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Biomedical subjects

H Aikawa

Publications and source records attributed to H Aikawa.

At least 37 records · Page 2Linked to original sources

What kind of hilar lung cancer can be a candidate for segmentectomy with curative intent?: Retrospective clinicopathological study of completely resected roentgenographically occult bronchogenic squamous cell carcinoma.

Although a randomized control trial demonstrated that limited surgery for small peripheral lung cancers was not as curative as lobectomy, there have been no reports concerning segmentectomy for small hilar lung cancers. In this study, we analyzed the clinicopathological features of roentgenographically occult bronchogenic squamous cell carcinomas in order to select candidates for limited resection with curative intent. From April 1982 through June 1995, 105 roentgenographically occult bronchogenic squamous cell carcinomas whose proximal edge of the lesion was more peripheral than the orifice of the segmental bronchus were completely resected. The bronchoscopic findings of the lesions were classified into three categories: remarkable, minute and hidden. Moreover, in terms of the range of endoscopic visibility, the lesions were classified into two categories: lesions within the range of endoscopic visibility and those beyond it. If lymph nodes show no signs of metastasis, roentgenographically occult bronchogenic squamous cell carcinoma is regarded as localized carcinoma and can be a candidate for segmentectomy with curative intent. In cases with minute or hidden bronchoscopic findings or of lesions within the range of endoscopic visibility, metastatic lymph nodes were never observed. Accordingly, roentgenographically occult bronchogenic squamous cell carcinomas with minute or hidden bronchoscopic findings or those within the range of endoscopic visibility can be candidates for curative segmentectomy.

Bronchoscopy↗

Sequential loss of heterozygosity in the progression of squamous cell carcinoma of the lung.

Radiographically occult bronchogenic squamous cell carcinomas are early lung cancers that localize mainly in the bronchial wall, and are thought to be a good model for investigating genetic alterations through lung cancer progression. In order to elucidate sequential genetic changes in lung cancers, we analysed the incidence of allelic losses on chromosome regions 2q33, 3p21, 5q21, 7q31, 9p21 and 17p13 for 40 cases of radiographically occult bronchogenic squamous-cell carcinomas and 40 cases of advanced lung cancers microdissected. In this study we used eight microsatellite dinucleotide polymorphic markers. Frequent loss of heterozygosity (LOH) was observed on 3p21 (53%), 5q21 (44%) and 17p13 (61%) in roentgenographically occult bronchogenic squamous cell carcinomas. 2q, 7q and 9p were lost less frequently in both roentgenographically occult bronchogenic squamous cell carcinomas and advanced lung cancers. These results suggest that several tumour-suppressor genes are associated with lung cancer progression and that genetic changes on 3p21, 5q21 and 17p13 are early events.

Carcinoma, Bronchogenic↗

[Flow cytometric analysis of the effects of 50 Hz magnetic fields on mouse spermatogenesis].

The cellular effects of an extremely-low-frequency (ELF) magnetic field on mouse spermatogenesis were assessed by DNA flow cytometry and serum testosterone. Seven week old male ICR mice were exposed to a 50 Hz magnetic field the strength of which was 1.0 m Tesla. Seven mice per treatment group were exposed for 13, 26, 39 or 52 days. For each experimental point, an equal number of mice per sham-treated group were used as a control and were exposed only to the background field below 1 mu Tesla in the same room as the treatment group. In the control mice, the testis cellular DNA content distribution by flow cytometory was characterized by four quantifiable populations; round spermatids (1C), spermatogonia and other diploid cells (2C), spermatogonial cells synthesizing DNA (S-phase) and primary spermatocytes (4C). In animals exposed for 26 days the number of cells in the 4C and the 4C:2C ratio was significantly lower, and the 1C:4C ratio (meiotic transformation) was significantly higher than the corresponding control groups. In animals exposed for 52 days the cell population in 1C and the 1C:2C ratio (total germ-cell transformation) was significantly higher, and the cell population in 2C was significantly lower than the corresponding control groups. The concentration of serum testosterone in animals exposed for 13 days was significantly higher than in the corresponding control group. These changes suggest that long-term exposure to an ELF magnetic field had a possible effect on the proliferation and differentiation of spermatogonia.

Animals↗

Pelvic extension of retroperitoneal fluid: analysis in vivo.

OBJECTIVE: The purposes of this study were to describe the pathway of fluid flow from the retroperitoneal space into the pelvic extraperitoneal space on CT in vivo, to clarify the relation between its occurrence and the site or amount of retroperitoneal fluid, and to delineate the anatomic relation between the retroperitoneal spaces and the pelvic extraperitoneal space. MATERIALS AND METHODS: We reviewed the CT scans of 37 patients with retroperitoneal fluid collections. Patients who had undergone pelvic laparotomy and patients who had either fascial thickening alone or fluid within muscle (such as the psoas muscle or iliac muscle) alone were excluded. RESULTS: Fluid extension into the pelvic extraperitoneal space was seen in six patients (16%). Extension by the infrarenal extraperitoneal space was seen in all six of these patients, but extension by properitoneal fat was seen in only one of the six patients. In patients with large amounts of fluid in the infrarenal extraperitoneal space, we frequently saw extension into the pelvic extraperitoneal space. Extension of pancreatic fluid into the infrarenal extraperitoneal space occurred in only 15% of the 37 patients. However, it occurred in both patients with ruptured abdominal aortic aneurysms. Three pathways from the infrarenal extraperitoneal space into the pelvic extraperitoneal space were seen: extension dorsally medial to the iliac vessels (n = 6), extension dorsally lateral to the iliac vessels (n = 1), and extension medially into the prevesical space (n = 2). Coexistence of two of these three pathways was seen in three patients. CONCLUSION: In vivo, extension of retroperitoneal fluid into the pelvic extraperitoneal space is not rare and occurs more often by the infrarenal extraperitoneal space than by properitoneal fat. Extension of retroperitoneal fluid to the infrarenal extraperitoneal space can be attributed less frequently to sources distant to the pelvic cavity such as pancreatic fluid. Such extension often derives from sources that can produce large amounts of retroperitoneal fluid such as ruptured abdominal aortic aneurysms. Of the three pathways from the infrarenal extraperitoneal space to the pelvic extraperitoneal space, dorsal extension medial to the iliac vessels is the most common, and multiple pathways often coexist.

Body Fluids↗

Safety and kinetic properties of a humanized antibody to human interleukin-6 receptor in healthy non-human primates.

A monoclonal antibody, hPM-1, was constructed by grafting the complementarity determining regions to human interleukin-6 (IL-6) receptor, raised in mouse, onto a human antibody backbone (humanized antibody). It is expected to be useful as a therapeutic agent for IL-6-related diseases such as multiple myeloma. To investigate the toxicological and kinetic properties of hPM-1 preliminarily, normal cynomolgus monkeys, which showed cross-reactivity with hPM-1, were intravenously administered with hPM-1 at doses of 0 (vehicle), 4 or 40 mg/kg once a week for 13 weeks. Upon toxicological examination, there were no changes in clinical signs, food consumption, body weights, urinalyses, body temperatures, electrocardiograms, hematological and biochemical parameters including blood platelet counts, serum levels of immunoglobulin G and C-reactive protein, and pathological findings. In a kinetic study, serum concentrations of hPM-1 showed a linearity between doses of 4 and 40 mg/kg. The serum concentrations, even at a dose of 4 mg/kg, were maintained at a high enough level to inhibit the IL-6 functions throughout the period of the study. Concentrations of hPM-1 in bone marrow were almost equal to those in serum. The antibodies against hPM-1 were detected only in one of four monkeys receiving hPM-1. This study suggests that blockage of the IL-6 receptor by hPM-1 does not induce any influence on a healthy living body, and hPM-1 is not toxic under the conditions of this investigation.

Animals↗

Adenoid cystic carcinoma of the external auditory canal: correlation between histological features and MRI appearances.

A rare case of adenoid cystic carcinoma of the external auditory canal with magnetic resonance imaging appearances is reported. Both T1 weighted and T2 weighted MR images showed the tumour as a hypointense mass, although there was marked contrast enhancement. Microscopic examination of the resected tumour showed a preponderance of solid tumour cell nests. According to previous reports, these pathological and radiological findings indicate a poor prognosis.

Aged↗

[The significance of surgical treatment for T4 lung cancer].

A total of 114 pT4 patients underwent pulmonary resection from January 1980 to December 1993 at our hospital. The overall five-year survival rate of the 114 cases was 17%. There was no significance between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. Five-year survival rates of 17 patients with N0 disease, 29 patients with N1 disease, 51 patients with N2 disease, 1 patients with N3 disease, and 16 patients with NX disease were 40%, 21%, 21%, 0%, and 0%, respectively. Five-year survival rate of 89 cases with single factor of T4 was 24% and that of 25 cases with more than one factor was 4% (0.05 < P < 0.1). In the patients with only single factor of T4, five-year survival rates of 6 patients with left atrium invasion, 13 patients with major vessel invasion, 9 patients with trachea/carina invasion, and 18 patients with vertebral body, were 50%, 38%, 22%, and 0%, respectively. Furthermore, in 38 pT4 patients with involvement only to single adjacent structure, five-year survival rates were 47% in curative operation (n = 17) and 10% in non-curative operation (n = 21) (P < 0.05). We conclude that surgical treatment for T4 lung cancer should be performed to patients with single structure invasion which is expected to have a curative operation. N0 disease is more favorable than N1 or N2 disease.

Adenocarcinoma↗

[A child of malignant lymphoma diagnosed by transbronchial aspiration cytology under general anesthesia with a laryngeal mask].

A 8-year-old male with Wiskott-Aldrich syndrome was admitted to our hospital because of left hilar swelling on a chest roentgeonogram. Bronchofiberscopy and transbronchial aspiration cytology (TBAC) was performed under general anesthesia with a laryngeal mask. The specimen obtained by TBAC was immediately stained and diagnosed as malignant lymphoma. One month later, thoracotomy was performed in order to get more detail diagnosis, which is necessary to determine the regimen of chemotherapy, and the nodal specimen were diagnosed as Hodgkin's disease. The ABVD therapy was performed which induced the complete remission. The laryngeal mask is a useful device for bronchofiberscopy in children.

Anesthesia, General↗

Usefulness of ultrasonography in operation for pulmonary arteriovenous fistula.

A 54-year-old woman presented with nonhereditary, bilateral pulmonary arteriovenous fistulas. One of them was small (10 x 10 mm) and embedded in the parenchyma; it was neither visible nor palpable from the pleural surface. We therefore used intraoperative ultrasonography and succeeded in detecting and enucleating the small fistula with minimal resection of the normal lung tissue.

Arteriovenous Fistula↗

[Two cases of clear cell tumor of the lung].

We report two cases of benign clear cell tumor of the lung, which were found as well-circumscribed lesions on chest X-ray films without any symptoms, and removed surgically. Light microscopy showed proliferation of clear cells filled with glycogen in both cases. Immunohistochemical examination performed in a case suggested that the tumor cells might be associated to a derivation from neural and/or smooth muscle cells, because of positive staining for NSE and SMA. In another case, the tumor formed a necrotic cavity, which could be detected by the preoperative MRI examination. This report might introduce a note of caution for the pathologic and radiographic diversity of this disease.

Adult↗

[Standardization of use of 4-F size catheter for selective transcatheter angiography and intervention of abdomen].

To evaluate the safety and efficacy of a new 4 French (F) catheter/sheath system with large lumina for selective abdominal arteriography and intervention, the usefulness of the 4F sheath (4F group, 88 patients) was compared with that of a 5.5F sheath and a 7F sheath (5.5F group, 7F group, 156 patients). The compression time of the arterial puncture site and the ambulation time in the 4F group were significantly shorter than those in the 5.5F and 7F groups. The hemorrhagic complication rate in the 4F group (15%) was less than those in the 5.5F group (23%) and 7F group (27%). The severity of hemorrhagic complications in the 4F group (hematoma 2.3%, woozing 14%, and rhexis 0%) was significantly less than in the 5F group (3%, 21%, 0%) and 7F group (11%, 19%, 2.4%). The controlability of the 4F catheter as compared with a 5F catheter was estimated in 35 patients by questionnaire. The torque transmissibility and the endurability of the kink of the 4F catheter were poor in comparison with the 5F catheter. However, with respect to the ability to follow over a guidewire, the 4F catheter showed great advantage over the 5F catheter. It is concluded that the 4F catheter/sheath system is feasible for general use in selective abdominal arteriography and interventions.

Abdomen↗

[Assessment of a new TNM classification produced by UICC for resected lung cancer with intrapulmonary satellite tumor(s)].

We examined the efficacy of a new classification produced by International Union Against Cancer (UICC) in 1993 for 61 patients who underwent resection of lung cancer with intrapulmonary satellite tumor(s) during 1952 to June 1991. Survival rate after resection was calculated according to the new classification. Survival rate of patients with stage I lung cancer was 67% at four years after surgery, that with stage IIIA was 33% and stage IIIB 5% at five years after surgery. There was a significant difference between the survival of stage IIIA and stage IIIB. Five year survival of patients with N0 or N1 lung cancer was 62%, which was significantly better than four year survival (3%) with N2, N3, or NX lung cancer. Five year survival for patients with squamous cell carcinoma was 61%, which was significantly better than that (9%) with adenocarcinoma. The new TNM classification produced by UICC is acceptable in investigating lung cancer with ipsilateral satellite tumor(s). It is necessary to investigate lung cancer with contralateral satellite tumor(s). Prognosis of patients with N0 or N1 lung cancer, especially squamous cell carcinoma, even if with intrapulmonary satellite tumor(s), was relatively good after resection. Such lung cancers may be synchronous multiple lung cancers from a therapeutic point of view.

Adult↗

Effects of ethyl alcohol administration to THA rat dams during their gestation period on learning behavior and on levels of monoamines and metabolites in the brain of pups after birth.

Children born from chronic alcoholic mothers have shown behavioral teratogenic effects more frequently than morphological malformations. To investigate the possible mechanisms and evaluate maternal alcohol dosage levels to induce behavioral dysfunctions, we gave pregnant Tokai High Avoider (THA) rats 0, 5, 10, and 20% ethanol (EtOH) as drinking water during the gestation period. We evaluated the brain function of pups born of alcohol-administered dams. Sidman avoidance behavior test and the levels of monoamines (nor-adrenalin, dopamine, and serotonin) and metabolites (3, 4-dihydroxyphenyl acetic acid, homovanillic acid, and 5-hydroxyindole acetic acid) in whole brain were examined for neurobehavioral and neurochemical effects. EtOH-exposed THA offsprings showed high pre- and postnatal mortality, growth deficits, and brain weight reductions. Compared with the results of the same conditioning experiment using Wistar rats, the THA rat may have higher susceptibility to the effects of in utero EtOH exposure than Wistar rats. EtOH-exposed THA pups exhibited deficits in avoidance operant learning that were not shown in Wistar rats. We also observed the increased levels of all monoamines that were assumed to be related with the deficit of learning, the decreased levels of 3, 4-dihydroxyphenyl acetic acid and homovanillic acid, and the unchanged levels of 5-hydroxyindole acetic acid in pups from dams administered 10 and 20% EtOH. However, contrary alteration of monoamines and their metabolites were shown in pups from 5% EtOH-administered dams.

Animals↗

[Results of surgical treatment of intrathoracic recurrence after complete resection of non-small cell lung cancer: clinical significance of subsequent lesion in lung parenchyma].

Results of surgical treatment for 33 intrathoracic recurrence after complete resection of non-small cell lung cancer were analyzed. Prognosis of the second surgical treatment were favorable in patients with subsequent cancer with in situ component and solitary lesion in lung parenchyma. Retrospective study of 53 patients who recurred and were thoroughly followed up their clinical course until lung cancer death revealed that the solitary one tends to be confined to the intrathoracic location, and the multiple one did not confined to the intrathoracic location but also extended to the extrathoracic distant metastasis or to the supraclavicular lymph nodes.

Carcinoma, Non-Small-Cell Lung↗

Multiple intrahepatic aneurysms following transcatheter arterial embolization. Work in progress.

PURPOSE: To discuss the mechanism of multiple intrahepatic aneurysm formation after transcatheter arterial embolization (TAE) performed in five patients with hepatocellular carcinoma. MATERIALS AND METHODS: TAE was performed with gelatin sponge particles and iodized oil as embolic materials. Mitomycin C was also used in four cases. RESULTS: Three to 14 aneurysms 1-6 mm in diameter were found in third-to sixth-order branches of the hepatic arteries at repeat angiography performed 25-45 days after TAE. Follow-up angiograms in three cases revealed that most aneurysms were no longer apparent except in one patient in whom two aneurysms remained and were larger than before. In none of the five cases were any signs of aneurysm rupture noted. CONCLUSION: Radiologists should be aware of this complication of TAE. It is speculated that the main cause of aneurysm formation in these patients was the embolic agents used.

Aneurysm↗

[Flow cytometric analysis of nuclear DNA content of lung cancer--correlation between nuclear DNA content and tumor doubling time].

A total of 65 resected cases with primary lung cancer were examined on correlation between nuclear DNA content by flow cytometry and other prognostic factors, including tumor doubling time (DT). 1) DNA diploidy was found in 18 cases (28%) and DNA aneuploidy in 47 cases (72%). Percent aneuploidy was 79.5% in cases with adenocarcinoma, which tended to be higher than that in cases with squamous cell carcinoma (57.1%). 2) Percent aneuploidy in cases with advanced carcinomas tended to be higher than that in cases with earlier carcinomas, and percent aneuploidy in cases with rapid growing carcinomas tended to be higher than that in cases with slow growing carcinomas. 3) The geometric mean of DT of DNA aneuploid tumor was 130.0 day, which tended to be shorter than that of DNA diploid tumor (171.9 days), but the difference was not significant. There was not a significant correlation between DT and DNA Index. 4) The five-year survival rate of 47 patients with DNA aneuploid tumor was 45%, which was significantly lower than that of 18 patients with DNA diploid tumor (78%).

Cell Division↗

[Assessment of nucleolar organizer regions (Ag-NORs) in primary lung cancer--correlation between Ag-NORs and tumor doubling time].

A total of 86 resected cases with primary lung cancer were examined on relationships between argyrophil nucleolar organizer regions (Ag-NORs) and other prognostic factors and correlation between Ag-NORs and tumor doubling time (DT). Survival rates were compared between patients with low Ag-NOR counts and patients with high Ag-NOR counts. 1) After logarithmic conversion of mean Ag-NOR counts in lung cancer, a small skewness (0.00486) and a small kurtosis (-0.7859) showed a normal distribution. Mean Ag-NOR counts was found to have a log-normal distribution. 2) There was a significantly inverse correlation between mean Ag-NOR counts and DT (correlation coefficient -0.705, p < 0.001). By plotting log (DT) on X axis and log (Ag-NORs) on Y axis, a formula representing a linear correlation was obtained: Y = 1.17-0.312 X, correlation coefficient -0.886. 3) The five-year survival rate (35%) of 46 patients with mean Ag-NOR counts which were more than or equal to 3.0 significantly lower than that (74%) of 40 patients with mean Ag-NOR counts of less than 3.0.

Adult↗