[Treatment of osteogenic sarcoma].
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Bone Neoplasms↗
Biomedical subjects
A Tateishi
Publications and source records attributed to A Tateishi.
The effects of sevoflurane on cerebral blood flow, cerebral metabolic rate for oxygen, intracranial pressure, and the electroencephalogram are similar to those of isoflurane in the rabbit.
The effects of 0.5 and 1.0 MAC end-tidal concentrations of sevoflurane on intracranial pressure, cerebral metabolic rate for oxygen, cerebral blood flow, and the electroencephalogram were compared to those of equi-MAC concentrations of isoflurane in rabbits anesthetized with morphine-nitrous oxide. At 1.0 MAC end-tidal level, both sevoflurane and isoflurane caused a significant reduction in cerebral metabolic rate for oxygen of about 50%. Neither anesthetic caused a significant change in global cerebral blood flow or cortical cerebral blood flow during either 0.5 or 1.0 MAC administration. However, both sevoflurane and isoflurane caused small but significant increases in intracranial pressure during 0.5 MAC and 1.0 MAC administration. The electroencephalogram of animals anesthetized with 1.0 MAC of either anesthetic demonstrated a burst suppression pattern with no evidence of spike or seizure activity. The data suggest that the effects of sevoflurane on cerebral blood flow, cerebral metabolic rate for oxygen, intracranial pressure, and the electroencephalogram are indistinguishable from those of equivalent concentrations of isoflurane in the rabbit.
Animals↗
Anterolateral uncoforaminotomy for cervical spondylotic myeloradiculopathy.
Thirty-five patients with cervical spondylotic radiculopathy and myeloradiculopathy had anterolateral uncoforaminotomy. Spondylotic spurs associated with radiculopathy were continuous from the uncovertebral joint to the posterior ridge of the vertebral body in 33 patients and to the posteriorly bulging disc with posterolateral bony spurs in 2 patients. Anterolateral uncoforaminotomy was found safe to remove the continuous type of spur, resulting in decompression of the cord-root complex, which shifted anteriorly after surgery. The outcome was satisfactory in 19 of 20 radiculopathy patients, and in all 15 myeloradiculopathy patients. Decompression of the cord-root complex is the most important factor in relieving neurologic manifestations of cervical spondylosis.
Adult↗
Effects of nifedipine on intracranial pressure in neurosurgical patients with arterial hypertension.
The effects of nifedipine, 20 mg administered via a nasogastric tube, on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were examined. Nifedipine was administered to treat arterial hypertension (greater than 180 mm Hg, systolic). Ten measurements were made in eight patients with cerebrovascular disease or head trauma. The mean arterial blood pressure (MABP) and ICP were measured before and for 30 minutes after the administration of nifedipine. The MABP gradually decreased and reached its lowest value at approximately 10 minutes after initiation of nifedipine administration, and thereafter remained unchanged. The MABP decreased significantly from 128 +/- 8 (mean +/- standard deviation) to 109 +/- 7 mm Hg, and the CPP decreased from 105 +/- 11 to 84 +/- 10 mm Hg. The ICP increased by 1 to 10 mm Hg in eight of 10 measurements, and the mean change of ICP from 19 +/- 7 to 22 +/- 6 mm Hg was statistically significant. These changes were not accompanied by alterations in neurological signs. The results suggest that enteral nifedipine produces a small but statistically significant increase in ICP. Accordingly, neurological signs must be closely observed to detect deterioration, which can be caused by an increase in ICP and/or a decrease in CPP.
Adult↗
[Evaluation of adjuvant chemotherapy of osteosarcoma with special reference to adriamycin (final report)].
Adjuvant chemotherapy mainly with ADR performed in 117 patients (pts) with primary osteosarcoma of the extremity for the purpose of preventing pulmonary metastasis after radical ablative surgery. The mean follow-up period for 117 pts was 51.7 months (range: 3 to 137), for 53 survivors, 90.1 months (range: 60 to 137) and for 64 decreased, 20.5 months (range: 3 to 73). ADR was administered intravenously with 0.6-0.8 mg/kg/day for 3 consecutive days at monthly intervals after surgery until reaching 600 or 500 mg/m2 of the total cumulative dose. Five-year overall and disease-free survival rate of all pts was 50.2% and 39.4%, respectively. Thirty-seven pts (multi-drug group) with the combination of ADR and HDMTX had a higher survival rate (63.1% in 5-year overall survival rate and 47.8% in 5-year disease-free survival rate) than that of 80 pts with ADR alone (ADR group) (44.4% in 5-year overall survival rate and 35.6% in 5-year disease-free survival rate). Five-year survival rate for 65 pts administered the greater than 500 mg of ADR was 59.3% compared to 36.9% for 52 pts the less than 500 mg (p less than 0.05). In 65 pts administered the greater than 500 mg of ADR, 5-year survival rate (76.5%) of the multidrug group (17 pts) showed superiority to that 52.1%) of the ADR group (48 pts) (p less than 0.01). Even in the multi-drug group, 5-year survival rate (76.5%) of 17 pts administered the greater than 500 mg of ADR was higher than that (41.3%) of 20 pts given the less than 500 mg (p less than 0.01). Distant metastases were recognized at lung in 52 pts (lung group), lung + extrapulmonary organs in 14 (+ extragroup), and only extrapulmonary organs in 3 (extra group). Five-year survival rate of 66 pts with pulmonary metastasis was 17.1% and 21.2% in the lung group compared with 0% of the extra group (P less than 0.01). Five-year survival rate for 23 pts treated with thoracotomy was 43.5% compared to 2.6% for 43 without it (p less than 0.01).
Adolescent↗
[Indications for thoracotomy in pulmonary metastatic sarcoma and its prognosis].
Between 1960 and 1987, 46 patients underwent thoracotomy for pulmonary metastatic sarcoma. The histologic classification of the sarcoma was osteosarcoma in 33 patients, other malignant bone tumors in 6 and soft tissue sarcoma in 7. The cumulative five-year survival rate of the 33 patients with osteosarcoma was 23%. Ten patients survived more than 3 years and 8 of them are still alive without pulmonary metastasis. Prognosis was significantly better with intensive multidrug chemotherapy. In this series, prognosis was not significantly related to the interval from initial onset to initial treatment, that from initial treatment to pulmonary metastasis and that from pulmonary metastasis to initial thoracotomy. The five-year survival rate of the 6 patients with other malignant bone tumors was 35%, and that of the 7 patients with soft tissue sarcoma 26%. Good indications for thoracotomy in pulmonary metastatic osteosarcoma are: (1) the primary sarcoma is resected, (2) the interval from initial treatment to pulmonary metastases is more than 6 months, (3) the number of pulmonary metastases is less than 4 or 5 nodules, and (4) the number and diameter of pulmonary metastases is controlled with chemotherapy within 2 or 3 months after occurrence of metastasis.
Adolescent↗
Intracranial pressure following cardiopulmonary resuscitation.
Intracranial pressure (ICP) was measured in six patients following cardiopulmonary resuscitation (CPR). The causes of cardiac arrest were respiratory or circulatory problems and the primary intracranial pathology was not detected. The measurement of ICP started 3 to 10 h following CPR except one patient in whom it started on the day 7. Duration of ICP measurement ranged from 2 to 7 days. In five out of six patients, ICP persistently remained below 20 mmHg. In the remaining one patient, ICP elevation associated with seizure activity was observed and ICP ultimately increased to 57 mmHg. Among these, four patients died and two remained in a persistent vegetative state. These results suggest that ICP following CPR does not necessarily increase if the patient has no primary intracranial pathology or seizures.
Adult↗
[Limb salvage in osteosarcoma. Significance of preoperative isolation perfusion chemotherapy].
In our Department since 1960 isolation perfusion chemotherapy has been performed as a preoperative procedure combined with surgery in 134 patients with osteosarcoma of the extremity. In this paper, the significance of isolation perfusion chemotherapy was presented. The cumulative 5-year survival rate of 114 perfused patients was 42.7%, while that of 41 non-perfused patients before 1960 was 17.1%. Of the 114 patients 102 underwent amputation and 12 had limb salvage surgery. The cumulative 5-year survival rate of the 9 patients who have received limb salvage surgery since 1978 is 68%. Eleven patients who received preoperative aggressive chemotherapy including isolation perfusion chemotherapy showed a 91% clinical and radiological response to the drug. The tumor was microscopically analyzed and the ratio of necrotic to viable tumor cells was calculated. The degree of tumor necrosis was classified as excellent (greater than or equal to 95%), good (80-94%), fair (50-79%) and poor (less than 50%). The response in 22 patients who received preoperative aggressive chemotherapy using adriamycin, methotrexate and cis-platinum including the use of isolation perfusion was excellent in 41%, good in 36%, fair in 14% and poor in 9%. We believe that preoperative isolation perfusion chemotherapy is an effective procedure for limb salvage surgery.
Adolescent↗
Case report 382: Benign chondroblastoma of talus invading calcaneus.
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Adolescent↗
Nicardipine increases cerebral blood flow but does not improve neurologic recovery in a canine model of complete cerebral ischemia.
The effects of the calcium entry blocker nicardipine on CBF, CMRO2, and neurologic outcome following 10 min of complete cerebral ischemia were examined in dogs. In CBF and CMRO2 studies, the CBF in the untreated group (seven dogs) and the nicardipine group (seven dogs; 20 micrograms kg-1 at 30 min postischemia and a subsequent infusion of 2 micrograms kg-1 min-1 for 90 min) initially increased to 300-400% and then returned to preischemic values at 30 min postischemia. Thereafter the CBF in the untreated group significantly decreased to 50% of preischemic values for the following 90-min period (hypoperfusion), while the CBF in the nicardipine group did not differ from preischemic values. The CMRO2 in both groups decreased to approximately 50-80% of preischemic values after 15 min postischemia and did not differ between the groups throughout the study. In neurologic outcome studies, 18 dogs were divided into three groups (of six dogs each): untreated; saline infusion only, posttreated; nicardipine as in CBF and CMRO2 studies, pretreated; nicardipine 20 micrograms kg-1 at 2 min preischemia and a subsequent infusion of 2 micrograms kg-1 min-1 from immediately postischemia to 120 min postischemia. Nicardipine treatment initiated either before or after ischemia failed to improve neurologic outcome at 48 h postischemia. Thus, the increase of postischemic global CBF by nicardipine is not accompanied by neurologic recovery in a canine model of complete cerebral ischemia.
Animals↗
Epidural migration of extruded cervical disc and its surgical treatment.
Twenty-two patients with epidural migration of cervical disc fragments were reviewed. Disc sequestrations can migrate to the anterior, posterior, and lateral aspects of the spinal canal and are divided into four types according to their localizations. Those migrating to the anterior or posterior surface of the spinal canal, causing myelopathy, were removed through either an anterior or posterior route. Removal of lateral sequestration by uncoforaminotomy provided full recovery for all patients with radiculopathy and drop-attacks. The number of disc sequestrations was not always one: three fragments were present in three patients and two fragments in five patients. Various routes combined with other approaches were indicated to eliminate completely the freely migrating disc sequestra.
Cervical Vertebrae↗
Chondroblastoma of the sacrum. A case report.
Death due to a chondroblastoma of the sacrum is uncommon. We report the case of a 48-year-old man with this condition. During a 10-year period, the tumor spread into the retroperitoneal space and was an enormous mass after repeated radiotherapy. The patient died of renal failure. The tumor was histologically benign even at autopsy.
Chondroblastoma↗
[Surgical treatment of thoracic outlet syndrome].
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Humans↗
Type of collagen in chordoma.
Pepsin-soluble collagen was extracted from three histologically proven cases of chordoma and nucleus pulposus. The collagen types of these materials were investigated by differential salting-out, SDS-PAGE (sodium dodecyl sulphate-polyacrylamide gel electrophoresis) of native collagen and their CNBr (cyanogen bromide) cleaved peptides, and their amino acid compositions. Although the collagen of nucleus pulposus was type II, that of chordoma was largely type I. Collagen of notochord, the origin of nucleus pulposus, is known to be type II. Further investigation is necessary in view of the fact that collagen of chordoma, a tumor believed to be derived from notochord, is not type II.
Aged↗
Cerebral circulation and metabolism during enflurane anesthesia in humans.
The effects of enflurane anesthesia on cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) were studied in 17 patients. The patients were divided into two groups according to the depth of anesthesia. Cerebral perfusion pressure was maintained above 60 mmHg with phenylephrine. In Group 1 (arterial enflurane concentration, 15 mg/dl), patients were studied before surgery, while in group 2 (enflurane concentration, 27 mg/dl), the measurements were performed before and during surgery. In Group 1, mean CBF and CMRO2 were 53 and 2.8 ml X 100 g-1 X min-1, respectively. These values were not significantly different from CBF (46 ml X 100 g-1 X min-1) and CMRO2 (3.1 ml X 100 g-1 X min-1) values previously obtained in awake patients. In Group 2 before surgery, mean CBF and CMRO2 were 61 and 2.6 ml X 100 g-1 X min-1, respectively, and were significantly different from the awake values, while the EEG showed frequent spikes and suppression. In Group 2 during surgery, mean CBF and CMRO2 did not differ from the values obtained before surgery, despite significant EEG changes. The results indicate that enflurane is a cerebral vasodilator and causes an increase in CBF and a decrease in CMRO2 in humans at an anesthetic level characterized by frequent spikes and suppression on the EEG.
Adult↗
[Clinical features and treatment of pulmonary metastasis in osteosarcoma].
Ninety-seven pulmonary metastatic cases in 141 osteosarcoma from 1960 to 1981 were analysed. The overall cumulative 5-year survival rate of the cases was 38.1%, whereas that of the recent 41 cases with systemic chemotherapy was 56.2%. Eighty percent of pulmonary metastases were found within one year since their first visit to our clinic. It was revealed that there were positive relationship between the doubling time of the pulmonary metastases and the post-metastatic survival (p less than 0.001), and between the period from their first visit to our clinic to metastases and the post-metastatic survival (p less than 0.001). The favorable effects of the systemic chemotherapy using adriamycin, vincristine, methotrexate and cis-platinum were recognized. The thoracotomy revealed effective and five cases are living without disease for average 80.8 months after surgery.
Antineoplastic Agents↗
[Determination of malignancy of cartilaginous tumors (1). Clinical and histopathological evaluation of chondrosarcoma].
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Adolescent↗
[Determination of malignancy of cartilaginous tumors (2). Determination of malignancy by nuclear DNA contents and their distribution patterns in cartilaginous tumors].
In 40 different types of cartilaginous tumors, the number of binuclear cells was calculated and DNA content was examined using fluorescent Feulgen cytophotometric technique. In 7 enchondromas and 1 synovial chondromatosis, the DNA content was diploid in 7 and hypotetraploid in 1, and showed a unimodal normal distribution. The number of binuclear cells was 0.1-0.45%, and the mean DNA content was below 4. These cases showed no evidence of disease after curettage and bone graft. The follow-up period was from 4 years 6 months to 7 years 1 month, averaging 6 years 2 months. In 2 enchondromatoses and 2 benign chondroblastomas, the DNA content was diploid and showed a unimodal normal distribution. One chondromyxoid fibroma showed a broad-unimodal tetraploid distribution, and one benign chondroblastoma showed a broad-aneuploid distribution. The nuclear DNA content was sometimes histologically similar to that of chondrosarcoma in some benign cartilaginous tumors. In 5 secondary chondrosarcomas, the DNA content was hypo- or hypertetraploid, hexaploid, and showed broad-unimodal or broad-bimodal distribution. The number of binuclear cells was from 13% to 23%. Although the size of the nucleus was small, the number of binuclear cells was evidently numerous. The preferred treatment for secondary chondrosarcoma is principally wide resection, but amputation is sometimes indicated in cases of recurrence and large tumor size. The follow-up period was from 2 years 2 months to 18 years 11 months, averaging 9 years 11 months. All 5 patients were surviving at the time of follow-up. The DNA content in chondrosarcoma was mostly hypo- or hypertetraploid, hexaploid, or octaploid and showed broad-unimodal, broad-bimodal or broad-aneuploid distribution. The number of binuclear cells was 0.55-3.5%. The mean DNA content was proportional to the number of binuclear cells, the positive correlation between the mean DNA content and the number of binuclear cells was found (p less than 1%).
Adolescent↗