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Biomedical subjects

M Fujishita

Publications and source records attributed to M Fujishita.

At least 19 recordsLinked to original sources

Three-dimensional computed tomography evaluation of postsurgical condylar displacement after mandibular osteotomy.

OBJECTIVE: The purpose of this study was to examine both condylar displacement of the temporomandibular joint after sagittal split ramus osteotomy with rigid osteosynthesis and intraoral vertical ramus osteotomy without osteosynthesis in patients with mandibular prognathism by means of three-dimensional computed tomography. STUDY DESIGN: In this pilot study, five patients treated with sagittal split ramus osteotomy and 5 patients treated with intraoral vertical ramus osteotomy were evaluated. A technique to superimpose a postoperative three-dimensional computed tomography image on its corresponding preoperative image was designed. Postoperative condylar displacement, rotation, and tilting were measured in three-dimensional computed tomography images. RESULTS: Within 3 to 6 months after surgery, changes in the inclination of the condylar axes were distinctly seen, although changes in the position of the condyles within the joints were minimal. In particular, outward rotation of the condylar long axes after intraoral vertical ramus osteotomy was a frequent finding. CONCLUSIONS: The three-dimensional computed tomography superimposition technique was a practical method of evaluating postsurgical condylar displacement after mandibular osteotomy.

Adolescent

[A case of Kartagener's syndrome with S. pneumoniae lung abscess].

A 38-year-old male with Kartagener's syndrome (KS) was admitted to our department for evaluation of recurrent pneumonia. Before admission the patient was diagnosed as having pneumonia in another hospital and received ofloxacin (300 mg/day). Fever and production of purulent sputum decreased initially but again increased in the middle of April. On admission the films of both X-ray and CT scan of the chest revealed several air-fluid levels and infiltrative shadows on the left lower lung field. The patient was diagnosed as lung abscess using bronchofiberscopy. Gram staining of the intrabronchial specimens revealed many Gram-positive cocci and neutrophils including phagocytosed bacteria. A new carbapenem (L-627, 600 mg/day), was started intravenously. After the therapy Streptococcus pneumoniae were eradicated soon from the sputum. At the same time the above symptoms including dyspnea on exertion subsided, and the findings of the chest X-ray and CT scan were also improved. Regarding KS the electron micrograph of the cilia showed the absence of the outer-dynein arms. While by both the saccharin test and the sputum cytology impaired mucociliary clearance was found. Lung abscess infrequently accompany KS. There are reports of respiratory infections in KS, but to our knowledge no report of lung abscess was found in KS. We present this case report describing lung abscess in KS.

Adult

Diagnosis of coronoid process hyperplasia by three-dimensional computed tomographic imaging.

Three-dimensional (3D) CT imaging was performed on three cases (one unilateral, two bilateral) of coronoid process hyperplasia. This technique displayed the impingement of the enlarged coronoid process on an exostosis on the lower border of the malar bone. In addition, a small concavity was found on the inner surface of the malar bone that was not displayed by other imaging modalities. The 3D images were useful in planning surgical treatment. In cases of limitation of opening, finding a malar exostosis on conventional radiographs such as a Water's view should suggest the presence of coronoid process hyperplasia even if the impingement cannot be demonstrated.

Adult

Magnetic resonance evaluation of the temporomandibular joint disc position and configuration.

Although magnetic resonance imaging (MRI) is the modality of choice for evaluation of TMJ disc position, it is sometimes difficult to determine when it is displaced or reduced. The MR images of 273 Patients with a clinical diagnosis of TMJ disorders were assessed for disc position and configuration. Most (90-97%) of the slightly anteriorly displaced discs were reduced to the normal position in the open-mouth position. However, the greater part (76%) of the distorted discs was completely displaced anteriorly and without reduction. Since no distorted discs were found in the normal disc position, we conclude that discs are distorted after displacement.

Adolescent

The clinicoradiologic predictability of perforations of the soft tissue of the temporomandibular joint.

One hundred thirty-one arthrographic examinations of temporomandibular joints were performed on 119 patients. The relationships between clinical symptoms, tomographic findings, and soft-tissue perforation were examined. Perforations of the articular disk or posterior attachment were revealed in 58 joints. Joints with crepitation showed a high frequency of perforation (20 of 22). Pain in the joint area and limitation of opening correlated to disk reduction. Perforations were observed in 12 of 21 joints with continuous pain. Osseous changes were detected in 89 joints. Joints with abnormal radiodensity (erosion, sclerosis) combined with abnormal shape (pocket erosion, osteophyte formation, deformity) showed a high frequency of perforation (41 of 45), which corresponded to 84% in this study. In those cases with osseous change or crepitation, positive predictive values of perforation were both 91%. These types of osseous change and their clinical significance might predict soft-tissue perforation with high accuracy before an arthrogram is performed.

Adolescent

Serotonergic neurons in the brainstem modulate animal hypnosis.

We previously found that the center of animal hypnosis production in the rabbit is located around the locus ceruleus and brachium conjunctivum (LC-BC) of the brainstem. The involvement of serotonergic neurons in this area of animal hypnosis was investigated by microinjection of serotonin into these regions. The duration of animal hypnosis (DAH) induced by inversion was diminished to about 65% of the controls by serotonin microinjection into the LC-BC and microinjection of methysergide prolonged the DAH to 3.2 times that of the controls. Flexor muscle contraction (CFM) of the upper extremities induced by electrical stimulation of the motor cortex was enhanced by serotonin. In normal rabbits, hard pressure on the ear base or the lumbar paravertebral area reduced CFM and this effect was partially antagonized by serotonin microinjected into the LC-BC. The results suggest that serotonergic neurons in the LC-BC modulate animal hypnosis.

Animals

P2 purinergic receptors and cellular calcium metabolism in A 431 human epidermoid carcinoma cells.

Stimulation of P2 purinergic receptors on A 431 human epidermoid cells with ATP rapidly mobilized intracellular calcium and increased cytosolic free Ca2+ ([Ca2+]i). Incorporation of 45Ca2+ was also stimulated by ATP at a rate less than that of [Ca2+]i elevation. Among a number of nucleosides, nucleotides, and their analogues examined, ATP, GTP, UTP, ADP, UDP, adenosine 5'-O-(3-thiotriphosphate) (ATP gamma S), and 5'-adenylylimidodiphosphate (AMP-PNP) increased both [Ca2+]i and 45Ca2+ influx, whereas others did not; these latter two analogues (ATP gamma S and AMP-PNP) blocked the ATP-stimulated 45Ca2+ influx only very slightly, suggesting that they are not prominent antagonists but rather agonists. A high correlation between [Ca2+]i increase and 45Ca2+ influx, in terms of nucleotide specificity, suggests the involvement of [Ca2+]i in influx of 45Ca2+. It appeared that [Ca2+]i elevated by several nucleotides or nucleotide analogues opened a calcium gate, thus allowing the influx of 45Ca2+. P2 purinergic receptors on these cells had such a characteristic that they were rapidly desensitized. These nucleotides or analogues also affected epidermal growth factor (EGF) receptors by inhibiting the EGF binding. The differences of ligand or substrate specificities between P2 purinergic receptors and ecto-nucleotidases indicates that the two components are different molecules involved in different systems.

Calcium

Preliminary nuclear magnetic resonance studies on human saliva.

Of gustatory-stimulated human whole, parotid, submandibular and sublingual saliva only parotid saliva, a serous rather than mucous secretion, presented a relatively well-resolved proton NMR spectrum with satisfactory signal-to-noise ratio in a short time (30 min). The proton signal intensities showed significant circadian rhythms related to the circadian rhythms of protein concentrations in saliva. Age- and sex-associated differences in spectra were not observed for healthy saliva. On the other hand, marked differences in the spectra were observed for patients with suspected sialoadenitis.

Adult

Role of cholinergic fibers in a center essential to animal hypnosis.

We previously found that the center from which animal hypnosis is controlled in the rabbit is located in the area that includes the brachium conjunctivum and locus coeruleus (LC-BC) of the brainstem. Microinjection was used to investigate functions of cholinergic fibers in this area in relation to animal hypnosis. The duration of animal hypnosis (DAH) induced by inversion was diminished to about 60% of the controls by microinjecting atropine into the LC-BC, whereas microinjection of carbachol prolonged the DAH to 3.5 times that of the controls. Flexor muscle contraction of the upper extremities, induced by electrical stimulation of the motor cortex (CFM), was enhanced by atropine and suppressed by carbachol. In normal rabbits; hard pressing on the ear base or the lumbar paravertebral area reduced CFM (pressing effect), and this effect was partially antagonized by atropine microinjected into the LC-BC. The results suggest that cholinergic fibers in the LC-BC modulate functions involved in animal hypnosis.

Animals

[Clinical features of 32 cases of fungal pneumonia].

A total of 32 patients with mycoses other than cavity-formed aspergilloma were reviewed. The main pathogenic fungi were Aspergillus in 14, Candida in 8, Cryptococcus in 4, Trichosporon in 4 and Mucor in 2. Coinfection by two species was detected in 3 cases: Trichosporon and Aspergillus in 2 and Aspergillus and Candida in 1. The underlying diseases were hematologic malignancies in all cases except 1 case of lung cancer. The hematologic malignancies were mostly leukemias of various types. Cryptococcosis developed in patients given long-term corticosteroid treatment but not in leukemic patients. All cases of aspergillosis, candidiasis and mucormycosis were due to nosocomial infection. On the other hand, 3 of 4 cases of cryptococcosis or trichosporonosis were attributable to community-acquired infection. Two of 4 trichosporonosis cases were considered to have been acquired during 2-day home stays. The diagnosis of pulmonary mycosis was made pathologically in 18 and clinically in 14 cases. Of the latter, 6 cases had an air-crescent sign on chest X-ray films and 8 cases were culture-positive. Extrapulmonary involvement was seen in all 16 cases of candidiasis, cryptococcosis and trichosporonosis but not in 10 of 14 aspergillosis cases. Severe granulocytopenia was present in all cases except 4 cases of cryptococcosis and 3 cases of aspergillosis. Chest X-ray findings of aspergillosis were of two types: one was an air-crescent sign which was noted in the recovery phase from leukopenia and the other was gradually enlarging consolidation which was bound by the interlobar fissure and progressed to lobar penumonia. A diffuse granular shadow was not characteristic of any fungus species.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Williams-Campbell syndrome complicated by multiple meniscus signs in an adult case; is it a characteristic finding?].

A 49-year-old woman visited our hospital for further examination of abnormal lung shadows in September 1984. She had suffered from pneumonia at the age of 3 years and had been treated for bronchial asthma until the age of 15. Many thin-wall cystic shadows were seen on her chest X-ray film in 1983. In July 1984, a mass-like lesion with a meniscus sign appeared in one of the cystic shadows. The number and the size of similar lesions increased with worsening of productive cough. An infiltrative shadow was recognized in the left lower lobe in September 1987 and January 1988, but was resolved by treatment by ofloxacin. Frequent bacterial examinations of sputum and bronchial secretions revealed numerous Pseudomonas aeruginosa but no fungi. Serum antibody to Aspergillus fumigatus was negative and antifungal therapy was not effective. Bronchography showed many cystic dilated bronchi, which ballooned during inspiration and collapsed with expiration. The peripheral bronchi seemed to be normal. These findings along with her clinical course led us to make a diagnosis of Williams-Campbell syndrome. The mass-like shadows were considered to have arisen from viscid secretions that were rendered round by the characteristic movement of the ectatic bronchi.

Bronchi

[Analysis of complications following double contrast arthrotomography of the temporomandibular joint].

Temporomandibular joint (TMJ) arthrography is a valuable diagnostic method to evaluate the pathology of soft tissue components of the TMJ. However, arthrography is more or less invasive technique. The aim of this study was to investigate the sort and content of injury following TMJ arthrography. The symptoms before and after the arthrography were compared. In 90 joints that underwent TMJ arthrography, complications such as pain and/or trismus were encountered in 39 joints within one month. Twenty six patients complained of the change of pain conditions including the discomfort. The most common one was the pain on mouth opening. In every joint the pain disappeared within one month without any treatment. There was a high frequency of exacerbated pain in patients with some pain before the arthrography. The change of the degree of maximum opening was recognized in 11 patients. The duration of that condition was somewhat longer than that of pain conditions. In 5 joints with late clicking, 3 developed closed lock. Other complications were swelling, disability of mastication, eczema, hearing impairment and facial paresthesia. All the symptoms disappeared within 1 week without any treatment. From these results it was suggested that TMJ arthrography has low possibility of severe damage to the TMJ although there is some possibility of injury to the bone and soft tissue by arthrographic procedures.

Arthrography

[Seizure and tremor occurring in acute leukemia patients treated with imipenem/cilastatin].

We report here four patients with acute leukemia, who developed seizure or tremor following treatment with imipenem, a new broad-spectrum antibiotic. All four patients had no renal dysfunction and recovered after discontinuation of the drug. Two patients who developed seizure had a past history of cerebral hemorrhage with symptoms of meningitis in one and the other had received frequent intrathecal injections of methotrexate. Seizure also occurred in another patient who was given multiple intrathecal injections of methotrexate. The remaining old patient developed tremor after the first administration of imipenem which did not progress to convulsion. Cerebral hemorrhage or meningitis is known to predispose patients for convulsion following imipenem treatment. In addition, the present study suggests that central nervous system damage related with intrathecal injections of methotrexate may be a predisposing factor. Thus, imipenem should be given with caution to acute leukemia patients who often have risk factors for developing imipenem-related complications.

Acute Disease

Milk-borne transmission of human T-cell leukemia virus type I in rabbits.

The mode of vertical transmission of human T-cell leukemia virus type I (HTLV-I) was investigated by foster-nursing in rabbits. Two of five rabbits born to noninfected mothers and fostered by virus-infected females seroconverted for HTLV-I after 7 weeks, whereas all seven rabbits born to virus-infected mothers and fostered by noninfected females remained seronegative for the observation period of 6 months. Culture of peripheral blood lymphocytes gave rise to an HTLV-I-carrying T-cell line from each of the two seroconverted rabbits. These findings suggest that HTLV-I is transmitted through milk from mother to offspring.

Animals

Trisomy 4 in a case of acute nonlymphocytic leukemia (M2).

Trisomy 4 in a Japanese patient with type M2 acute nonlymphocytic leukemia is reported. Karyotypic analysis was unsuccessful at diagnosis and complete remission lasted 4 years. The cytogenetic change was detected in the first and second relapses as the only chromosome abnormality. Unusual nuclear irregularities were found in many leukemic cells.

Acute Disease

Immunohistochemical identification of Trichosporon beigelii in histologic section by immunoperoxidase method.

An indirect immunoperoxidase method capable of identifying an opportunistic fungus, Trichosporon beigelii, in formalin-fixed, paraffin-embedded tissue has been developed. The authors studied autopsy materials from 19 patients with various fungal infections, including 3 patients with disseminated T. beigelii infection, 8 patients with localized or systemic candidiasis, 4 patients with invasive aspergillosis, 2 patients with pulmonary mucormycosis, and 2 patients with systemic cryptococcosis. T. beigelii could be successfully visualized in tissue sections from all three patients with this infection and a patient with systemic candidiasis who was found to have concomitant infection by T. beigelii. The capsule of Cryptococcus neoformans was also stained, indicating the presence of cross-reactive antigen between T. beigelii and C. neoformans. C. neoformans-absorbed antiserum was reactive with T. beigelii but not with other fungi, including C. neoformans.

Antibodies, Fungal