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Biomedical subjects

M Kida

Publications and source records attributed to M Kida.

At least 19 recordsLinked to original sources

Ultrasonic esophagoprobe for TNM staging of highly stenosing esophageal carcinoma.

BACKGROUND: Endosonographic staging of esophageal carcinoma may be limited in one third of cases by tumor stenoses that cannot be traversed with conventional echoendoscopes. We designed and evaluated a new endosonographic instrument (ultrasonic esophagoprobe) for TNM staging of highly stenosing esophageal carcinomas. METHODS: Eighty-seven consecutive patients (64 men, mean age 61 years) with highly stenosing esophageal carcinomas were studied with the esophagoprobe (features: diameter of 7.9 mm, bougie-shaped tip, no fiber optics, insertion over a guide wire). RESULTS: The esophagoprobe was successfully inserted past the stenosis without complication in all patients. Nine patients (10%) required preliminary bougienage to 33 F. The imaging quality was high and allowed for complete T and N staging in all patients. M staging was indeterminate in 15 patients because of inadequate visualization of the celiac axis region. Histopathologic correlation in 38 patients who underwent surgery showed an overall T stage accuracy rate of 89% (T2 = 80%, T3 = 95%, T4 = 87%), and N and M stage accuracies of 79% (N0 = 44%, N1 = 90%) and 91% (M0 = 94%, M1 = 75%), respectively. CONCLUSIONS: The esophagoprobe enables safe passage of highly stenosing esophageal carcinomas for TNM staging. Accuracy rates are similar to those reported for conventional echoendoscopes.

Adult

Pancreatic adenocarcinoma presenting as a splenic abscess: case report and diagnostic approach.

As the fourth leading cause of cancer death in the United States, pancreatic adenocarcinoma is both a diagnostic and a therapeutic challenge. Its incidence has risen in the past four decades so that pancreatic cancer ranks second to colon cancer as a leading cause of death from gastrointestinal malignancy. Despite technical and therapeutic advances, the prognosis remains dismal; the average survival time after diagnosis is characteristically only five to eight months. The current patient had a pancreatic adenocarcinoma that mimicked other disorders. Variability in clinical presentation and imaging studies warrants consideration of this entity in the differential diagnoses of many splenic and pancreatic lesions.

Abscess

[Intra-arterial infusion chemotherapy for advanced liver metastases from lung cancer via implantable vascular access: report of six cases].

Six patients with advanced liver metastases judged as a survival limiting factor from lung cancer were treated with intra-arterial infusion chemotherapy employing totally implantable vascular access. The treatment regimen included 5-FU/CDDP/EPIR/MMC/etoposide in various combinations and this therapy was repeated as long as possible. There were no serious side-effects or complications, such as bone marrow suppression or gastrointestinal symptoms. The therapy could be continued for a mean duration of 7.2 months (ranging from 2 to 13 months). Cause of death was due to extra-hepatic lesion in all 5 patients. The direct effect on liver metastases reviewed on CT scan was 83.3% (CR: 1, PR: 4, NC: 1), and the median survival period was 108 days (for small-cell group: 92 days; for non-small-cell group: 407 days). We conclude that this therapy is useful in the treatment of liver metastases from lung cancer because of its limited toxicity and high direct effect.

Adenocarcinoma

Automated homogeneous liposome-based assay system for total complement activity.

We developed an automated homogeneous immunoassay, based on immune lysis of dinitrophenyl (DNP)-labeled liposomes, for measuring total complement activity. Liposome lysis caused by complement activity was detected spectrophotometrically from entrapped glucose-6-phosphate dehydrogenase activity. Complement activity in human sera was quantified by comparison with a calibration curve. For ease of application to fully automated routine clinical analyzers, we adopted a two-reagent system, one reagent containing a homogeneous population of small DNP-labeled liposomes and one containing antibody/substrate. This system required calibration only once a week. Within-run and between-run CVs were 0.4-1.3% (n = 10) and 1.8-4.7% (n = 10), respectively. Serum results were linear upon dilution (with saline) over a twofold range. Bilirubin, hemoglobin, Intrafat, and serum proteins such as rheumatoid factor, M protein, IgG, and IgA did not affect the assay results. The results (y) correlated well with those from a hemolytic complement activity test (x): y = 1.05x - 1.14, r = 0.92, on 66 samples in the range < 10- > 50 kU/L. This method should therefore be of great use for the determination of complement activity.

Adolescent

Chromosome 1q terminal deletion resulting from de novo translocation with an acrocentric chromosome.

Distal deletion of chromosome 1q has been reported in nearly 30 patients, all being associated with a deletion ranging from the 1q42 or q43 band to 1qter region. Here, we describe a girl with 1q terminal deletion resulting from an unbalanced de novo translocation t(1;D or G)(q44;p11), as revealed by the presence of a satellited feature and an NOR-stained region at the tip of 1q. We suggest that most of the phenotypic abnormalities seen in patients with 1q distal deletion are attributable to the monosomy for band 1q44.

Child, Preschool

Is 300 msec too long for cardiac MR imaging? Feasibility study demonstrating changes in left ventricular cross-sectional area with use of single-shot turboFLASH imaging.

PURPOSE: To assess the feasibility of demonstrating cardiac motion with 313.6-msec single-shot turbo-fast low-angle shot magnetic resonance imaging. MATERIALS AND METHODS: Effects of motion on single-shot images were evaluated with a phantom moving at known velocity. Single-shot images were obtained in eight healthy volunteers and four cardiac patients and compared with conventional cine images. RESULTS: The moving phantom was visualized at the location where zero phase-encoded data were sampled. When the velocity was within the physiologic range of left ventricular wall motion (< 11 cm/sec), the full width at half maximum of the object on a 64 x 64-matrix image with a 4.9-msec repetition time was comparable with that of a stationary phantom. The left ventricular cross-sectional area determined with single-shot imaging showed good correlation with results of conventional cine imaging (r = .96) in healthy volunteers. CONCLUSION: Single-shot imaging can be used for simple and quick assessment of cardiac function.

Feasibility Studies

Dobutamine prevents both myocardial stunning and phosphocreatine overshoot without affecting ATP level.

Catecholamines can overcome myocardial stunning. However, a previous report on energy metabolism in stunned myocardium during catecholamine infusion was based on the conventional biochemical methods which might affect contractile function. Twenty farm pigs were anesthetized and underwent 15 min coronary artery occlusion and 2 h reperfusion. Ten pigs were given 10 micrograms/kg/min dobutamine from immediately after and throughout the reperfusion (dobutamine group). The other ten pigs were given saline (control group). Phosphorus-31 magnetic resonance spectroscopy and sonomicrometry were done alternately. Dobutamine improved percent segment shortening after reperfusion (control/dobutamine = 3.8%-5.7%/11.7%-13.4%; P < 0.01). At 15 min ischemia, adenosine triphosphate (ATP) decreased (control/dobutamine = 72 +/- 8%/73 +/- 10%, n.s.), and remained depressed after reperfusion in both groups. After reperfusion, phosphocreatine (PCr) returned to and maintained the preischemic value in the dobutamine group, while in the control group, PCr overshoot (112 +/- 5%) was observed. Except for the presence and absence of PCr overshoot, there was no significant difference of ATP and PCr between the two groups, although rate pressure product was significantly higher in the dobutamine group than in the control group. Regional myocardial blood flow after reperfusion was significantly higher in the dobutamine group. Dobutamine may improve "stunning" through effective improvement of energy utilization and production, indicated by the disappearance of PCr overshoot and maintained ATP level.

Adenosine Triphosphate

Time-dependent loss of surface complement regulatory activity during storage of donor blood.

The survival of transfused red cells (RBCs) diminishes with time of in vitro storage in blood banks, but the molecular mechanisms underlying the slow but incessant deterioration are incompletely understood. To investigate the possibility that impaired resistance to autologous complement attack could play a role in this phenomenon, packed RBCs stored for variable periods were assayed for decay-accelerating factor (DAF) and CD59, two glycoinositol-phospholipid (GPI)-anchored, membrane-associated complement regulatory proteins that function physiologically to protect blood cells from autologous complement activation on their surfaces. Immunoradiometric and flow cytometric assays employing DAF and CD59 monoclonal antibodies showed that levels of both surface proteins gradually declined over 6 weeks. Digestion analyses with phosphatidylinositol-specific phospholipase C, an enzyme that releases GPI-anchored proteins from cell surfaces, showed that DAF and CD59 molecules with GPI anchors containing unacylated inositol were preferentially lost. These findings suggest: 1) that DAF and CD59 molecules with acylated GPI anchors are more stable in RBC membranes than are molecules with unacylated GPI anchors, and 2) that DAF and CD59 loss may participate with other membrane alterations that occur during in vitro storage in compromising the survival of transfused cells.

Antigens, CD

11q trisomy detected by fluorescence in situ hybridization.

A patient with psychomotor developmental delay, multiple minor anomalies, congenital heart disease and left inguinal hernia is reported. His karyotype was 45,X/46,X,+mar (3:37 cells), and the marker chromosome was identified as t(Y;11)(q12;q14?) using fluorescence in situ hybridization and fluorescent chromosome painting. He was diagnosed as mosaic for de novo 11q trisomy.

Abnormalities, Multiple

Cognitive performance and event-related brain potentials under simulated high altitudes.

The effects of hypobaric hypoxia on cognitive processing in humans were studied by recording event-related potentials (ERPs) from the scalp in a go/no-go reaction time (RT) paradigm under various simulated high altitudes. Most subjects indicated abrupt impairment of RT at high altitudes. RTs lengthened in association with changes in latency and amplitude of the N2-P3 components, reflecting sensory discrimination and evaluation processes. Some subjects did not suffer any changes in RT up to an extremely high altitude of 6,000 m. In the latter case, although the N2-P3 components did not undergo any changes, the P3 component was followed by a sequence of negative on-going (frontal maximum) and positive on-going (parietal maximum) slow waves. The amplitudes of these slow waves increased as altitude increased. Although these same waves appeared in the ERPs of subjects who demonstrated the increase in RTs at high altitudes, when the subjects failed in the RT task, both of the slow waves either disappeared or diminished. Such slow waves may be associated with attempts to maintain RTs against the deteriorative effects of hypobaric hypoxia.

Adult

Preconditioning improves energy metabolism during reperfusion but does not attenuate myocardial stunning in porcine hearts.

BACKGROUND: It has been reported that a brief period of coronary occlusion and reperfusion slows the rate of ATP depletion during subsequent sustained ischemia as well as limiting infarct size. However, it has not yet been determined whether ischemic preconditioning also has an effect on the functional and metabolic recovery of stunned myocardium. Our study was designed to address this problem. METHODS AND RESULTS: Farm pigs were anesthetized with fluothane and randomly assigned to either a control group or a preconditioned group. The control group (n = 15) underwent 15 minutes of coronary occlusion followed by 120 minutes of reperfusion. The preconditioned group (n = 14) underwent two episodes of 5-minute occlusion and 5-minute reperfusion followed by 15 minutes of occlusion and 120 minutes of reperfusion. This protocol was designed to exclude the stunning effect of the preconditioning procedure itself as much as possible besides preconditioning the heart. A pair of ultrasonic crystals was implanted in the area at risk perfused by the left anterior descending coronary artery. 31P-nuclear magnetic resonance spectroscopy and sonomicrometry were performed alternately. Regional myocardial blood flow (RMBF) was determined with colored microspheres. At 15 minutes of sustained ischemia, phosphocreatine (Pcr), ATP, and intracellular pH were significantly better preserved in the preconditioned group (Pcr: control/preconditioned, 1 +/- 1%/14 +/- 1%; ATP:control/preconditioned, 66 +/- 2%/74 +/- 2%; pH:control/preconditioned, 6.32 +/- 0.07/6.52 +/- 0.05; P < .05). After reperfusion, ATP increased progressively and was almost normalized at 120 minutes of reperfusion in the preconditioned group (control/preconditioned, 73 +/- 4%/95 +/- 3%; P < .05). Overshoot of Pcr (which indicates that the energy generating system is operating better than energy utilizing system) persisted in preconditioned hearts but disappeared rapidly in controls (control/preconditioned, 104 +/- 3%/130 +/- 3% after 120 minutes of reperfusion). There was no significant difference in percent segment shortening (%SS), RMBF, and hemodynamics between the two groups throughout the experiment (%SS: control/preconditioned, 29.8 +/- 5.9%/28.8 +/- 6.3% of baseline after 120 minutes of reperfusion). CONCLUSIONS: Preconditioning improves energy metabolism during reperfusion, although it does not attenuate myocardial stunning for at least 2 hours after reperfusion.

Adenosine Triphosphate

[Comparison between ELISA and culture method for detection of Helicobacter pylori].

Detection of Helicobacter pylori (H. pylori) by ELISA was compared with that by the culture method in 115 patients with gastroduodenal diseases. Both the sensitivity and specificity were more than 85% for patients with histological gastritis with neutrophil infiltration. This indicated that the detection of H. pylori by ELISA is useful for the diagnosis of H. pylori-related gastritis. Although the sensitivity between the ELISA and culture method was 85%, the specificity was 58.8%. The false negative detection may have been caused by a sampling error during the endoscopic biopsy.

Adult

Constitutional translocation t(4;22) (q12;q12.2) associated with neurofibromatosis type 2.

We report on a female patient with bilateral acoustic neurinomas and other tumors in the central nervous system (neurofibromatosis type 2: NF2) and the constitutional translocation, t(4;22) (q12;q12.2). The precise identification of the translocation breakpoint (q12.2) on chromosome 22 implies the refined localization of a gene responsible for NF2, and would provide a clue to its molecular characterization and to the isolation of the gene. Chromosomes of a paraspinal neurinoma from the patient were also analyzed, and the same karyotype as seen in cultured peripheral lymphocytes was found. The patient's father was also a carrier of the translocation, but he had no clinical symptoms of NF2, nor did other relatives. Several explanations are offered for the different expression of the translocation between the patient and her father.

Adult