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Biomedical subjects

H Hashimoto

Publications and source records attributed to H Hashimoto.

At least 1,009 records · Page 56Linked to original sources
PubMed1989

[A case of synchronous double primary malignant neoplasms (malignant astrocytoma, and lung cancer) diagnosed by autopsy].

Discussed is a deceased patient, a 54-year-old male, who was admitted to hospital with the chief complaint of motor aphasia. Computed assisted tomography in the cranium showed a massive lesion in the left brain. Further, chest X-ray showed an abnormal tumorous shadow with a pleural indentation in the left middle lung field. In spite of a negativity of cancer cells in a bronchial biopsy and a brushing, we decided that this case reflected a lung cancer with brain metastasis. However, on autopsy, the tumor in the lung histologically was determined as being an (adenocarcinoma alveolar cell type) and the brain tumor was found to be a malignant astrocytoma. We have reported on this case because a double primary neoplasm, a malignant astrocytoma and lung cancer, is rare in the literature.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1989

[An analysis of autopsy cases of malignant soft tissue and bone tumors].

Clinicopathologically we studied the autopsy cases including 110 soft tissue sarcoma (28 malignant fibrous histiocytomas, 23 rhabdomyosarcomas, 18 leiomyosarcomas, 11 liposarcomas, 7 synovial sarcomas, 4 angiosarcomas, 3 malignant schwannomas, and 16 others) and 29 malignant bone tumors (19 osteosarcomas, 3 Ewing's sarcomas, 3 chondrosarcomas, and 4 others). We may summarize as follows: (1) In autopsy cases sarcomas occurring in the retroperitoneum outnumbered those in surgical cases in frequency, probably because most retroperitoneal tumors could not be removed and were difficult to diagnose without the help of autopsy findings. (2) Metastases were disclosed most often in the lungs, followed by the bones and liver. Lymph-node metastases were also encountered more frequently than expected, particularly in rhabdomyosarcoma (48%) and synovial sarcoma (57%). (3) Transition in histologic features, including cellular differentiation, nuclear grade and cellularity, from the surgically resected tumors to the tumors at autopsy in the same case, occurred not infrequently.

Autopsy↗
PubMed1989

[A new model of complete global brain ischemia produced by clamping the ascending aorta with aorta to right-atrium and aorta to femoral vein bypass formation in dogs].

The author made a new model of complete global brain ischemia (CGBI) in dogs, by clamping ascending aorta with aorta to right atrium and aorta to femoral vein bypass formation. In this study, dogs were kept under CGBI for 18 minutes with this method, and their hemodynamic changes and neurologic outcome after ischemia were evaluated. In all dogs, cardiovascular functions were well preserved without any hemodynamic support after CGBI. Although neurologic functions were severely damaged and all dogs were in vegetative state, all of them survived for at least 4 days after ischemia. With this method, it is possible to keep animals under CGBI long enough to cause severe neurologic damages without serious extracerebral complications. I conclude that, to evaluate the efficacy of treatments with neurologic outcome, this is the most appropriate model of complete global brain ischemia in dogs.

Animals↗
PubMed1989

[Proposal of revised criteria for malignant rheumatoid arthritis].

The diagnostic criteria for malignant rheumatoid arthritis (MRA), which was proposed by the Research Group of MRA and periarteritis nodosa supported from the Ministry of Health and Welfare has been widely used since 1973. This diagnostic criteria was established for selecting RA patients with life-threatening extraarticular manifestations caused by vasculitis. However, in practice, RA patients with extraarticular involvements related to vasculitis, as well as, cases which were not related to vasculitis were diagnosed as MRA in this criteria. Because of the aforementioned and after research, we revised the diagnostic criteria for MRA. At first, we defined MRA as RA patients having intractable and severe extraarticular manifestations by various causes including vasculitis. One hundred and sixty-nine patients with MRA and 227 patients with RA from 39 medical facilities were analysed. Sixteen extraarticular clinical manifestations and 9 laboratory findings were compared between MRA and RA patients. Comparison of specificity in each criterion for MRA was made by using the Second quantitative analysis. Thereafter, the combinations of the variables which were most specific to MRA were studied. At the same time, sensitivity and specificity for MRA were also studied. The revised criteria are as follows: A. Clinical and Laboratory Findings--(1) visceral infarction, (2) myocarditis, (3) skin ulcer or skin infarction, (4) episcleritis or iritis, (5) polyneuritis, (6) high titers of rheumatoid factor, (7) immune complexes or low complement levels, (8) subcutaneous nodule, (9) pleuritis or pericarditis, (10) interstitial pneumonitis or lung fibrosis. B. Histopathological Findings from Biopsy Specimens--necrotizing vasculitis and/or granulomatous vasculitis and/or endoarteritis obliterans in small and/or medium size arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Rheumatoid↗
PubMed1989

[Time course of blood velocity changes and clinical symptoms related to cerebral vasospasm and prognosis after aneurysmal surgery].

Cerebral vasospasm is a major complication associated with subarachnoid hemorrhage. In spite of extensive research, the pathogenesis of vasospasm remains obscure, and clinical management has so far been extremely difficult. For the evaluation of the efficacy of any treatment and the timing of operation, the development and resolution of the arterial narrowing should be monitored. It is important to know the correlation between the change in flow velocity and the course of clinical symptoms. In this study, the blood flow velocity in the different arteries was measured at short intervals (at least every third day) with transcranial Doppler ultrasonography, in eighteen patients with ruptured cerebral aneurysm. Flow velocity changes began to accelerate from 3 days after surgery, and reached the maximum value between 7 and 10 days, with normalization occurring within the following 2 weeks. The changes showed a significant relationship to the severity of vasospasm, the side of the operative approach, and the administration of calcium antagonist. Based on our results, we categorized the flow velocity changes of vasospasm for clinical practice as follows. (1) A slight acceleration of up to 120 cm/s in MCA and 90 cm/s in ACA was defined as within the normal range. In this state vasospasm was never observed angiographically. (2) Flow velocity changes between 120 and 140 cm/s were a subcritical state. These changes were seen in vasospastic patients who did not develop ischemic deficits. (3) Flow velocity changes of over 140 cm/s in MCA and 100 cm/s in ACA were critical vasospasm, since all of the patients who developed ischemic symptoms were in this group. Velocity changes higher than 170 cm/s in MCA and 130 cm/s in ACA seem to indicate a critical condition with a tendency to develop into brain infarction. The comparison between the time course of the flow velocity changes and clinical status showed that in symptomatic vasospasm the increase in velocity occurred before the manifestation of clinical symptoms. The transcranial Doppler measurements help to identify those patients who have a high risk of developing neurological deficits due to vasospasm, and help to select those who would benefit from preventive treatment in asymptomatic stage.

Adult↗
PubMed1989

[Ectopic meningioma of the ethmoid sinus: case report and a review of the literature].

A rare case of ectopic meningioma of the ethmoid sinus is reported. A 57 year-old male patient was admitted with complaints of anosmia and headache. Computed tomography revealed a relatively high-density mass in the bilateral ethmoid and sphenoid sinuses. The mass was markedly enhanced after intravenous administration of contrast medium. The cerebral angiography showed tumor stains fed by bilateral internal and external carotid arteries with right side dominance. The tumor in the ethmoidal sinus was removed by otolaryngologists at first and then the tumor in the sphenoid sinus was removed using sublabial transseptal sphenotomy. The histological examination resulted in a diagnosis of transitional meningioma with psammoma bodies. The tumor in this case is suspected to have originated from heterotopic meningocytes or meningocytes accompanying the perineural sheath of the olfactory nerve.

Cerebral Angiography↗
PubMed1989

[Therapeutic irradiation of brain tumor and cerebrovasculopathy].

The first case was a 5-year-old girl treated with a total of 6000 rads after total removal of a left temporoparietal tumor extending into the basal ganglia. About 4 years after completion of the radiation therapy, she showed left hemiplegia and deterioration in her level of consciousness. A plain CT scan showed calcification in the region of the bilateral basal ganglia and low density area in the right fronto-parietal region. An enhanced CT revealed gyral enhancements in the pre- and postcentral gyrus of the right hemisphere. Left carotid angiograms showed a narrowing of the horizontal portion and an occlusion of the distal portion of the left anterior cerebral artery. The distal portion of the right anterior cerebral artery was filled through the anterior communicating artery. Right carotid angiograms revealed an occlusion of the terminal portion of the internal carotid artery, retrograde filling of the anterior and middle cerebral arteries by leptomeningeal anastomosis via the posterior cerebral artery, and partial filling of the anterior cerebral artery via the anterior falx artery. Preoperative arteriography did not show occlusion and stenosis of the cerebral arteries. Superficial temporal artery-middle cerebral artery anastomosis in the right hemisphere was performed. Regional cerebral blood flow measured during operation increased from 34 to 72 ml/100 gr/min due to the surgery. About two weeks after surgery, left hemiplegia disappeared completely. The second case was a 67-year-old man who had received radiotherapy, following surgery of a chromophobe pituitary adenoma. About one year after irradiation he began to complain of gait disturbance and dysarthria.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[A case of primary transitional cell carcinoma of the prostate].

A 58-year-old man was admitted to our hospital with the complaint of pollakisuria and micturitional pain. The urine cytology showed malignant cells suggesting the urothelial cancer, but various examinations could not reveal the malignant lesion. The prostate was also normal by the digital examination, endoscopy, roentgenography, ultrasonography and serum markers, and the transperineal prostate biopsy showed no malignancy. Three years after the first admission the prostate showed slight hardness and the transperineal biopsy suggested adenocarcinoma of the prostate. Hormonal therapy was then started and the prostate showed no remarkable change until about two years later, when rapid progression of the prostatic tumor was recognized. The transperineal biopsy of the prostate revealed the transitional cell carcinoma with negative staining of Alcian-Blue, PAS and PSA (prostate specific antigen). The epithelia of the bladder and posterior urethra were normal. The radical cystoprostatectomy was done and the histological diagnosis was the pure type of primary transitional cell carcinoma of the prostate. The literatures were reviewed and the clinical differentiation between transitional cell carcinoma and adenocarcinoma of the prostate was discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Immunohistochemical study of idiopathic bronchiolitis obliterans organizing pneumonia].

To examine the characteristics of idiopathic BOOP and to compare them with those of organizing pneumonia (OP) with known causes, immunohistochemical examinations using monoclonal antibodies against T- and B-lymphocytes which are available for formaldehyde-fixed and paraffin-embedded sections, and polyclonal antibodies against human IgG, IgA and IgM, and bovine S-100 protein, were carried out, along with conventional histopathological examinations. Histopathological observations demonstrated that both of the 7 BOOP cases and 5 OP cases had polypoid masses of organizing tissue in the lumen of small airways, alveolar ducts, and some alveolar sacs, and infiltration of pulmonary interstitium by a large number of lymphocytes and moderate number of plasma cells, eosinophils and mast cells. Degree of bronchiolo-alveolitis was greater in idiopathic BOOP. Immunohistochemically, the majority of lymphocytes which had diffusely infiltrated into the interstitium were T-lymphocytes, the degree of which was higher in the cases of BOOP. On the other hand, B-lymphocytes were seen mainly in the lymphoid follicles. Furthermore, S-100 protein positive dendritic cells were noted in the lymphocyte rich interstitium in the all cases of both groups, and similarly between two groups. Immunoglobulin (Ig) positive plasma cells were also seen, but there was no evidence indicating the preferential increase of plasma cells which produce a particular class of Ig. These observations suggest that there might be some immunological mechanisms in the pathogenesis of BOOP in which T-lymphocytes, mast cells and eosinophils are involved.

Adult↗
PubMed1989

[Treatment of urinary tract infection with cefixime].

Cefixime (CFIX) was administered orally in the treatment of 59 cases of urinary tract infection (UTI). According to the response criteria defined by the Japanese UTI committee, the rate of clinical efficacy for 26 cases of uncomplicated cystitis was 96.2%. The rate of clinical effectiveness of five patients with complicated UTI and five with uncomplicated pyelonephritis was 80.0%. In the other 23 cases which did not meet the response criteria, the efficacy rate was also high. The results indicated that CFIX was an effective drug for the treatment of UTI.

Anti-Infective Agents, Urinary↗
PubMed1989

[Testicular leydig cell tumor in a child: a case report].

A 7-year-old boy was admitted to the department of pediatrics in our hospital with the complaint of sexual precocity manifested by a growth spurt, penile enlargement and pubic hair development. He was referred to our department because of the enlarged left testis. The diagnosis of Leydig cell tumor of the left testis was suggested by hormonal laboratory data and testicular ultrasonographic investigation. Left orchiectomy was performed. The histological examination revealed the characteristics of Leydig cell tumor. Twenty-four cases of testicular Leydig cell tumor reported in the Japanese literature until 1988 are clinically analyzed. We discuss the usefulness of ultrasonography in detecting and localizing the tumor.

Child↗
PubMed1989

[A clinical study of prostatic carcinoma].

Seventy seven patients with prostatic carcinoma were treated in our clinic between 1977 and 1986. Most of them were treated by a hormonal agent as the first therapy. None of the 9 stage A1 cases showed any reactivation, but 4 of the 5 stage A2 cases relapsed to metastatic disease. The chemotherapy performed in 3 of the 4 reactivated cases had no obvious effect on the disease. Seven of the 8 patients with stage B disease were alive without relapse. Relapse was seen in the other patient who had poorly differentiated carcinoma and chemotherapy in this case resulted in stable disease for the present. Four of the 15 stage C cases including 3 poorly differentiated carcinomas were hormone resistant or reactivated. For these resistant cases radiotherapy and/or the chemotherapy were performed, but a response was seen in only one case. Consequently, the first therapy for stage A2, B and C of poorly differentiated carcinoma must be improved. Of the 40 stage D cases, 4 patients who were treated by an early combination of hormonal therapy and chemotherapy had a better prognosis than the others. These 4 patients had poorly differentiated carcinomas with multiple bone metastases. Two of these 4 patients were alive without relapse for 17 and 72 months, and one of the 2 patients with relapse was also alive for 75 months. We believe that early chemotherapy is the key for better prognosis in stage D cases.

Androgen Antagonists↗
PubMed1989

[Diffusion of sulbactam and cefoperazone into the prostatic tissue].

Diffusion of sulperazone (SBT) and cefoperazone (CPZ) into the prostatic tissue was studied in 20 cases. Two g of SBT/CPZ was injected intravenously and 1 hour later, prostatic tissue was obtained surgically and venous blood was drawn simultaneously. The serum concentration of CPZ (58.0 micrograms/ml +9.2) was higher than that of SBT (25.9 micrograms/ml +/- 9.3) and the prostatic tissue concentration of CPZ (14.9 micrograms/ml +/- 6.1) was higher than that of SBT (10.9 micrograms +/- 6.1). However, the SBT concentration ratio of prostatic tissue to serum level (P/S ratio) was significantly higher (42.5%) than that of CPZ (25.9%). The SBT concentration in the prostatic tissue was high enough to enhance the antibacterial activity of CPZ. SBT/CPZ was appraised to be an effective chemotherapeutic agent for infections of prostate caused by susceptible organisms, especially by beta-lactamase producing bacteria.

Aged↗