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Biomedical subjects

M Ide

Publications and source records attributed to M Ide.

At least 109 records · Page 6Linked to original sources

Factors influencing physiological FDG uptake in the intestine.

The intestine is a well-known site of physiological 18F-fluorodeoxyglucose (FDG) accumulation in positron emission tomography (PET). To identify factors influencing physiological FDG uptake in the intestine, the intensity of FDG uptake was evaluated in a total of 1,068 healthy adults. Non-attenuation-corrected whole-body PET images were obtained for all subjects and visually evaluated. Subjects were then classified into two groups according to the intensity of intestinal FDG uptake. Sex, age, presence or absence of constipation, and serum glucose, hemoglobin A1c, and free fatty acid levels were compared between the two groups. High intestinal FDG uptake was observed at an overall rate of 11.0%. Sex (female), age, and bowel condition (constipation) were found to affect intestinal FDG uptake. The factors we identified lead to further questions regarding the relationship between intestinal motility and glucose uptake that warrant further study.

Adult↗

The differential diagnosis of sensitive teeth.

A major presenting complaint in dental practice is of sensitive teeth. In order to manage the problem well, a correct diagnosis is essential. Whilst it is true that 'common things occur commonly', one should consider all possible causes of pain in taking a history and examining the patient. This paper summarizes how to identify the potential causes of such a complaint.

Dentin Sensitivity↗

[Fatal pulmonary thromboembolism in a patient with paroxysmal nocturnal hemoglobinuria].

A 38 year old woman with paroxysmal nocturnal hemoglobinuria was admitted to our hospital because of hemoptysis. Pulmonary infarction was diagnosed by the perfusion lung scan. In spite of the administration of prednisolone, dextran, low molecular weight heparin, and warfarin, she died of pulmonary infarction and secondary pulmonary hypertension. Autopsy revealed thromboembolism of both pulmonary arteries and hepatic central vein thrombosis. Recent understanding of the pathogenesis and incidence of thromboembolism in paroxysmal nocturnal hemoglobinuria was discussed.

Adult↗

[Clinical relapse of rheumatoid arthritis (escape phenomenon) during low-dose methotrexate therapy].

OBJECTIVE: To clarify the incidence and background of clinical relapse (escape phenomenon) during low-dose methotrexate therapy for rheumatoid arthritis. METHODS: Seventy one patients with rheumatoid arthritis (RA) were analyzed. They were started on therapy with methotrexate (MTX) between April 1, 1991 and May 30, 1995. Among them, 60 patients showed clinical improvement within 6 months after the start of the therapy and were subjected to the analysis for clinical relapse (escape phenomenon). RESULTS: Twelve patients showed an initial improvement followed by a relapse with increased serum CRP and number of painful joints despite the MTX therapy was continued. Two types of the relapses were seen; (1) early, escape (relapse after an initial brief improvement) in 7 patients, and (2) late escape (relapse after a long-term improvement with MTX therapy) in 5 patients. The early escape was seen at 9.0 +/- 0.7 months after the start of therapy while the late escape was seen at 23.3 +/- 4.8 months. Patients with both types of escape phenomenon had the longer duration of the disease and more advanced stage. There was no relationship between clinical relapse and age, baseline RA activity, MTX dose, or concurrent use of corticosteroids and other disease modifying anti-rheumatic drugs. The efficacy of MTX for RA was restored by increasing dose of MTX in 11 patients. CONCLUSION: These results suggest that clinical relapse is not rare in RA patients during low-dose methotrexate therapy, but could be improved by increasing dose.

Antirheumatic Agents↗

[Osteoporosis in rheumatoid arthritis].

Patients with rheumatoid arthritis (RA) develop both periarticular and generalized osteoporosis. Periarticular osteopenia in appendicular bones occurs early in the course of RA and is one of the earliest radiological signs of RA. An uncoupled state in bone resorption-formation linkage, contributes to the development of periarticular osteopenia and it might be mediated through an increased productions of cytokines and prostaglandins by synovium and bone marrow. Accordingly, early suppression of rheumatoid synovitis is necessary for the prevention of periarticular osteopenia. Generalized osteoporosis is also common in RA and leads to increased risk of fractures. Generalized osteoporosis considered to be multifactorial and factors contributing to lumbar osteoporosis might be different from those to loss of appendicular bones, such as femur and radius. Corticosteroids and menopausal state are important risk factors for lumbar osteoporosis. Rheumatoid activity and reduced physical activity are also important determinants. According to the previous studies, however, the influence of functional impairment is more prominent in the femoral BMD compared to spinal BMD. In addition to control of RA and maintenance of physical activity, hormone replacement therapy (HRT) and bisphosphonate are possible agents for the treatment of osteoporosis in RA patients, especially postmenopausal women.

Arthritis, Rheumatoid↗

[The frequency and development of tissue iron deficiency in 6 iron deficiency anemia patients with plummer-vinson syndrome].

The physical signs of tissue iron deficiency include smooth and red tongue, angular stomatitis, koilonychia, and pica. The incidence of these conditions is unknown in Japan. We evaluated the frequency and development of tissue iron deficiency in 353 patients with iron deficiency anemia. The frequency of tissue iron deficiency was 6.8%; papillary atrophy of the tongue, 5.4%; abnormal nails, 5.4%; angular stomatitis, 1.1%; Plummer-Vinson syndrome, 1.7%; and pica, 0.06%. These findings were compared with the date collected by Wintrobe and Beveridge. The development and incidence of tissue iron deficiency correlated significantly with the severity of iron deficiency anemia.

Adult↗

Spontaneous regression of primary intracranial germinoma. A case report.

BACKGROUND: Testicular seminomas are well known to regress spontaneously at a higher incidence than other tumors. To date, there have been no reports of spontaneous regression of an intracranial germinoma, although these tumors are histologically identical to testicular seminomas. METHODS: The authors present a patient with a primary intracranial germinoma that regressed spontaneously. RESULTS: A 21-year-old man was admitted to the study facility with acute onset of headache and vomiting. He had a 3-year history of polydipsia and polyuria. Computed tomography (CT) demonstrated a large tumor in the third ventricle, accompanied by hydrocephalus. He underwent ventriculoperitoneal shunt placement on the second day of hospitalization. A CT scan obtained on the fifth postoperative day demonstrated a remarkable decrease in tumor size. Because serial magnetic resonance imaging (MRI) demonstrated a gradual decrease in tumor size, tumor resection was not performed at that time. The patient was discharged and followed with MRI. The tumor continued to regress for more than 2 months. The patient was readmitted due to tumor regrowth, confirmed by MRI 4 months after the initial admission, despite the absence of symptom exacerbation. Two weeks later, the suprasellar portion of the tumor was resected through a right frontotemporal craniotomy. The histopathologic diagnosis was a germinoma. No concurrent tumors were found on whole body examination. The residual tumor gradually regressed after conventional radiation therapy and there has been neither tumor recurrence nor metastasis to date. CONCLUSIONS: Although the precise cause of the transient partial regression is unknown, this case indicates that, like their testicular counterparts, intracranial germinomas may on occasion spontaneously regress.

Adult↗

Evaluation of metabolic heterogeneity in brain tumors using 1H-chemical shift imaging method.

Seventeen brain tumors were measured by 1H-CSI (chemical shift imaging) in a 1.5 T clinical magnetic resonance scanner. The metabolic peaks obtained were evaluated by two methods. One method was to obtain the percentage of each metabolite relative to the combined choline, creatine and NAA peak areas, and the other method was to obtain a ratio of the tumor to contralateral brain. The percentage of choline (%Cho) and choline ratio increased, and the %NAA and NAA ratio decreased in the gliomas and malignant tumors. In relation to grading, %Cho increased but the choline ratio did not. We believed the reason for this was that there were many foci of microscopic necrosis in the glioma grade IV. Free lipids were observed in most of the high grade gliomas and in a malignant tumor. Lactate increased in higher grade tumors. Meningiomas showed the highest %Cho. Statistical differences between the grades of glioma were not detected because many tumors had heterogeneous tissue. One resolution to this problem was metabolite mapping. Mapping of the percentage of metabolites was suitable because it described the regional metabolic changes and the resulting signal to noise ratio was better than that achieved by other methods of evaluation.

Aspartic Acid↗

Muscle damage occurring in wheelchair sports people.

Seven college-age healthy men exercised on a wheelchair treadmill to evaluate muscle damage that may occur from wheelchair propulsion. An experimental model in which a participant performs up-hill running in a wheelchair was prepared. Plasma creatinekinase (CK), myoglobin (Mb) and lactatedehydrogenase (LDH) were measured as parameters. Blood samples were taken pre-, immediately after-, 24 h after- and 72 h after the exercise. All of these parameters significantly increased after the exercise, but their time-courses were apparently varied. It is concluded that wheelchair propulsion causes muscle damage in certain situations such as up-hill running.

Adult↗

Middle cerebral artery stenosis caused by relatively low-dose irradiation with stereotactic radiosurgery for cerebral arteriovenous malformations: case report.

OBJECTIVE AND IMPORTANCE: There have been occasional reports of stenosis or occlusion of major cerebral arteries occurring several years after stereotactic radiosurgery for cerebral arteriovenous malformations. Nevertheless, little information is available regarding the actual irradiation dose to which the affected artery had been exposed. CLINICAL PRESENTATION: We present a patient with arteriovenous malformations who, although asymptomatic, developed remarkable stenosis of the middle cerebral artery trunk (M1) 3 years after gamma knife radiosurgery. The nidus was covered with a 50% isodose volume. A central dose of 36 Gy was used. A gradual decrease in nidus volume had been suggested by 1- and 2-year postradiosurgical neuroimaging examinations. Three-year postradiosurgical angiography revealed severe segmental stenosis of the M1, as well as remarkable nidus shrinkage. INTERVENTION: The actual irradiation dose delivered to the affected portion of the artery, as retrospectively determined using a highly accurate three-dimensional analysis technique, was estimated to be 5.1 to 9.8 Gy. CONCLUSION: This case suggests that a normal major artery, if located close to the target volume, may be affected by low-dose irradiation (10 Gy or even slightly less) delivered with radiosurgery, although a decrease in blood flow through the M1 because of nidus shrinkage or associated stenosis of the distal middle cerebral artery, as well as other unknown factors, may also contribute to proximal M1 stenosis.

Arterial Occlusive Diseases↗

A diffuse white matter ischemic lesion appearing 7 years after stereotactic radiosurgery for cerebral arteriovenous malformations: case report.

OBJECTIVE AND IMPORTANCE: Little information is available about radiation-induced complications occurring more than 5 years after radiosurgical treatment for arteriovenous malformations. CLINICAL PRESENTATION: We present a patient with arteriovenous malformations who experienced hemimotor weakness caused by a diffuse white matter necrotic lesion developing 7 years after gamma knife radiosurgery. The original nidus had been too large (24.1 cm3) to be totally covered and irradiated with a peripheral dose of 20 to 25 Gy. Therefore, the lower half of the nidus, which was adjacent to the major feeding artery, had been partially covered with a 30% isodose volume using two target points with an 18-mm collimator. A central dose of 70 Gy was used to obtain 21 Gy at the periphery. Complete nidus obliteration was angiographically confirmed 38 months after radiosurgery. After a 6-year uncomplicated period, this patient experienced a convulsive seizure and then mild right hemiparesis. INTERVENTION: Computed tomography demonstrated a diffuse hypodense area in the left white matter, which had not been revealed by the previous examination. With steroid treatment, this patient achieved clinical improvement, although there was no significant improvement in the computed tomography-demonstrated white matter lesion. CONCLUSION: Although the evaluation of this patient may not be sufficient and further examinations may be necessary, we tentatively conclude that the computed tomography-demonstrated hypodense lesion in this patient is a radiation-related necrotic lesion. Long-term follow-up is crucial, even after the "treatment goal" has been achieved.

Adult↗

Tumor cell counting using an image analysis program for MIB-1 immunohistochemistry.

A cell counting method for MIB-1 immunohistochemistry, using an image analysis program, NIH Image, on a personal computer, has advantages over manual cell counting by microscopy. MIB-1 slides were photographed at a magnification of x 50 on 24 x 36 mm color films and the photographs were then enlarged to adequate size for observation. The MIB-1-positive cells, on the enlargements, were marked with a white pen, and negative cells with a black pen. Subsequently, the image of an enlargement was converted into data that can be processed by the program using a flatbed image scanner. Threshold levels were adjusted according to the respective white and black markings, and the program automatically counted the number of MIB-1-positive and negative tumor cells. Our method has the following significant advantages: Once cells had been marked and the image converted into the NIH Image data, the cell count process was completed within a few minutes; in contrast to manual microscopic cell counting, count overlapping or cells missed by the observer are eliminated; overlapping nuclei could be separated by the marking procedure; our method required no elaborate and costly image analysis system. The present method may be recommended to researchers undertaking cell kinetic studies utilizing immunohistochemical methods.

Brain Neoplasms↗

[1H-MRSI of Alzheimer's disease].

To evaluate neuronal change in the neocortex of the patients with Alzheimer's disease in early stage, proton MRSI study was performed in 13 probable AD patients and 6 healthy volunteers and the change of NAA, a putative neuronal marker, between the temporal cortex and the white matter including basal ganglia was analyzed. Proton MRSI data were measured with 3D-FT-CSI method, using spin echo method with TE = 135 ms. Two directional 16 x 16 phase encodings were applied on the field of 18 x 18 x 1.5 cm3. One voxel size was 1.9 cm3. Out of thirteen probable AD patients, 7 patents, who were considered in early stage, showed low NAA levels in the temporal neocortex without NAA change in the white matter including basal ganglia. Six patients, who were considered in more advanced stage, showed low NAA levels in both regions. NAA decrease in neocortical area is considered to be a good indication of AD in early stage at the examination with proton MRSI.

Adult↗

Short-term low dose methotrexate ameliorates abnormal bone metabolism and bone loss in adjuvant induced arthritis.

OBJECTIVE: To clarify whether short term weekly methotrexate (MTX) therapy aggravates bone abnormalities in adjuvant induced arthritis (AIA) or improves them through its antiarthritic effect. METHODS: Bone metabolism and bone mineral density (BMD) were studied in 6 groups of Lewis rats: (1) normal controls, (2) rats given MTX 0.3 mg/kg weekly, (3) rats given MTX 3 mg/kg weekly, (4) AIA rats, (5) AIA rats given MTX 0.3 mg/kg weekly, and (6) AIA rats given MTX 3 mg/kg weekly. Osteogenic activity was determined from serum osteocalcin levels and number of marrow fibroblast colony forming units (osteogenic precursor cells). Bone resorptive activity was assayed by detecting osteoclast-like cells and pit formation in bone marrow cultures. RESULTS: In control rats, MTX (3 mg/kg weekly) suppressed osteogenic activity, as shown by low serum osteocalcin levels and decreased growth of marrow fibroblast colony forming units. Osteoclast-like cells and pit formation in bone marrow cultures from control rats were increased by MTX, but BMD was unchanged. In rats with AIA, MTX (3 mg/kg) suppressed arthritis and restored the decreased osteogenic activity of bone marrow cells, and reduced their increased bone resorptive activity. These changes resulted in a significant increase of periarticular BMD in the femur. CONCLUSION: Low dose weekly MTX therapy had a favorable effect on abnormal bone metabolism and osteopenia in rats with AIA.

Animals↗

MIB-1 staining index and peritumoral brain edema of meningiomas.

BACKGROUND: Growth rates and tumor aggressiveness of meningiomas are thought to be closely related to brain edema development. However, histopathologic data alone are not consistently accurate predictors of the behavior and clinical course of a meningioma. METHODS: The authors examined 57 histologically proven intracranial meningiomas to identify factors, including growth fractions determined by MIB-1 immunostaining, that may influence the development of meningioma-associated peritumoral brain edema. There were 54 benign, 2 atypical, and 1 anaplastic meningiomas. The MIB-1 staining index (SI) percentage was defined as the number of MIB-1 positive cells divided by the total number of tumor cells in a 1.037-square millimeter area on the slide. The extent of peritumoral brain edema was determined using preoperative magnetic resonance imaging. The extent of edema was classified as Grade 0,1, or 2 (GR0, GR1, or GR2), in order of increasing severity. RESULTS: The MIB-1 SIs of the 57 cases ranged from 0.06-6.8% (median, 0.80%). There were 26 GR0, 20 GR1, and 11 GR2 edema cases. The MIB-1 SI rose in order of increasing edema severity. There was a statistically significant correlation between the MIB-1 SI and the extent of brain edema (P<0.0001), and also between the tumor size and the extent of brain edema (P=0.001). Meningothelial and atypical/anaplastic meningiomas were associated with peritumoral brain edema more often than any other subtype (P<0.005). CONCLUSIONS: Growth fractions, as determined by MIB-1 immunostaining, rise with increasing severity of peritumoral brain edema, indicating a close relationship between tumor aggressiveness and edema development.

Adult↗

Epidemiological data on anorexia nervosa in Japan.

An epidemiological survey on anorexia nervosa was performed in Japanese hospitals in 1985 and 1992 using a questionnaire. The reported number of patients with anorexia nervosa was 2391 from 732 institutions. From these data, the total number of anorexia nervosa patients treated in 1985 in Japanese hospitals was estimated to be about 3500-4500. In 1992, the reported number of patients with AN was 2247. The total number of AN patients treated in 1992 was estimated to be about 4500-4600, which is a little higher than that in 1985 (3500-4500). The prevalence was 3.6-4.5 per 100000 among the general population, 6.3-9.7 per 10(5) among the female population, and 25.2-30.7 per 10(5) among the 13-29 year-old female population.

Adolescent↗