. In this study, we examined the effect of a novel angiotensin II type I receptor antagonist, TCV-116, on neointimal formation after rat carotid artery balloon injury. Oral administration of TCV-116 at doses of 1, 5 or 10 mg/kg/day significantly reduced the cross-sectional intimal area by 30%, 46% and 54%, respectively, and reduced the ratio of the intimal to medial cross-sectional areas by 23%, 41% and 50%. An angiotensin-converting enzyme inhibitor, lisinopril, had an effect similar to that of TCV-116. The effect of both drugs was significantly correlated with the reduction of both blood pressure and cardiac hypertrophy. We conclude that TCV-116 can prevent neointimal formation after balloon injury as well as reducing blood pressure and preventing cardiac hypertrophy.

Angiotensin Receptor Antagonists↗

Inhibition of cultured leukemia cell growth by enhanced adriamycin cytotoxicity with reduction of glutamine or asparagine level in medium.

The effect of a singular amino acid, asparagine (Asn), glutamine (Gln), or proline deletion in a cultured medium (RPMI 1640 supplemented with 10% fetal calf serum and other ingredients) on adriamycin (ADR) cytotoxicity was evaluated in the growth of P388 murine leukemia cells and CEM human acute lymphoblastic leukemia cells over a 3 day period. No enhancement of ADR cytotoxicity was observed in the assay of IC50 values under the amino acid deleted condition. Singular deletion of Gln or Asn from ADR-free medium apparently inhibited the proliferation of both cells, i.e. both cell lines strongly require them. The cytotoxicity of 5 nM ADR was then examined in medium which included one or the other of them in stepwise levels varied at 80, 60, 40, 20 and 0% of the ordinary level. Change of Asn level caused a difference in ADR toxicity; also, the change of Gln level, especially the 60% level caused ADR toxicity of 5 nM, which is less than the IC50 value, in the proliferation of both cells. This suggested the usefulness of glutamine level modification on the enhancement of ADR cytotoxicity.

Animals↗

Prognostic value of cerebrospinal fluid neuron-specific enolase and S-100b protein in Guillain-Barré syndrome.

We measured the cerebrospinal fluid (CSF) concentrations of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods, in 24 patients with Guillain-Barré syndrome and 46 controls, and examined their prognostic values. Sixteen of 24 patients showed elevated levels (> the mean + 2SD levels of controls) of NSE, S-100b, or both, and in those with higher NSE or S-100b levels there was a rather longer duration of disease, whereas 8 patients with the normal levels showed an early recovery. Further, NSE or S-100b levels were significantly correlated with months to recovery. Thus, NSE and S-100b in CSF may be useful markers for predicting the outcome of Guillain-Barré syndrome.

Adolescent↗

Chimeric renin-angiotensin system demonstrates sustained increase in blood pressure of transgenic mice carrying both human renin and human angiotensinogen genes.

A reaction between enzyme renin and its only natural substrate angiotensinogen is the initial and rate-limiting step for producing a potent vasoconstrictor angiotensin II as the final product of the renin-angiotensin system, a contributory factor in the pathogenesis of hypertension. In order to assess the role of the interaction of human renin with human angiotensinogen in the development of high blood pressure, we have constructed the chimeric renin-angiotensin cascade in mice comprising both human renin and human angiotensinogen as well as the endogenous angiotensin-converting enzyme and angiotensin II receptor by cross-mating separate lines of transgenic mice carrying either the human renin or human angiotensinogen genes. Although each single gene carrier did not develop hypertension despite the observed normal tissue-specific expression of the transgenes, dual gene strains exhibited a chronically sustained increase in blood pressure. Administration of a human renin-specific inhibitor (ES-8891) was effective in reducing the elevated blood pressure only against the cross-mated hybrid mice, but treatment of an angiotensin-converting enzyme inhibitor (captopril) and a selective antagonist (DuP 753) directed at the angiotensin II receptor decreased the basal level of blood pressure even in single gene carriers as well as in dual gene mice. These results clearly demonstrated that the sustained increase in blood pressure of the hybrid mice was initiated by the interaction between the products of the two human genes.

Angiotensin I↗

[Staging of rectal cancer: assessment with Gd-DTPA enhanced MR imaging].

This study was designed to assess the value of Gd-DTPA enhanced imaging in the staging of rectal carcinoma. Twenty-five patients were prospectively evaluated with MR imaging using a 1.5 Tesla unit. Based on the results of a barium study and/or digital examination, a balloon catheter was inserted to the level of the lesion before examination. Both T1- and T2-weighted images and Gd-DTPA enhanced images were obtained in all patients, and Gd-DTPA enhanced fat-saturation images were obtained in 11 patients. When both T1- and T2-weighted images were used, 24% of tumors were ill defined. However, when Gd-DTPA and Gd-DTPA enhanced fat-saturation imaging was added, all tumors were well defined and the quality of the images increased. There was no significant difference between images in the detection of muscular invasion. In the detection of perirectal fat invasion, however Gd-DTPA fat-saturation imaging showed increased sensitivity. Nevertheless, it also decreased specificity, so there was no significant difference between images. In the detection of metastatic lymph nodes, Gd-DTPA enhanced and Gd-DTPA enhanced fat-saturation imaging were not useful. Tumor detection using Gd-DTPA enhanced fat-saturation images was excellent. However, the accuracy of staging was not improved by supplemental Gd-DTPA enhancement.

Adult↗

Thoracic vertebral bone metastasis from uterine leiomyosarcoma.

We report a patient with solitary thoracic vertebral bone metastasis (Th 8) from uterine leiomyosarcoma. The vertebral metastatic lesion was treated surgically, and vertebral body replacement with ceramic prosthesis and anterior spinal stabilization were performed. Such aggressive surgical intervention for solitary vertebral bone metastasis may contribute to the improvement of prognosis and maintenance of general quality of life in the patient.

Female↗