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Biomedical subjects

E Sakai

Publications and source records attributed to E Sakai.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Two cases of Ewing's sarcoma originating from the adult rib].

Two cases of Ewing's sarcoma originating from the adult rib were reported. Case 1: A 23-year-old male was admitted for further examination of a right anterior chest wall tumor. The tumor was resected and the pathological examination revealed Ewing's sarcoma. Adriamycin, vincristine, cyclophosphamide and actinomycin-D were administered. After 1 year the patient died due to local relapse. Case 2: A 28-year-old male was found to have a left extrapleural tumor on chest roentgenogram. He responded to chemotherapy consisting of CDDP, etoposide, ifosfamide and radiotherapy at a dose of 38.4 Gy before surgery. On the surgical specimen no tumor cells were observed and his postoperative course has been good. According to our experience, exact preoperative diagnosis and adjuvant therapy are necessary to improve the prognosis of Ewing's sarcoma patient.

Adult↗
PubMed1991

[Acute and chronic effects of vasodilators in a case of chronic recurrent pulmonary embolism].

A 65-year-old man was admitted to our hospital because of shortness of breath on exertion. As the results of examinations including pulmonary angiography, pulmonary perfusion scan and pulmonary ventilation scan, we diagnosed the case as chronic recurrent pulmonary embolism. Although the patient received thrombolytic therapy by a tissue plasminogen activator (t-PA), there was no noticeable improvement. However, oxygen and vasodilator therapy had marked effective on the hemodynamics. In chronic pulmonary embolism, vasodilators are generally not considered to be effective for improvement of hemodynamics. However, if the acute effects of vasodilators were confirmed, we should try to administer them while paying attention to possible adverse effects.

Aged↗
PubMed1990

[Photodynamic therapy in the early treatment of cancer].

The clinical application of photodynamic therapy (PDT) began in the late 1970's. Hematoporphyrin derivative has been used as a photosensitizer and recently Photofrin II (Dihematoporphyrin ether, DHE) was also developed as a second generation photosensitizer. The argon dye laseris used to excite the photosensitizer, however an eximer dye laser was recently developed as more effective laser. In a multicenter research study project team (7 institutions) on photodynamic therapy organized by the Ministry of Health and Welfare, 133 cases of gastric cancer (including 120 cases of early stage cancer), 209 cases of lung cancer (69 cases of early stage cancer), 66 cases of esophageal cancer (22 cases of early stage cancer), 68 cases of bladder cancer (68 cases of early stage cancer), and 86 cases of other organ cancers were treated. In early stage cancer cases 77.3% showed complete remission (CR) but among those the recurrence was 15.7% in lung cancer cases and opposed to 100% CR and 22.2% recurrence in gastric cancer cases, 80% CR and no recurrence in esophageal cancer cases, and 68.6% CR and 58.3% recurrence in bladder cancer cases. Especially in limited lesions less than 1 cm in diameter, the CR was obtained in 100% and the recurrence was recognized in only 1 (2.6%) of 28 lung cancer lesions, 100% CR and no recurrence was obtained in 30 lesions of gastric cancer and also 100% CR with no recurrence was recognized in 16 lesions in bladder cancer. This study suggests that PDT has the potential to cure early stage cancer lesions.

Esophageal Neoplasms↗
PubMed1990

[A case of giant bullae of the lung with thrombosis in the inferior vena cava and the pulmonary artery].

A case of giant bullae of the lung is rarely accompanied with thrombosis in the inferior vena cava and the pulmonary artery, and because of the risk of pulmonary infarction, this case needed a surgical treatment. At this time, we removed the thrombus from the IVC as the first step of the operation, and two months later a bullectomy and the exploratory incision of the right main pulmonary artery were attempted as the second step of the operation. However, the thrombus in the pulmonary artery had spontaneously disappeared. The postoperative course was uneventful and there has been no evidence of recurrence with anticoagulant therapy.

Cysts↗
PubMed1990

[Respiratory pathophysiology during sleep in patients with myotonic dystrophy].

Myotonic dystrophy is a genetic disorder inherited as an autosomal dominant trait. It is known to be associated with endocrine dysfunction, polar cataracts, cardiac abnormalities and other conditions. Respiratory distress constituents the principal problem in myotonic dystrophy. The author investigated postural change of respiratory function in 12 patients with myotonic dystrophy (MYD), and 7 patients with limb-girdle dystrophy (LG) and overnight polysomnography was performed on 10 patients with MYD and 5 patients with LG. The respiratory function in seated posture showed no significant difference between LG and MYD, but in patients with MYD, the vital capacity and the expiratory reserve volume in a supine posture was reduced in comparison to that during seated posture. However, the respiratory function in patients with LG was not significantly different in seated and supine postures. Also, in patients with MYD, there was a significant decrease in arterial PO2 from the seated posture to the supine posture, without a significant change in the arterial PCO2. However, in patients with LG, there was no significant change in arterial blood gas analysis parameters. It was speculated that these findings concerning respiratory function and blood gas analysis in patients with MYD were caused by the involvement of the diaphragm. In the supine posture, the diaphragm shifted to the cranial position because of the abdominal contents rising into thorax, therefore the lung volume was reduced and the ventilation-perfusion ratio deteriorated. The changes of respiratory function parameters and PaO2 were partly responsible for the hypoxemia observed during sleep in patients with MYD. Overnight polysomnography showed that 9 of the 10 patients with MYD and 1 of the 5 patients with LG presented apneas during sleep, particularly during REM, stage 1 and stage 2. Almost all apneas were central type, with a low percentage of obstructive apneas and the apnea index was 19.0/h (mean) in MYD, 6.5/h in one case of LG. These result strongly suggest that sleep apnea is of central origin, but the distinction between a central and an obstructive etiology is difficult in neuromuscular disease and particularly when a disorder of central ventilatory responsiveness is suspected. The respiratory function of MYD and LG in seated and supine postures was studied and overnight polysomnography performed. It was emphasized that it was important for the respiratory care of neuromuscular disease to consider the influence of postural changes in the respiratory function. The present series of studies revealed central sleep apnea in the patients with myotonic dystrophy.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1990

[A case report of isolated congenital tricuspid regurgitation].

Reports of isolated congenital tricuspid regurgitation are very rare. A 20-year-old female with severe tricuspid regurgitation was reported. The patient was admitted to our hospital with complaints of easy fatigability and palpitation. Right ventriculogram showed severe tricuspid regurgitation. She was treated with tricuspid valve replacement with a 33 mm bioprosthetic valve. Seven surgical treated cases of isolated congenital tricuspid regurgitation including our case were collected from literature and reviewed.

Adult↗
PubMed1990

The effects of photosensitization by hematoporphyrin derivative on the protein content of cultured human lung cancer cells. A flow cytometric analysis.

In order to study the cytotoxic mechanisms of photodynamic therapy (PDT), the changes in the intracellular content of protein and DNA of cultured human lung cancer cells were examined by flow cytometry using the fluorescent dyes fluorescein isothiocyanate (FITC) and propidium iodide (PI). Immediately after PDT, the protein content increased while the DNA content showed little change. After more than 24 hours, the protein and DNA content were markedly decreased in lethally damaged cells; in sublethally damaged cells, however, the protein content gradually decreased to the level of that before PDT while the DNA content showed little change. These changes in the protein content may reflect the impairment of the plasma membrane function by PDT and its subsequent recovery in some cells.

DNA, Neoplasm↗
PubMed1990

[Diagnosis of invasion to thoracic aorta and superior vena cava in lung cancer; comparative studies on CT and MRI in resected or autopsied cases].

The diagnostic accuracy of invasion to the thoracic aorta (n = 23) and the superior vena cava (n = 22) on CT and MRI was compared to operative or autopsied finding in lung cancer. MRI was slightly superior to CT in its ability to diagnose tumor invasion to them. It is noteworthy that this invasion could be easily demonstrated by multiplanar MRI. In conclusion, because CT or MRI has diagnostic weak point respectively, these modalities should be combined adequately corresponding to the areas of tumor invasion.

Aorta, Thoracic↗
PubMed1989

[MR imaging in the assessment of lung cancer patients: primary lung cancer staging, evaluation of therapeutic effect and diagnosis of recurrent tumor].

Magnetic resonance imaging and computed tomography were compared in a prospective study of 137 lung cancer patients proved by surgery or autopsy for determining the staging, evaluation of therapeutic effect and diagnosis of recurrent tumor. 1. Lung cancer staging In peripheral lung cancer, T1 and T2 relaxation times of the tumors before operation have some correlation with those of operated specimens. These relaxation times, however, are of limited nodule characterization. Hilar mass and adjacent pulmonary consolidation (obstructive pneumonia or collapse) can be distinguished on T2-weighted image (77%) and Gd-DTPA enhanced image (80%). Therefore these images help in distinguishing tumor from peripheral lung disease. In the diagnosis of tumor invasion to the heart and great vessels, MRI is superior to CT because MRI can be helpful in distinguishing true mass from heart and great vessels. As for the chest wall, MRI is more useful than CT in detecting tumor invasion especially to the thoracic inlet and superior regions. In the diagnosis of mediastinal and hilar lymphadenopathy, MRI is equivalent or slightly inferior to CT, but MRI can easily demonstrate the lymphadenopathy at subcarinal region on coronal image. 2. Evaluation of therapeutic effect in lung cancer patients treated by radiation and chemotherapy MRI patterns of therapeutic effect was divided into 3 types. It is suggested that there is some correlation between these patterns and histologic types. MRI can easily demonstrate necrotic area on T2-weighted and Gd-DTPA enhanced images. 3. Diagnosis of recurrent tumor in treated lung cancer Concerning detecting recurrent tumor after surgery or irradiation, and delineating tumor from radiation pneumonitis, T2-weighted and Gd-DTPA enhanced images are of clinical value.

Combined Modality Therapy↗
PubMed1989

[Two cases of miliary tuberculosis with SIADH].

Two cases of miliary tuberculosis with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were reported. Case 1. A 70-year-old woman suffering from general fatigue and appetite loss developed neck stiffness and stupor three days after admission. The chest X-ray film showed a miliary pattern in both lungs. The lumber puncture showed high pressure and increased leucocytes in the cerebrospinal fluid. Serum natrium concentration was 113 mEq/L. Tubercle bacilli were seen in the broncho-alveolar lavage fluid by the Ziehl-Nielsen staining. An improvement in electrolytes balance was produced by 2.5% NaCl and antituberculous treatment, then her mental function recovered. Case 2. A 71-year-old man was admitted with gastric ulcer. When he developed dry cough thirty days after admission, the chest X-ray film showed a miliary pattern in both lungs. Acute respiratory failure advanced concomitantly. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl-Nielsen staining. Antituberculous treatment was started. Although the miliary shadow improved gradually, hyponatremia was rather progressing. The following values for serum constituents were determined: sodium, 118 mEq/L; antidiuretic hormone, 10.3 pg/ml. Antituberculous treatment and supplement of NaCl (10 g/day) improved serum natrium level. He had no mental disturbance in his clinical course. In both cases, thyroid, renal and adrenal function were normal. Systemic edema and dehydration did not exist at the state of hyponatremia, and it was very clear that laboratory data were compatible with SIADH criteria. Miliary tuberculosis is one of the least commonly recognized causes of SIADH.

Aged↗