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Biomedical subjects

F Tanaka

Publications and source records attributed to F Tanaka.

At least 199 records · Page 11Linked to original sources

[A case of mediastinal liposarcoma].

Primary liposarcomas of the mediastinum are rare neoplasms comprising only 0.13-0.75% of mediastinal tumors. We report a case of liposarcoma arising in the right posterior mediastinum. A 74-year-old man without symptoms was admitted to our hospital for evaluation of an abnormal shadow on chest roentgenogram. Computed tomogram (CT) and magnetic resonance (MR) imaging revealed a mediastinal tumor. The tumor was surgically removed, and the diagnosis of well-differentiated liposarcoma was established. MR imaging was superior to CT in evaluation of tumor extent, but not in differential diagnosis as liposarcoma or lipoma.

Aged↗

[Four cases of spontaneous pneumothorax with no reexpansion of collapsed lung despite chest tube drainage].

We report four cases of spontaneous pneumothorax with no reexpansion of the collapsed lung despite chest tube placement and adequate suction. The cause of absence of reexpansion was endobronchial obstruction by bronchogenic carcinoma in one patient and by sputum plug in another. In the other two patients, the collapsed lung had pulmonary fibrosis and did not reexpand at all because of reduced pulmonary compliance.

Adult↗

[Therapeutic application of Nd-YAG laser treatment for the chest surgery area].

Laser therapy is now a well-established procedure and an accepted method of treatment in thoracic surgery. Therefore, using Nd-YAG laser (Model Md-50 Y) at hospital, we had discussed for the technique and its indication of laser therapeutic application against chest diseases. The following results were obtained; 1) The first object of endoscopic laser therapy is to keep the normal air-way from tracheobronchial stenosis or its bleeding as fast as possible. 2) As this laser techniques are not only the quick expansion of the residual lung but also relative absence of air-leak and blood loss, they are indicated for open lung biopsy or partial resection of metastatic lung tumors, particularly in patients with poor pulmonary function. 3) In conjunction with standard surgical technique of chest surgery, this laser treatment provides numerous other possibilities which facilitate the achievement of the therapeutic goal of surgical operation on the lungs.

Adult↗

Incidence of prominent corneal nerves in multiple endocrine neoplasia type 2A.

We studied the increased visibility of corneal nerves inside an 8-mm diameter central corneal area in 14 patients with multiple endocrine neoplasia type 2A, one patient with multiple endocrine neoplasia type 2B, five patients with nonhereditary medullary thyroid carcinoma, ten patients with anterior keratoconus, and ten normal subjects. We used a grading system (grade 0 through grade 4) for nerve visibility based on slit-lamp biomicroscopic examination and photographic documentation. All 20 normal eyes showed either grade 0 or grade 1, which indicated no pathologic thickening of corneal nerves. Sixteen of the 28 eyes (57%) with multiple endocrine neoplasia type 2A, however, were evaluated as grade 2 or higher, which indicated thickened corneal nerves. The incidence of high nerve visibility in eyes with multiple endocrine neoplasia type 2A was significantly greater compared to normal eyes (P less than .0001), anterior keratoconus (P less than .0001), and nonhereditary medullary thyroid carcinoma (P = .0012). Furthermore, eight of the 28 eyes (29%) with multiple endocrine neoplasia type 2A showed markedly prominent corneal nerves (grade 3 and 4), a prominence similar to those seen in eyes with multiple endocrine neoplasia type 2B. There was no definite relationship among prominent nerve, age of the patient, and occurrence of pheochromocytoma. These findings suggest that over half of all patients with multiple endocrine neoplasia type 2A show corneal nerves pathologically thickened to different degrees.

Adult↗

Ischemia-reperfusion arrhythmias and lipids: effect of human high- and low-density lipoproteins on reperfusion arrhythmias.

The effect of high- and low-density lipoproteins separated from human serum on the postischemic reperfusion arrhythmias was investigated. The hearts were perfused by working heart mode with Krebs Henseleit bicarbonate buffer containing arachidonic acid (1 microgram/ml) for 5 minutes. Whole heart ischemia was induced by the use of a one-way ball valve, and hearts were perfused for 15 minutes followed by 20 minutes of reperfusion. Physiologic concentrations of high- and low-density lipoproteins were constantly infused through the atrial route during ischemic perfusion. Coronary effluent was collected via pulmonary artery cannulation for subsequent radioimmunoassay of thromboxane B2 and 6-keto-prostaglandin F1 alpha, the major stable metabolites of thromboxane A2 and prostacyclin, respectively. The incidence of ventricular arrhythmias during reperfusion was 6/6 (100%), 1/6 (17%), and 6/6 (100%) in control, high-density lipoprotein and low-density lipoprotein infusion groups, respectively. There was no significant difference in coronary flow among the three groups throughout the perfusion. Both thromboxane B2 and 6-keto-prostaglandin F1 alpha increased significantly during ischemia compared with preischemic values in all groups of hearts. However, the ratio of these two parameters varied in control and low-density lipoprotein infusion groups during ischemia, while there was no significant change in the high-density lipoprotein infusion group. These results provide the possibility that arachidonate metabolites may be involved in the regulation of ischemia-reperfusion arrhythmias and that high-density lipoprotein that was infused during ischemia markedly inhibits the incidence of ischemia-reperfusion-induced ventricular arrhythmias, due in part at least, to stabilizing the arachidonate metabolites during ischemic perfusion.

Animals↗

A new method of hernioplasty for adult groin hernias centering on repair of the transversalis fascia.

A new method of hernioplasty for adult groin hernias centering on repair of the transversalis fascia was assessed by a questionnaire conducted every five years on adult patients who had received the above operation. The efficacy of this method was evaluated in terms of the postoperative quality of life and prevention of recurrence of groin hernias. Over the last 9 years, 834 adult patients with 921 groin hernias, including bilateral lesions, have undergone the above procedure and overall, favorable results were obtained, with only one case of recurrence (0.1 per cent) being reported. Contralateral herniation, which has been often reported following Bassini's or Hatakoshi's method, was found in only one of our patients although the number of patients who complained of pain in the operated region was comparatively high, being 51 cases or 11.4 per cent.

Adult↗

[Choroidal detachment associated with rhegmatogenous retinal detachment and aqueous flare].

The aqueous protein level (APL) in eyes of rhegmatogenous retinal detachment (RRD) combined with or without choroidal detachment (CD) was investigated using a laser flare-cell meter. The APL in eyes of RRD with CD was 70 times higher than in eyes of simple RRD. The APL increased suddenly with the appearance of CD and decreased rapidly in accordance with the disappearance of CD. The longer the CD continued, the higher the APL remained preoperatively as well as postoperatively. The APL in eyes of RRD with CD was still twice as high as in eyes of simple RRD 6 months after successful retinal reattachment. This marked and prolonged intraocular inflammation in eyes of RRD with CD might result in a poorer visual outcome. The extremely high APL might be caused by reflux of suprachoroidal protein through the uveoscleral route and/or venous protein through the trabecular meshwork due to ocular hypotony and possibly by diffusion of protein via posterior chamber and vitreous cavity due to the breakdown of the blood-ocular barrier.

Adult↗

[Role of surgical treatment in thoracic empyema with bronchopleural and/or thoracic empyema].

Sixty-nine patients with thoracic empyema treated surgically were experienced from May, 1978 through December, 1990. Thirty-nine cases had bronchopleural and/or thoracic fistula. Thirty-two patients were associated with pulmonary tuberculosis, of whom fourteen had tuberculous empyema and eighteen were sequelae of pulmonary tuberculosis or tuberculous pleurisy. The remainder were postoperative, postpneumonic, and posttraumatic empyemas. Of fourteen patients who developed postoperative bronchopleural fistula, there were ten patients who had lobectomy or pneumonectomy for lung cancers. Omental pedicle flap method, in which empyema space was filled with the omentum and pedicled muscle flap, was performed on 19 patients with bronchopleural or thoracic fistula or both. Fifteen patients were cured successfully by single-stage procedure, though there was one operative death due to aspiration pneumonia, and two recurrences which were treated by muscle plombages. There was another patient who had multiple surgical procedures in the past resulting in partial recurrences, but the fistula of this patient subsequently closed without reoperation. Postoperative decrease of %VC, FEV1.0/PVC were minimal. Treatment of long standing bronchopleural fistula is a difficult problem, and our omental pedicle flap method is relatively simple and safe which can be most suitably applied to those patients in whom other procedures have failed and to those with poor pulmonary functions.

Adolescent↗

[A case of leiomyoma of the trachea].

An asymptomatic 59-year-old male in whom an abnormal shadow was detected on indirect chest X-ray film, was referred to our hospital for further examination. Further examinations revealed no problem at the previously checked site. However, bronchoscopy revealed a protruding hemispheric lesion on the membranous portion of the trachea 2 cm above the carina. The biopsy specimens revealed that the lesion was leiomyoma of the trachea. Transbronchoscopic biopsy was performed three times and the lesion disappeared. A few small fibrous nodules remained. The incidence of this primary tracheal tumor is rare, and benign lesions are much less common than malignant lesions. Furthermore, leiomyoma of the trachea is extremely rare. Only 20 cases have been reported in Japanese and English literature. The average age of the reported cases, including our case, was 49.3 years old. Among the male patients, most cases were around 50 years old but among female patients, there was no standard age for this disease. Clinical symptoms included coughing, dyspnea, wheezing and bloody sputum. There were several patients with severe dyspnea, two of which died. Ten patients (50%) had been misdiagnosed as having bronchial asthma. If a case is suspected to be bronchial asthma in which and where bronchodilators have little effect, we must always consider the possibility of this type of lesion, and perform further examinations and treatment.

Bronchoscopy↗

[Poly-lactic-acid (PLA) sternal pins for the closure of median sternotomy--report of a case].

Poly-lactic-acid (PLA) sternal pins were used for the closure of median sternotomy in a case of bilateral pneumothorax. After placement 7 sutures of polyester and 2 wires, PLA sternal pins were inserted into the bone marrow of the sternum. The wires were then twisted and tightened, and all sutures were tightened, and the wires were removed. No significant postoperative complications, i.e., osteomyelitis and mediastinitis, sternal dehiscence, or bone marrow dysfunction, were observed. In addition, the PLA sternal pins were absorbed. In the closure of median sternotomy, PLA sternal pins provide stable sternal adhesion, which is essential to the prevention of sternal dehiscence and other complications. Moreover, with the use of PLA sternal pins, the retention of steel wires in the body is unnecessary.

Adolescent↗

[A case of recurrent corneal erosion caused by self-inflicted injury].

A 20-year-old female developed periodically recurrent corneal erosion in a 10mm diameter area of the central cornea. Since the episodes of corneal erosion occurred suddenly in the early morning every 6-7 days and since medical treatments could not prevent recurrence, we suspected that the corneal erosion was due to self-inflicted injury such as mechanical damage and/or topical application of toxic drugs. Psychological tests also indicated that the patient had a tendency towards hysteria. The corneal erosion has not recurred since we completely protected both her eyes at night. These findings strongly suggested that the cause of this corneal erosion was due to self-inflicted injury.

Adult↗

[Effect of intravenous administration of coagulation factor XIII concentrate on persistent pleural air leak].

We administered coagulation factor XIII concentrate intravenously to six patients suffering from persistent air leak with no evidence of bronchopleural fistulae They are those who had either failed to be healed in response to pleurodesis, intrapleural fibrin glue injection and surgery or had not received such treatment. Their blood coagulation factor XIII activity levels were less than 70% of the standard plasma level. In four of the six patients, air leak stopped within 10 days after the treatment begun. Because factor XIII plays an important role in wound healing, reduction in the activity level can be a cause of insufficient healing of pulmonary surface fistulae and may lead to persistent air leak. In such cases, intravenous administration of factor XIII concentrate increases the activity levels and may put an end to persistent air leak.

Adolescent↗

[A clinical study of small advanced lung cancer with metastasis to mediastinal lymph node].

From January 1981 through December 1989, 15 patients with small advanced lung cancer were treated surgically at the Tenri Hospital. In these cases, the diameter of peripheral lung cancer did not exceed 3.0 cm (T1) and mediastinal lymph nodes were proved to be N2 postoperatively by lymph node dissection or sampling. The histological types were as follows: 8 adenocarcinoma, 4 large cell carcinoma, 1 squamous cell carcinoma, 1 small cell carcinoma, and 1 adenosquamous carcinoma. All but one patient were received postoperative chemotherapy and/or radiotherapy. The survival rate was 44.5% at 3 years, and median survival time was 36 months. The mediastinal lymph node metastasis with small peripheral lung cancer (T1N2) was ominous, and it should be said that complete mediastinal lymph node dissection and adjuvant therapy were indispensable to small advanced adenocarcinoma of lung.

Aged↗

[A clinical study on bilateral metachronous pneumothorax].

Three hundred and thirty-six cases of spontaneous pneumothorax were treated in our hospital from 1976 to 1988. In these 336 cases, there were 49 cases (14.6%) of bilateral metachronous pneumothorax. Bilateral metachronous pneumothorax happened significantly more frequently in the younger generation. There was no correlation between occurrence rate of contralateral pneumothorax and Brinkman index. In addition, postoperative contralateral recurrence occurred in 18.1% of surgical cases under general anesthesia. Especially nitrous oxide might have influence on postoperative contralateral recurrence.

Adolescent↗

[Fever of unknown origin: re-evaluation of 67Ga scintigraphy in detecting causes of fever].

Radioactive gallium citrate has been known to accumulate not only in neoplasms but also in inflammatory foci, and thus widely used to find out pyrogenic lesions in cases of unexplainable prolonged fever. However, with developments and improvements of other imaging modalities, its diagnostic significance may have changed. To probe that issue, recent 65 scans for the patients with fever of unknown origin were reviewed retrospectively. Of these, 56 had sufficient clinical assessment and laboratory examinations to evaluate causative illnesses. Gallium images of 33 patients were interpreted as positive. Local inflammatory lesions were detected in 23 cases, with lung tuberculosis, urinary tract infection, and inflammatory joint diseases as prevalent final diagnoses. Pyogenic abscesses, though popular in the literatures on fever of unknown origin, were found in only 2 cases in our present series. This seemed to be due to earlier detection of affected sites by other imaging technics. Osteomyelitis, other major cause of fever in the past, was not found this time, probably owing to wide use of antibiotics. Besides localized diseases, seven cases of generalized disorders were found. There were 3 patients with hematological malignancies, 3 with systemic autoimmune diseases, and 1 with severe infectious mononucleosis. There were three false positive cases; intestinal gallium radioactivity in 2 cases and physiological pulmonary hilar accumulation in 1 were erroneously read as abnormal. Of 23 cases with negative gallium scan, no definite cause of fever were found in 19; twelve patients had spontaneous reduction of fever, 2 did so with antibiotics, and 5 with corticosteroids. False negative cases were; two with urinary tract infection on antibiotics, one with bacterial meningitis, and one with polyarteritis nodosa. Our results reconfirmed the excellent sensitivity and accuracy of gallium scan in the diagnosis of fever of unknown origin. In addition to the detection of focal inflammations, it may sometimes contribute to an early diagnosis of unexpected systemic diseases. From the results obtained, it is advisable that, in patients with fever of unknown origin, this test should be done early in diagnostic schedule and before administration of drugs that may mask potential sites of abnormal accumulation.

Adolescent↗