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Biomedical subjects

M Ide

Publications and source records attributed to M Ide.

At least 127 records · Page 7Linked to original sources

Neuroimaging studies of postobliteration nidus changes in cerebral arteriovenous malformations treated by gamma knife radiosurgery.

BACKGROUND: Following radiosurgical treatment, the majority of patients with arteriovenous malformations (AVMs) are periodically examined by means of computed tomography (CT) and magnetic resonance imaging (MRI) to assess the attainment of nidus obliterations, as well as adverse radiation effects in the surrounding brain. However, few neuroimaging studies of the long-term results following complete obliterations, confirmed by angiography, have been published to date. METHODS: CT, MRI, magnetic resonance (MR) angiographic and angiographic images, obtained after angiographic confirmation of complete nidus obliteration, were reviewed in 11 AVM patients treated with gamma knife radiosurgery. The period between angiographic confirmation of nidus obliteration and these most recent examinations was 12-84 months (mean, 29 months). RESULTS: In ten patients who were assessed by CT, the obliterated nidus was shown to be isodense (eight cases). A significant time-related decrease in contrast enhancement was observed within 1 to 2 postobliteration years (five/seven cases). Eight patients were evaluated by MRI. On T1-weighted imaging, the nidus was shown to be hypointense (six cases) or a mixture of hypointense and isointense areas (two cases). On T2-weighted imaging, nidus intensity varied more than than observed on T1-weighted imaging, and time-related intensity increases were observed (two/seven cases). No flow-signal void was demonstrated in any of these cases. In four of the seven cases, in which serial postobliteration follow-up MRI studies were conducted, significant gadolinium enhancement persisted 3 years or more after obliteration (maximum of 7 years). No vascular abnormalities were demonstrated in seven patients who were assessed by conventional angiography and/or MR angiography. CONCLUSIONS: Radiosurgery-induced changes in a nidus may continue for several years after angiography has shown complete AVM obliteration.

Adolescent↗

Outbreak of acute glomerulonephritis in children: observed association with the T1 subtype of group A streptococcal infection in northern Kyushu, Japan.

Group A streptococcal infection is associated with the occurrence of acute glomerulonephritis (AGN) and rheumatic fever (RF). A surveillance study in the Saga area, in northern Kyushu, Japan, showed a small variation in the reported number of group A streptococcal infections in the period 1988-94. However, of the AGN cases reported in this period, more than half were observed in 1992. In order to examine whether some change had occurred in the serotype distribution of Streptococcus pyogenes during the period, patients in the Saga area diagnosed as having group A streptococcal infection and patients with AGN or RF were analyzed. Serological T-typing of S. pyogenes was carried out for patients with group A streptococcal infections, and the association between the occurrence of AGN or RF and the distribution of each different T subtype was analyzed. M-typing of S. pyogenes was also carried out and the correlation between T and M types was examined. From 1988 to 1994, the annual number of patients with group A streptococcal infections in the Saga area showed a small variation, range 65-100 patients/year. Of the 42 patients with AGN and three with RF observed in this period, 27 with AGN (64%) and one with RF (33.3%) were detected in 1992. Only the T1 subtype increased in 1992; the other T subtypes showed little variation in incidence. The number of patients with the T1 subtype was significantly correlated with the occurrence of AGN by regression analysis (P < 0.01). Of the 170 subjects tested for both T and M subtypes, 44 of the 45 T1-typed subjects had the M1 protein. Our epidemiological study suggested that the T1 subtype of streptococcal infection was associated with an outbreak of AGN in 1992 in the Saga area.

Acute Disease↗

Is unchanged tumor volume after radiosurgery a measure of outcome?

We report three patients who underwent Gamma Knife radiosurgery for benign tumors (meningioma, neurinoma and hemangioblastoma), in whom an 'unchanged tumor volume' demonstrated by postirradiation follow-up neuroimaging could be regarded as a successful treatment results, as compared with preradiosurgery tumor growth. It is our view that unless significant tumor growth has been observed before radiosurgery, 'unchanged in size' after radiosurgery cannot be regarded as a successful treatment result. Because relatively few hemangioblastoma patients have been treated radiosurgically, this report emphasizes the course of one case with hemangioblastoma.

Adult↗

[A 4-week oral toxicity study of prulifloxacin (NM441) in dogs followed by a 4-week recovery test].

A repeated dose toxicity study of prulifloxacin, a new antibacterial agent, was conducted in beagle dogs. Male and female dogs were given the test material orally for 4 weeks at doses of 0 (control), 30, 150 and 750 mg/kg. After discontinuation of the treatment, a 4-week recovery test was also conducted. Feces containing white material were seen in the 150 and 750 mg/kg groups. Salivation, prone, lateral or sitting position, gait disturbance, and locomotor depression were observed in the 750 mg/kg group. In this dose group, decreased body weight and food and water consumptions were also observed. There were no treatment-related effects on survival. Ophthalmoscopic and electrocardiographic examinations and urinalysis failed to show any abnormalities related to the treatment. Hematologic examination showed decreased WBC in the 750 mg/kg group. Blood chemical examination revealed increased GPT and alpha 2-globulin in the 750 mg/kg group. Pathological changes caused by the treatment were as follows. Rarefaction of matrix, cavitations and erosions in humeral and femoral articular cartilages, and inflammatory cell infiltration in synovium were seen in the 150 and 750 mg/kg groups. Focal hemorrhage in synovium was also observed in the 750 mg/kg group. In kidney, regeneration of tubular epithelium, inflammatory cell infiltration, fibrosis and crystalline substance in the tubular lumen were observed in the 750 mg/kg group. The above-mentioned changes were satisfactorily reversible except for the changes in the humeral and femoral articular cartilages and in the kidney. Plasma levels and urinary concentrations of active metabolite of the test material were increased in all dose groups with dose-related manner, whereby no sex difference was observed. No effects caused by the repeated dosing were seen in the plasma concentrations. Toxicological findings were not observed in the 30 mg/kg group. The results show that the NOAEL of prulifloxacin is 30 mg/kg for 4-week repeated dose toxicity in dogs.

Administration, Oral↗

Radiosurgery for acoustic neurinoma with rapid growth and relatively high staining indexes for proliferating cell nuclear antigen and MIB-1.

A 54-year-old female presented with a rapidly growing acoustic neurinoma. The tumor doubling time was 216 days or less before surgery and staining indexes for proliferating cell nuclear antigen (PCNA) and MIB-1 were relatively high (4.1% and 2.1%, respectively). The tumor was partially removed, but regrowth was detected with a tumor doubling time of 205 days. She underwent gamma knife radiosurgery for the residual tumor. The periphery of the tumor was irradiated with a dose of 15 Gy. Magnetic resonance imaging 30 months later demonstrated significant tumor shrinkage. The tumor half time following irradiation was determined to be 401 days. Neither surgery nor radiosurgery produced any additional neurological deficit or complications. Gamma knife radiosurgery can control neurinoma growth even when the tumor shows rapid growth and a relatively high growth fraction indicated by high staining indexes for PCNA or MIB-1.

Cranial Nerve Neoplasms↗

Gamma knife radiosurgery for brain tumors: postirradiation volume changes compared with preradiosurgical growth fractions.

The postradiosurgical volume changes were compared with preradiosurgical growth fractions defined as the tumor doubling time and/or MIB-1 staining index in 14 patients who underwent gamma knife radiosurgery for treatment of various brain tumors. The mean preradiosurgical observation period using neuroimaging techniques was 750 days (range 80-2967 days), and the mean follow-up period after radiosurgery was 664 days (range 328-1100 days). There were four neurinomas, three meningiomas, two craniopharyngiomas, two gliomas, one hemangioblastoma, one pituitary tumor, and one intracranially infiltrative lacrimal gland tumor. The mean patient age at the time of radiosurgery was 52 years (range 8-81 yrs). There were eight males and six females. Following gamma knife radiosurgery, the mean tumor half time was estimated to be 789 days (range 124-2101 days), and the volume reduction against the preradiosurgical tumor volume ranged from 6.3% to 76.1%. This study demonstrates that gamma knife radiosurgery can control tumor growth despite the lack of a correlation with preradiosurgical tumor growth or staining indices for MIB-1. Analyses of this type are essential to show that an "unchanged tumor volume" as demonstrated by postradiosurgery follow-up neuroimaging can be regarded as showing successful radiosurgery.

Adolescent↗

Perioperative antimicrobial prophylaxis in neurosurgery: clinical trial of systemic flomoxef administration and saline containing gentamicin for irrigation.

The efficacy of a new protocol consisting of a prophylactic antibiotic regimen of peri- and postoperative intravenous administration of flomoxef and irrigation of the operative field with saline containing gentamicin was assessed by comparing infection rates in two consecutive series of patients who underwent neurosurgical procedures. Group A received postoperative flomoxef administration, with saline containing no antibiotics for irrigation, from July 1988 to December 1989. Group B received the new protocol from January 1990 to December 1991. For further evaluation, this protocol was continued in most patients who underwent surgery from January 1992 through December 1993 (Group C). Only adult or adolescent patients who underwent clean neurosurgical procedures were included. The number of patients and procedures in each group were: 76 patients (97 procedures) in Group A, 103 (133) in Group B, and 107 (137) in Group C. There were no significant differences between Groups A and B in age, sex, clinical category, coexistent disease, clinical outcome, surgical procedures, general anesthesia, emergency operation, steroid administration, and the timing (season), duration, and frequency of surgery. Meningitis developed in three patients and subcutaneous infection in one in Group A. None of the patients in Group B experienced postoperative infection. This difference in infection rates (4.1% vs. 0%) was statistically significant (p = 0.0305). Furthermore, no postoperative infections developed in the Group C patients. The most appropriate interval for multiple dose administration was determined by analyzing intraoperative time-related changes in the serum flomoxef concentration during surgery in 21 recent patients. Serum flomoxef concentrations fell below therapeutic levels (3.0 micrograms/ml) by the 6th post-administration hour in 70% of patients. We conclude that this antibiotic regimen significantly reduces the postoperative infection rate following neurosurgical procedures. Multiple dose administration of flomoxef is recommended when the duration of surgery is 6 hours or more.

Adult↗

[Cancer detection with whole-body FDG PET images without attenuation correction].

Whole-body positron emission tomography (PET) using 2-deoxy-2-[18F]fluoro-D-glucose (FDG) has been applied successfully for the detection of cancer. In PET studies, transmission scans for attenuation correction are usually performed. In whole-body PET studies, however, the transmission scans lengthen the acquisition time and are not practical for routine clinical use. Thirty-two patients underwent whole-body PET studies with transmission scans. A total of 106 lesions were true positive on corrected images. At the same time that the corrected images were being reconstructed, uncorrected images were also reconstructed and visually inspected. In a patient with a large breast cancer (11 cm in diameter), the parasternal metastatic lymph node was not identified on the uncorrected image because of image artifacts produced by high FDG accumulation in the breast cancer. In a patient with recurrent colonic cancer, paraaortic metastatic lymph nodes were not well visualized because of attenuation effects. However, 104 out of 106 (98.1%) lesions were recognizable on uncorrected images as well as corrected images. This suggests that uncorrected images can be used for the detection of cancers.

Adult↗

[Cancer screening with whole-body FDG PET].

We are using whole-body positron emission tomography (PET) for cancer screening. A total of 1,105 healthy subjects have undergone PET studies 1,138 times in fifteen months. Emission scans were performed from the pelvis to the maxilla 45 to 60 minutes after intravenous administration of 260 to 370 MBq 2-deoxy-2-[18F]fluoro-D-glucose (FDG). Malignant tumors were detected with PET in nine patients (0.81%): 2 lung cancers, 2 colonic cancers, 1 breast cancer, 1 thyroid cancer, 1 gastric cancer, 1 renal cancer, and 1 lymphoma. Eight of these patients underwent surgery (excepting the lymphoma patient). Lymph node metastasis was not observed in any of the eight cases and surgery was curative. PET scan results were negative in the cases of three prostatic cancers, one bladder cancer, and two colonic mucosal cancers. High FDG accumulations were noticed in benign lesions such as sarcoidosis, chronic thyroiditis, pulmonary tuberculoma, Warthin's tumor of the parotid gland, and chronic sinusitis. In some cases, image artifacts caused by intense myocardial FDG accumulations resulted in incomplete examinations of the lung. Occasionally, high FDG accumulations were observed in the bowel. Our study results suggest the possibility of using whole-body PET for detecting wide varieties of cancers in resectable stages.

Adult↗

Gamma knife radiosurgery for cerebral arteriovenous malformations: an autopsy report focusing on irradiation-induced changes observed in nidus-unrelated arteries.

BACKGROUND: In radiosurgical treatment for an arteriovenous malformation (AVM), the effects of irradiation on the intranidal and perinidal angioarchitectures have seldom been analyzed histologically. An autopsy case is reported, studying an AVM treated by gamma knife radiosurgery. Postmortem studies following AVM-unrelated death were performed after a 2-year angiography had demonstrated complete nidus obliteration. Irradiation-induced changes were also observed in surrounding nidus-unrelated arteries and the choroid plexus, both of which were within the irradiation target. METHODS: Microscopic studies were performed using a coronal section of the brain including the center of the AVM, on which the percent isodose volume gradient, corrected with a magnification rate, was superimposed. RESULTS: This study disclosed that intimal hypertrophy can occur in a normal, AVM-unrelated pial artery due to irradiation of 10 Gy or more and that more remarkable intimal hypertrophy with fragmentation of the elastic laminae, or even complete occlusion, can occur in these arteries with 25 Gy. Similarly, irradiation-induced degeneration was present in the choroid plexus, which had been exposed to doses varying from 10 Gy to 25 Gy. CONCLUSIONS: A normal surrounding blood vessel may also be affected by high-dose, single-fraction irradiation though the abnormal vessels have been reported to be more susceptible.

Adult↗

Sexual activities and concerns in persons with spinal cord injuries.

A survey of sexual activity and concerns of people with spinal cord injury living in the community was undertaken. A questionnaire was sent to 144 people, and 102 replies were collected. Of the sample, 59.8% reported having engaged in some aspect of sexual life. Sexual life ranked the lowest in terms of importance with respect to other aspects of life. However, 47.1% answered that they were not satisfied with their sexual life. It was indicated that the provision of information regarding sexuality should remain a high priority for health care providers.

Adult↗

Macrophage colony-stimulating factor-producing malignant histiocytosis.

We describe a patient with malignant histiocytosis who had a prominent neutrophilia uncommonly observed in this disease. Serum concentration of macrophage colony-stimulating factor (M-CSF) was markedly elevated, and correlated with clinical symptoms and neutrophil counts during clinical course. Moreover, M-CSF was detected in the cytoplasm of malignant histiocytes of the lymph node and bone marrow by immunohistochemical staining. These results indicate that the neutrophilia observed in this patient was caused by M-CSF produced by the malignant histiocytes.

Adult↗

Influences of season and of temperature, photoperiod, and subcutaneous melatonin infusion on the glomerular filtration rate of ewes.

Influences of season and of temperature, photoperiod, and subcutaneous melatonin infusion on glomerular filtration rate (GFR) were measured in ewes. There was a seasonal difference of GFR between summer (June-August) and winter (December-February) in Tokyo (35 degrees, 35' N); GFR was significantly (P < 0.05) higher in summer (4.2 +/- 0.3 ml/min/kg) than in winter (3.0 +/- 0.2 ml/min/kg). GFR was measured after exposure to three types of photoperiod, 24L:0D, 12L:12D, and 0L:24D, for 7 to 8 days. The value for GFR obtained at 20 degrees C was significantly lower (P < 0.05) with 0L:24D than with the other two photoperiodic conditions. GFR obtained during subcutaneous melatonin infusion (20 micrograms/hr for 16 hr/day for 7 days) with 24L:0D conditions was significantly (P < 0.05) lower (2.5 +/- 0.1 ml/min/kg) than without infusion (3.8 +/- 0.3 ml/min/kg) and was about the same as that obtained in animals under 0L:24D conditions. At 30 degrees C, GFR exhibited no difference between the 3 photoperiodic conditions and was always lower than that found at 20 degrees C. Possible influences of melatonin on GFR are discussed.

Animals↗

Periarticular osteopenia in adjuvant induced arthritis: role of interleukin-1 in decreased osteogenic and increased resorptive potential of bone marrow cells.

OBJECTIVE: To clarify the local osteogenic and bone resorptive potential of periarticular bone in adjuvant induced arthritis (AIA). METHODS: Formation of fibroblast colony forming units (FCFU; osteogenic precursor cells) and osteoclast-like cells in bone marrow culture was studied in AIA rats. Osteoclast-inducing activity in the AIA rat bone marrow was assayed by the addition of the marrow supernatant from rats with AIA to control cultures. Bone mineral density was determined by dual x ray absorptiometry. RESULTS: Marrow from AIA rats and that from animals receiving recombinant human interleukin-1 (IL-1) beta for seven days grew significantly fewer FCFU than control marrow. Formation of osteoclast-like cells was increased in bone marrow cultures from rats with AIA, especially when bone marrow cells were cultured in the presence of marrow supernatant. Formation of resorption lacunae on ivory slices was increased in the marrow cultures from rats with AIA, especially from the right (adjuvant inoculated) tibia. AIA rat marrow supernatant promoted osteoclast-like cell formation in control culture, and this was significantly suppressed by an anti-IL-1 antibody. Rats with AIA showed a significant decrease in the bone mineral density of the periarticular regions of the tibia and femur. CONCLUSION: An uncoupled state in bone resorption-formation linkage, possibly mediated through an increase of IL-1 in the bone marrow, may contribute to the development of periarticular osteopenia in inflammatory arthritis.

Animals↗

Gamma Knife radiosurgery in cerebral arteriovenous malformations: postobliteration nidus changes observed on neurodiagnostic imaging.

Computed tomographic (CT), magnetic resonance (MR), MR angiographic and angiographic images, obtained after complete nidus obliteration had been angiographically confirmed, were reviewed in 9 patients who had undergone Gamma Knife treatment for cerebral arteriovenous malformations (AVMs). The period between angiographic confirmation of nidus obliteration and the most recent examinations was 12-84 months (mean 29 months). The patients ranged in age from 9 to 54 years (mean 22 years). There were 6 females and 3 males. In 8 patients, the obliterated nidus was shown on CT to be isodense. Calcification was identified in 3 patients, 1 of whom had not shown calcification on CT before treatment. Contrast enhancement of the nidus was seen in 6 patients, in 5 of whom a significant time-related decrease in contrast enhancement was observed following nidus obliteration. In 6 patients, T1-weighted MR imaging showed a hypointense nidus in 4 cases, both hypo- and isointense in 1 and isointense in 1. T2-weighted imaging showed a more varied nidus intensity than was seen on T1-weighted imaging. No flow signal void was demonstrated in any of these cases. After gadolinium administration, the nidus was enhanced in all cases, markedly in 4 and moderately in 2. In 5 of the 6 cases a time-related decrease in gadolinium enhancement was observed following nidus obliteration. This change was, however, less significant than that observed on contrast-enhanced CT. Angiography and/or MR angiography showed no vascular abnormalities in 7 patients. These results show that radiosurgery-induced changes in a nidus may continue for several years after angiography has shown complete AVM obliteration. These late changes can be considered to involve further obliteration of the remaining or recanalizing vessels, reflecting an ongoing process from coagulation necrosis to liquefaction necrosis.

Adolescent↗