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Biomedical subjects

M Segawa

Publications and source records attributed to M Segawa.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Intelligence and language of individuals who incurred left hemisphere injury at no later than 3 years of age].

It is generally considered that damage to the brain during infancy and young childhood results in milder or different syndromes than does brain injury incurred during adulthood. However, only several past studies employed CT scans to confirm that lesions are confined to one of the two cerebral hemispheres. We examined intelligence and language skills of 5 cases, which sustained nonprogressive damage exclusively to the left cerebral hemisphere before 1 year of age, and 1 case, which incurred nonprogressive left hemisphere injury at 3 years of age. These cases were tested at 9 to 25 years of age, or 8 to 22 years after inflicting injuries. The following scales and tests, all of which are Japanese versions, were employed: the Wechsler Intelligence Scale for Children-Revised (WISC-R) to measure intelligence of 3 cases at 15 years of age or younger, the Wechsler Adult Intelligence Scale (WAIS) for 3 cases older than 15 years of age, the Western Aphasia Bettery (WAB) to measure language skills, and the shortened version of the Token Test to assess auditory comprehension skills. Upon administration of the tests, we obtained the following results: 1) Although 1 case had a large lesion in the left hemisphere, she exhibited a high IQ of 111, and was adapted well as a college student. The result suggested that large lesions, if incurred at no later than 1 year of age, may affect intelligence to only a little or negligible extent. 2) Verbal IQ generally declines from left hemisphere damage in adults. In all of our subjects, however, verbal IQ was similar to performance IQ.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Serum profiles of steroid hormones in patients with Cushing's syndrome determined by a new HPLC/RIA method.

We developed a method for simultaneously measuring steroid hormones in very small volumes of serum, using a combination of high-performance liquid chromatography (HPLC) and radioimmunoassay (RIA). By this method, aldosterone, cortisol, 11-deoxycortisol, estrone, estradiol, androstenedione, dehydroepiandrosterone, deoxycorticosterone, 17-hydroxyprogesterone, testosterone, pregnenolone, and progesterone could be determined in a single 100-microL aliquot of serum from normal adults and patients with Cushing's syndrome. The steroid profile associated with Cushing's syndrome caused by adrenal adenoma was quite distinct from that associated with the syndrome caused by adrenal hyperplasia. Serum concentrations of androstenedione, dehydroepiandrosterone, estrone, estradiol, 17-hydroxyprogesterone, pregnenolone, and testosterone were significantly higher in patients with adrenal hyperplasia than in those with an adenoma. We compared the results of this HPLC/RIA method with those of 125I RIAs. The use of a HPLC/RIA system to obtain an accurate and sensitive profile of a range of serum steroids, as described here, obviates the need for large volumes of blood.

Chromatography, High Pressure Liquid↗
PubMed1991

[Study of para-aortic lymph node metastasis for advanced gastric cancer on consecutive lymph node slices].

Para-aortic lymph nodes (No. 16) from 21 patients with advanced gastric cancer who underwent extensive lymph node dissection, were sliced consecutively at intervals of 50 mu to study minute metastasis of No. 16 lymph nodes. Twenty-six of 30 metastatic lymph nodes had minute involvement, in which carcinoma cells were detected in marginal sinus of lymph node, microscopically. The rate of the metastases to No. 16 lymph nodes was 19% among N0-3 cases by conventional method (not consecutive slices). On the contrary, the percentage of metastasis to No. 16 lymph nodes by consecutive slices was 33% among N0-3 cases. Therefore, No. 16 nodes are involved in metastasis at high rate at operation and the extensive lymph node dissection including No. 16 nodes (R4) will be recommended to prevent lymph node recurrence caused by such a minute metastasis.

Aorta↗
PubMed1991

[Sampling of specimens for laboratory examinations].

By the construction of hospital total system, marked developments, such as efficiency and labor-saving of work, have introduced to clinical practice and medical managements. Almost the same developments were also acquired by virtue of computerization in laboratory analysis. In our hospital, the Laboratory Information System (LIS) was connected in on-line mode with the Shared Hospital Information System (SHIS) and the Medical Data Administration System (MDAS). These systems resulted in the possession of the efficiency for laboratory process and in the diminution of various kinds of errors. However, the delay in the systematization was found on the problem in the preanalytical phase, especially on the collection of specimens. It is mainly because of multiformity of the circumstances reflected in every patient and in every ward, for example, variousness of clinicians' order for laboratory tests, many procedures and intricately scheduled timetable of the collection of blood. In order to obtain the more rapid and accurate test results, the construction of computerized system is also necessary for the collection and the transformation of blood. In this paper, problems concerning with the collection (sampling) of specimens were summarized.

Clinical Laboratory Information Systems↗
PubMed1990

A retrospective study on the efficacy of cervical lymph node dissection in well-differentiated carcinoma of the thyroid.

The management of cervical lymph node metastases in well-differentiated carcinoma of the thyroid is controversial. In our department, from 1963 to 1972, node plucking was performed only in patients with cervical lymphadenopathy whereas, from 1973 to 1983, modified radical neck dissection was therapeutically or electively performed. In order to determine whether the more extensive dissection is adequate, a retrospective analysis was performed using two groups of patients who were managed differently with regard to the treatment of cervical lymph node metastases. From this series of 206 patients with more than five years follow-up, it was found that the rates of survival and lymph node recurrence did not differ between the two groups. However, since the well-differentiated carcinoma of the thyroid has relatively indolent biological behaviour, further long-term follow-up seems to be necessary for demonstrating the efficacy of neck dissection.

Adolescent↗
PubMed1990

Effect of a platelet activating factor antagonist (CV6209) on shock caused by temporary hepatic inflow occlusion.

Platelet activating factor (PAF) is a newly discovered inflammatory chemical mediator, which was reported to play a pivotal role in various types of shock. There is also a great possibility that PAF plays an important role in the shock caused by hepatic inflow occlusion. In the present study, the effect of CV6209, a PAF antagonist, on the shock caused by the occlusion was investigated. Intravenous 3 micrograms/kg of PAF caused hypotension in Wistar rats (n=6), and pretreatment with intravenous 3 mg/kg of CV6209 significantly (p less than 0.01) prevented the hypotension (n=6). Forty-five minutes of hepatic inflow occlusion caused hypotension in rats during the occlusion period, and the hypotension continued even after restoration of blood flow in control group (pretreated with saline i.v. only, n=5). In contrast, this hypotension was significantly (p less than 0.01) reversed in PAF antagonist group (pretreated with 3 mg/kg of CV6209 i.v., n=5). In sham-operated rats (n=6), arterial pressure remained unchanged and not hypotensive during the monitoring period. The survival rate of rats 90 minutes after declamp was 30% in control group (n=20), and that was significantly (p less than 0.05) improved to be 65% in PAF antagonist group (n=20). In conclusion, PAF plays an important role in the shock and death caused by temporary hepatic inflow occlusion, and a PAF antagonist could be a therapeutic drug against temporary hepatic inflow occlusion.

Analysis of Variance↗
PubMed1990

Clinical features of the early stage of the Rett syndrome.

Our previous reports have pointed out that the Rett syndrome (RS) starts from early infancy with autistic behavior and muscle hypotonia, and we have raised the hypothesis in regard to the pathophysiology that RS can be an early developmental disorder of the monoaminergic and indolamine systems. This paper presents the reanalysis of early motor and behavioral features performed on 16 patients. The most frequent complaint was developmental delay, but 2 cases were presented with autistic behaviors. Development showed delay even from head control. Crawling was particularly difficult. Muscle hypotonia was present in all cases. Early autistic behaviors were seen in high degree and the most frequent was the pervasive lack of social association. Autistic behaviors characterizing older autism were seen in various degrees. These findings reconfirm our previous reports and hypothesis. Furthermore, it can be suggested that the onset may even be in the fetal stage and that lesions of specific neuronal systems occurring in early ontogeny could result in specific abnormality in the higher system which manifest later in development, after these structures reach certain levels of maturation.

Child↗
PubMed1990

Characteristics of motor disturbances of the Rett syndrome.

The stereotyped movement of hands, one of the core symptoms of the Rett syndrome (RS), was analyzed to study the pathophysiology. The development of hand function was delayed after mid-infancy and handedness was undetermined in most cases. Before the onset of the pathognomonic stereotypy, patients showed excessive or abnormal behaviors of hands and mouth, such as patting or licking hands, etc. The useful hand function was lost just before or after the onset of stereotypy. The characteristic "hand wringing" movement at midline became apparent from 8 months to 3 years of age. The synchronous hand movement without reaching the midline and leg movement at midline were also seen in some patients. Based on the analysis of these symptoms, it is suggested that the stereotyped movements of RS are manifestation of fragments of normal motor behaviors at immature levels appearing excessively and repetitively with the abnormal basic posture. The pathophysiological mechanism of these characteristics is thought to be due to the hypofunctional state of the monoaminergic system from early ontogeny, which is in accordance with our previous hypothesis that RS is a developmental disorder of the monoaminergic system. The roles of the cortical involvement and sensory system are also discussed.

Adolescent↗
PubMed1990

The pathophysiology of the Rett syndrome from the standpoint of polysomnography.

Twelve polysomnographies were performed on eight cases of the Rett syndrome and the results were compared between cases under and over 5 years of age. There observed an increase in the ratio of stage REM (sREM) against slow wave sleep (SWS) with age. The ratio of the number of mentalis twitch movement (ment TM) during sREM against the number of rapid eye movements (REMs) (reflecting dopaminergic activities) was below normal in the younger cases but increased markedly. The ratio of ment TM in the period of REMs burst against the total ment TM during sREM (reflecting the noradrenergic hypofunction) was high in the younger group, while it decreased later. The nocturnal variation became inapparent with age in % SWS and the phasic components of sREM, while that of % sREM exaggerated at later ages. The early hypofunctions of the noradrenergic and dopaminergic neurons later modified by the serotonergic dysfunction and dopaminergic postsynaptic supersensitivity are suggested.

Child↗
PubMed1990

HLA antigens in Japanese patients with myasthenia gravis.

HLA antigens in 104 Japanese patients and 41 families with myasthenia gravis (MG) were investigated. The frequencies of DR9 and DRw13 were significantly increased in the patients who developed MG before 3 yr of age. The DQw3 antigen was positive for all the patients that developed MG before 15 yr with only one exception. All the examined cases that developed MG before 3 yr (including this DQw3 negative patient) had the same DQA and DQB DNA restriction fragments. These HLA frequencies decreased as the age of onset increased, and no significant association was observed in adult-onset MG. No patients had B8, DR3, and DQw2. The relative risk was higher for the DR9/DRw13 heterozygotes (37.4) than for DR9 (16.4) or DRw13 (7.1) in the childhood-onset MG. Statistical analysis suggested that DR9 and DRw13 (or DQw1 and DQw3) act synergistically in the disease development. Family study revealed diverse DR9 haplotypes. The most frequent DRw13 haplotype was Bw44-BFF-C4A3B1-DRw13-DQw1, which may be evolutionarily related to the caucasian B8-DR3-DQw2 haplotype. These results showed that MG in early childhood in Japanese individuals is genetically different from that in adulthood and that in caucasians.

Age Factors↗
PubMed1990

[Neoadjuvant chemotherapy of far advanced gastric cancer--effect of preoperative chemotherapy by PMUE (CDDP, MMC, UFT, etoposide].

Preoperative chemotherapy with CDDP, MMC, UFT and etoposide (PMUE) was performed on cases of far advanced gastric cancer whose curative resection was impossible. The therapy comprised 1-5 courses of either intravenous or arterial infusion, or intraperitoneal administration of CDDP 75 mg/m2, MMC 10 mg/body and Etoposide 50 X 3 mg/body at 3-week intervals in combined use of UFT 400 mg/body. The effect of the preoperative PMUE therapy was CR, PR, NC and PD in 0, 7, 1 and 0 cases, respectively, the rate of effectiveness being 88% (7/8). 5 of 7 cases with PR were operated on, 2 cases succeeded in curative resection, but 3 cases did not. Histological judgment of effects confirmed Grade II-a, II-b and III in 2, 2 and 1 cases, respectively; these 5 cases further received 1-4 courses of PMUE therapy as postoperative adjuvant chemotherapy and are still alive at P.S. 0-2, suggesting the great efficacy of this PMUE therapy as a neoadjuvant chemotherapy for improvement in prognosis in far advanced gastric cancer. Abnormally high values of the tumor marker were noted in 5 of 8 cases, 4 of which had tumor marker values lowered in exponential function by the preoperative chemotherapy, which constituted an effective index in determining chemotherapeutic effects and the determination of the operative timing.

Adult↗
PubMed1989

[Experimental study on changes of temperature at palatal mucosa after denture wearing].

The purpose of this study is to estimate objectively temperature changes of palatal mucosa after denture wearing. Temperature at 7 measurement points of palatal mucosa in 10 normal dentate subjects were measured to determine the time constant by carrying out a least square approximation of the relation between temperature and time from the time of commencement of temperature measurement until the time of temperature elevation to a steady state. Changes in the time constant by thermal stimulation with cold and warm water and by wearing of an experimental palatal plate were studied. It was found that if the time constant is obtained from values measured at 60-second intervals, the predicted and measured values of steady-state temperature are well approximated and that the time constant is significantly reduced from 3 days after wearing of an experimental palatal plate and is significantly increased (prolonged) from 3 days after thermal stimulation. These results demonstrated that temperature changes of the palatal mucosa during the use of a removable denture can be subjectively and quantitatively estimated with accuracy on the basis of the time constant obtained by least square.

Body Temperature↗
PubMed1989

[Analysis of prognostic factors in patients with hepatocellular cancer treated by hepatic arterial infusion chemotherapy].

Analyses of the prognoses of thirty-four patients with hepatocellular cancer, who were treated by hepatic arterial infusion chemotherapy and/or transcatheter arterial embolization (TAE) and/or hyperthermotherapy, were performed by multivariate analysis using Cox's proportional hazard model and generalized Wilcoxon test. In the multivariate analysis on the conditions of patients, nine of fifteen variables were associated with the prognosis of patients who received regional cancer chemotherapy. The variables are: sex, liver cirrhosis, esophageal varices, GOT, GPT, albumin and gamma-globulin. One of three variables was associated with the prognosis in the therapy analysis, and the variable is TAE. Significant differences in survival curves which were estimated by generalized Wilcoxon test were noted in age, portal vein invasion, ascites, GOT and TAE. From these results it is suggested that the conditions of patients with unresectable hepatocellular cancer must be carefully investigated before regional cancer chemotherapy and the good therapy effects is obtained by hepatic arterial infusion chemotherapy combined with transcatheter arterial embolization therapy.

Aged↗
PubMed1989

[An intensification therapy of adults acute leukemia].

Between January 1980 and March 1983, a study was conducted on the effects of intensification therapy in 20 adult acute leukemia patients who had achieved complete remission with induction therapy. Intensification therapy consisted of cyclic administration of six combination therapies given at gradually longer intervals, using daunorubicin, cytosine arabinoside, 6-mercaptopurine and prednisolone (DCMP), cyclocytidine (DCyMP), vincristine (DCVP), behenoyl-ara-c (BHAC-DMP), aclacinomycin (BHAC-AMP) and (ACM-MP). Six combinations were given sequentially at one-month intervals, at 2-, 3-, 4-, 5- and eventually 6-month intervals, until 5-year survival. The median remission duration was 38 months for AML, and 17 months for ALL. The median survival was 66 months for AML, and 37 months for ALL. The five year survival rate was 50%. Nine of the 20 patients are still alive. Methotrexate and prednisolone were administered intrathecally for prophylaxis of CNS leukemia on Day 4 for each intensification therapy. There was no CNS leukemia. This intensification protocol was shown to be effective in improving the prognosis of adults acute leukemia.

Acute Disease↗
PubMed1989

[A neurologic model of early infantile autism].

Based on the abnormalities in sleep-wakefulness cycle of early infantile autism, the author discussed its pathophysiology focusing on its main lesion in the raphe nuclei. These neurons, located in the midline portion of the brainstem send their axons to various neurons of the upper and lower nervous systems, including the locus coeruleus and the dopamine neurons of the tegmentum, the former having a broad innervation and the latter a restricted area in the central nervous system. These monoaminergic neurons modulate the functions of the involved neurons and regulate their functional and structural maturation in the early developmental course. The early lesion of the raphe nuclei causes poor adaptation to environment which develops as abnormal circadian oscillation and pervasive lack of responsiveness. Combined hypofunction of the locus ceruleus, particularly of its dorsal bundle, results in the failure of extinction of acquired memory in mice which relates clinically to the excellent memory and resistance to change peculiar interests and attachments in humans. From early childhood, the disturbance of dopaminergic neurons becomes apparent clinically, and causes hyperkinesia and stereotyped activities. With the other two monoaminergic neurons, dopaminergic neurons cause occasional aggressiveness or self-mutilation. The latter behaviors are like those of pampered children and are simulated to "muricide" and "friendliness" observed in rats with these monoaminergic lesions. The particular language disturbance with echolalia is due to the right hemispheric dominance, which might have been caused by a delayed functional lateralization of the hemisphere resulting also from the delayed development of the circadian oscillation in infancy. The motor disturbances consisting of hypotonia and impaired locomotion might be due to decreased tonic innervations of the locus ceruleus and the raphe nuclei to the spinal locomotion center. CT examination of symptomatic autism showed the amygdala as one of the causative nuclei for the autistic behavior.

Animals↗