[Squamous cell carcinoma of the small bowel, colon and rectum].
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Carcinoma, Squamous Cell↗
Biomedical subjects
H Kikuchi
Publications and source records attributed to H Kikuchi.
[Preoperative care, but not premedication].
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Anesthesia↗
[Significance of phrenic nerve block in the anesthetic management of laparoscopic cholecystectomy].
The significance of phrenic nerve block was studied in the anesthetic management of laparoscopic cholecystectomy. Right phrenic nerve block with 1% mepivacaine 10 ml was performed after the patients were epidurally catheterized and anesthetized with isoflurane and nitrous oxide in oxygen. Intraoperative anesthetic requirement and postoperative shoulder pain incidence in patients with this block were compared with those in patients without block. Addition of the phrenic nerve block to general and epidural anesthesia did not reduce the intraoperative dosage of isoflurane, but it significantly prevented occurrence of postoperative right shoulder pain. It is known that phrenic nerve contains sensory element and that laparoscopic procedures of gall bladder elicit noxious stimuli which cannot be blocked by ordinary epidural anesthesia for abdominal surgery. Also, shoulder pain is said to be phrenic nerve-mediated referred pain. Our study suggests that blockade of these stimuli is effective in preventing postoperative event rather than intraoperative.
Adult↗
[Problems concerned with adult T-cell leukemia. 1) Causes of death and early diagnosis of cytomegalovirus pneumonia in adult T-cell leukemia. 2) Clinicopathological features of CD30 positive adult T-cell leukemia].
1) We studied the causes of death confirmed by autopsy or necropsy in 23 adult T-cell leukemia (ATL) patients. Of them eight showed involvement of tumor (35%), eleven infectious disease (47%) (nine cytomegalovirus (CMV) pneumonia, one varicella-zostervirus pneumonia, one pseudomonas aeruginosa pneumonia), and four others (17%). In seven recent cases treated with a new chemotherapy regimen in combination with G-CSF administration, survival was longer than in previous cases and tumor involvement as a cause of death decreased (one case, 14%). However, CMV pneumonia inclined to increase (six cases, 86%). Therefore, we tried to retrospectively detect CMV DNA in the serum of ATL patients using a nested polymerase chain reaction (PCR). CMV pneumonia was reliably diagnosed in eleven ATL patients, whereas CMV DNA was detected in all patients at the time of clinical onset of pneumonia and CMV DNA was detected only in eight patients from 7-35 days before the onset of pneumonia. These findings suggest that the nested PCR assay is a useful tool to early diagnosis CMV pneumonia in ATL patients. 2) Recently, several cases of ATL with CD30 antigen have been reported, but its clinical relevance remains unknown. Accordingly, we studied CD30 antigen expression in 36 ATL patients who had monoclonal integration of HTLV-I provirus in the tumor cells and demonstrated the immunohistochemical and clinical characteristics of these patients. CD30 antigen expression was evident in seven of these 36 patients (19.4%). A comparison of ATL cases with and without CD30 antigen expression revealed significantly large numbers of abnormal lymphocytes in the peripheral blood and lower serum calcium levels in CD30 antigen positive ATL.
Adult↗
[Percutaneous transluminal angioplasty (PTA) for stenosis at the subclavian artery and at the origin of the vertebral artery: therapeutic indication and some adjunctive safe methods during PTA].
Percutaneous transluminal angioplasty (PTA) for brachiocephalic occlusive lesions has progressed. In this paper our experiences and results of PTA in dealing with those lesions are described with emphasis on adjunctive procedures during PTA. Recently, twenty-four patients with stenosis of the subclavian artery (SA) and/or stenosis at the origin of the vertebral artery (VA) were included in this study. Among the 24, there were 16 cases with SA stenosis, 6 cases with stenosis at the origin of VA and 3 cases with both SA and stenosis at the origin of VA. The stenosis was due to atherosclerosis in 21 cases and aortitis in 3 cases. Most of the patients presented ischemic symptoms of vertebrobasilar circulation and affected upper extremities. In PTA of brachiocephalic lesions, one of the most formidable complications is an embolism distal to the central nervous system. To prevent this complication, a vascular endoscope was used for visualization of the luminal surface of the stenotic lesions in 7 cases, and a protective balloon was used in 4 recent cases. The protective balloon was used for transient occlusion of the artery to alter the flow direction so that the possible emboli might be forced to flow away to a less critical distal artery. In the distal protective balloon technique, the protective balloon was set so as to occlude the stenotic artery distally. Debris caused by PTA was aspirated and/or washed out to an extracranial artery with heparinized saline. In the proximal protective balloon technique, the protective balloon was set so as to occlude the stenotic artery proximally. Debris was washed out with blood flow caused by the induced steal phenomenon to an extracranial artery.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Basic evaluation of the new fully automated urine sediment analyzer (U-FCM) based on flowcytometric technology].
We developed a new automated urine sediment analyzer (U-FCM) based on Flow Cytometry with the cooperative technical aid of TOA Medical Electronics Co., ltd. Flow Cytometry using an argon laser (wave length 488 nm) is used as the method for detection. This instrument provides quick, easy and accurate screening for patients whose urinalysis abnormalities indicate the need for further testing. Abnormal patient samples are separated from patient samples whose parameters are totally normal, thus decreasing the need for additional testing. The instrument is useful as a diagnostic aid, and in monitoring the therapeutic effect. Also it is useful in the health checking service for visitors at the AMHTS office.
Autoanalysis↗
[A case of dumbbell-shaped hypoglossal neurinoma].
The authors report a case of dumbbell-shaped hypoglossal neurinoma. A 46-year-old female was admitted to our clinic with a history of right hemiatrophy of the tongue for more than 10 years and bilateral paresthesia on the face and legs for half a year. Neurological findings on admission were right hypoglossal palsy, attenuation of right gag and palatal reflex, mild truncal ataxia, right Bruns nystagmus, bilateral paresthesia on the face and legs (left > right), bilateral hyper-reflexia on the extremities. No sign of increased intracranial pressure was noted. Conventional computed tomography demonstrated the bone destruction around the right hypoglossal canal, and three-demensional computed tomography clearly revealed the extent of the bone destruction. Magnetic resonance imaging showed a large dumbbell-shaped mass extending both intra-and extra-cranially through the right hypoglossal canal, which severely compressed the brainstem postero-medially. Right suboccipital craniotomy with C1 laminectomy was performed in the prone position, and the occipital bone was drilled far-laterally around the Foramen Magnum with right occipital condyle rongeured to expose the intracanallicular mass. The mass was totally removed except around the IX Xth cranial nerves near the jugular foramen. Hypoglossal neurinoma is rare, and our case is the 62nd case, and the 15th dumbbell-shaped case in the literature. Hypoglossal nerve palsy is characteristic in dumbbell-shaped hypoglossal neurinoma. Enlargement of the hypoglossal canal can be detected by conventional and three-dimensional CT. MRI is more effective than CT in revealing the mass. Total removal of the dumbbell-shaped tumor requires that the hypoglossal canal can be exposed sufficiently.(ABSTRACT TRUNCATED AT 250 WORDS)
Cerebral Angiography↗
Characteristics of ethylene vinyl alcohol copolymer (EVAL) mixtures.
PURPOSE: To determine physical characteristics of mixtures of ethylene vinyl alcohol copolymer (EVAL) and metrizamide dissolved in dimethyl sulfoxide, liquid materials developed for embolization of arteriovenous malformations. METHODS: EVAL and dimethyl sulfoxide were mixed in various proportions and sterilized. The viscosity and density of each mixture was measured. Precipitation times were determined by dropping the mixtures into saline or human blood. The mixtures were filtered and the filtrates weighed. RESULTS: Densities and viscosities of the various mixtures differed significantly, proportionally to the concentration of EVAL. Precipitation times also differed significantly, in inverse proportion to the concentration of EVAL. Temperature and aqueous solution did not affect precipitation times significantly. The weight of the filtrate significantly increased with time but was constant for each precipitation time. Temperature significantly affected filtrate weight; aqueous solution did not. CONCLUSIONS: Because of their different physical properties, the various EVAL mixtures are suited to embolizing different types of arteriovenous malformations.
Arteriovenous Malformations↗
[Neoadjuvant chemotherapy for elderly advanced gastric cancer: a case report of MTX/5-FU sequential therapy followed by radical gastrectomy].
A 70-year-old-male was diagnosed as having gastric cancer (Borr. 2, 78 mm in size on the body region; mod. dif. adenocarcinoma). CT scan revealed direct invasion of the liver. A course of MTX/5-FU sequential therapy was started (MTX 100 mg/m2, 5-FU 500 mg/m2, i.v., weekly; interval, 2 hours) on March 23, 1992. The gastric tumor showed 67% reduction on week 8 and 86% on week 10. The liver invasion had almost disappeared by CT scan (total doses, MTX 1,040 mg, 5-FU 6,750 mg). On June 25, the tumor was completely resected by radical.gastrectomy. The pathological specimen showed a "submucosal carcinoma" (10 mm in size, Stage I). Twenty-two months after the operation, the patient is alive and in good health. No cancer recurrence has been found without post-operative chemotherapy.
Adenocarcinoma↗
[Surgical treatment of atlanto-axial dislocation in a patient of athetoid cerebral palsy].
The authors report a case of successful surgical treatment of atlanto-axial dislocation (AAD) secondary to athetoid cerebral palsy. A 61-year-old woman was admitted to our hospital in July 1993 complaining of progressive weakness in the right upper extremity and gait disturbance. She had been suffering from athetoid movements of her face, neck and arms due to cerebral palsy. Neurological examinations on admission revealed down-beat nystagmus on downward gazing, motor weakness of extremities, pallhypesthesia, hyperreflexia exaggerated in the right side and bilateral positive pathological reflexes. Lateral tomogram of the upper cervical spine demonstrated instability of the atlanto-axial joint, increased atlanto-dental interval (ADI) by 5.5 mm (in flexion), and narrowed canal at C1 level. Myelogram showed narrowed dural sac and angulation of the spinal cord at C1 level. A halo vest was applied two days before operation for reduction of the atlanto-axial junction and external fixation. She underwent posterior internal fixation using a Hartshill Ransford Loop combined with posterior decompression. This loop was secured to the occiput, C1, C2 and C3 by sublaminar wiring, and foramen magnum decompression and laminectomy of C1 were performed. Postoperative course was uneventful. Postoperative plain X-ray film, tomogram and computed tomography demonstrated good fixation (ADI was 2.5 mm) and excellent stability. There has been no problem during 6 months since the operation. It is known that involuntary movements in patients with athetoid cerebral palsy sometimes cause cervical spondylosis (especially at C3/4 and C4/5 level). Recently, AAD due to athetoid cerebral palsy has been reported. Almost every case of AAD secondary to athetoid cerebral palsy is combined with incompetence of the odontoid process.(ABSTRACT TRUNCATED AT 250 WORDS)
Athetosis↗
[Organoid forming method--a new in vitro chemosensitivity test].
In 1988, Friedman and coworkers reported a new chemosensitivity test using "organoids" (epithelial cell aggregates) which had a high plating efficiency and short assay period. The authors recognized this test to be useful and studied it experimentally. Human tumor xenografts maintained in the subcutis of BALB/c nu/nu mice were minced into cell aggregates and filtered, then resuspended in enriched NCTC 135 cell culture medium which contained no serum. Petri dishes were coated with a mixture of collagen-I and bovine serum albumin and dried for an hour. The cell aggregates were seeded in these coated dishes and cultured in a condition of low O2 tension (3% O2). Plating efficiency at 24 hours in cultures of three tumors were 20.8 +/- 2.6% on SC-6-JCK (stomach), 37.8 +/- 3.8% on NS-8 (stomach) and 27.2 +/- 1.5% on PAN-1-RITC (pancreas), respectively. The cell number of each organoid increased until 72 hours in culture, although the organoid number of each dish decreased slightly. Flow cytometrical measurement of total DNA content in dishes showed that the amount of human DNA increased more rapidly than that of mouse DNA which was derived from interstitial and infiltrative cells. This culture system appeared to allow a selective growth of epithelial cells. Subsequently, some drug sensitivity was tested using this system. SC-6-JCK tumor is sensitive to mitomycin C (MMC), although resistant to adriamycin (ADM) in a test using nude mice (sc-ip system). Organoids were formed from this tumor and chemosensitivity was tested against MMC and ADM from the viewpoint of change in the organoid number in each dish. After one hour of drug exposure, only a part of the cells in organoids was affected. On the contrary, after an exposure of 24 hours, the ADM-treated group showed the same results as the MMC-treated group. Hence this test was considered to become more appropriate by counting not the organoid number but the total cell number in the dish.
Animals↗
[Idiopathic normal pressure hydrocephalus in the aged].
Continuous lumbar cerebrospinal fluid pressure measurement was made in 19 cases of aged patients suspected of idiopathic normal pressure hydrocephalus. Based on the pressure study, they were divided into high pressure group (H group) and normal pressure group (N group). H group was composed of 11 cases and N group of 8 cases. Baseline pressures in H group and N group were 16.3 +/- 3.0 mmHg, 9.6 +/- 1.7 mmHg, respectively and the difference was statistically significant. Pulse pressure was high in H group and frequency of pressure waves was also significantly high in H group. There were no significant differences in clinical symptoms and CT findings between the two groups, except for clinical improvement after cerebrospinal fluid removal, which was noted in all of 6 cases examined in H group. No difference between them was noted on CT cisternography and cerebral blood flow measurement. Shunt surgery was carried out in the cases of H group and it was effective in 8 of 11 cases (72.7%). Thus, continuous lumbar cerebrospinal fluid measurement was useful for selection of idiopathic normal pressure hydrocephalus in the aged.
Aged↗
[Surgical indication for the cerebral aneurysms].
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Humans↗
[Clinico-epidemiologic study of infantile hydrocephalus in Japan].
A nation-wide survey on congenital hydrocephalus, including secondary hydrocephalus occurring within one year after birth, was carried out in 1988. The number of patients with congenital hydrocephalus treated during the previous one year was estimated to be 3,200-3,500 throughout Japan. The number of new cases of this disease which occurred during the year was calculated to be 800. This indicates a rate of 0.58 per 1,000 live births. Clinico-epidemiologic features were compared with regard to three subjects listed below. (1) The difference between the epidemiologic profile of term and preterm infants with hydrocephalus was investigated. As for etiology, the incidences of primary hydrocephalus and hydrocephalus complicated by Arnold-Chiari malformation type II and meningocele were significantly higher in term infants than in preterm infants. It was estimated that about 30% of the hydrocephalus in preterm infants and only 7.7% in term infants occurred as a consequence of intracranial hemorrhage. The degree of neurological impairment and the mortality rate were higher in preterm infants than term infants. (2) The changing panorama of infantile hydrocephalus in Japan was investigated comparing the epidemiologic data of four groups according to the birth year. As for pregnancy period, preterm infants with hydrocephalus were gradually increasing recently. Hydrocephalus secondary to intracranial hemorrhage was increasing and that secondary to intracranial infection was decreasing. The rate of shunt malfunction was decreasing significantly. (3) Clinico-epidemiologic features of intractable hydrocephalus based on the diagnostic criteria of the research committee was investigated comparing intractable with non-intractable groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Humans↗
Disseminated Trichosporon infection. A case report and immunohistochemical study.
An autopsy case of disseminated Trichosporon beigelii infection in a patient with acute promyelocytic leukemia is presented. We diagnosed the T beigelii infection with immunoperoxidase method using our rabbit antiserum to T beigelii. The diagnosis of T beigelii infection is difficult, because of its close resemblance to Candida species in both clinical features and histopathologic findings. We could consistently identify T beigelii in tissue sections with the present immunohistologic method. We conclude that the immunoperoxidase method using antiserum to T beigelii is very useful to diagnose T beigelii infection.
Cadaver↗
Isolation of dental papilla from young rat lower incisor by three step digestion.
In order to establish an in vitro model system, a three step digestion procedure, trypsin + collagenase pretreatment, followed by trypsin or collagenase treatment, and then trypsin posttreatment, was employed for the dissociation of rat lower incisors into dental papilla and enamel organ. Both the pre- and post-treatments promoted destruction of the basement membrane located between the dental papilla and enamel organ, resulting in effective dissociation of the tissues. The isolated dental papilla, including differentiating odontoblasts, was well preserved after this treatment. The results indicated that the three step digestive treatment may be very useful in isolating the dental papilla from the rat-incisor enamel organ accompanied by the basement membrane. The material provides a model system for studying odontoblast differentiation, development, and maturation in vitro.
Animals↗
In vitro study of differentiating odontoblasts in isolated rat incisor dental papillae.
The dental papillae isolated from rat incisor were examined morphologically and autoradiographically in order to investigate progressive odontoblast differentiation in vitro. Four to eight days after incubation, the preodontoblasts which were labelled with 3H-thymidine became elongated, polarized, odontoblast-like cells with long cytoplasmic processes. They produced an 3H-proline labelled extracellular matrix on the substrate with which the dental papillae were coated. In addition, the odontoblasts located on the initially formed predentin maintained their ordinary shape as elongated cell bodies with long cytoplasmic processes and polarity fo the organelles during the term of culture. The results indicate that the surface of the agar gel substrate may be a critical requirement for odontoblast differentiation, development, and maturation in the absence of both the basement membrane and the enamel epithelium in the culture system used in this study.
Agar↗
Effect of bone resorbing factors on u-PA and its specific receptor in osteosarcoma cell line.
This study investigated the effect of bone resorbing factors on the pericellular fibrinolytic system of osteosarcoma NY cells. Parathyroid hormone (PTH), prostaglandin E2, (PGE2) or tumor necrosis factor alpha (TNF-alpha) enhanced the secretion of urokinase-type plasminogen activator (u-PA) antigen and suppressed the secretion of plasminogen activator inhibitor-1 (PAI-1) antigen to the conditioned medium. The former two factors also increased u-PA antigen in the cell surface. Transforming growth factor beta (TGF-beta) enhanced u-PA antigen, but its activity was suppressed due to the increased secretion of PAI-1. The binding assay of [125I]DFP-u-PA to NY cells revealed the presence of a single class of binding sites with a Kd of 5.51 nM and Bmax of 0.92 x 10(5) binding sites/cell. PTH or PGE2 increased Bmax 1.4-fold and enhanced the u-PA receptor (u-PAR) mRNA level 1.4-fold or 2.4-fold, respectively. However, TGF-beta did not alter either the Kd or u-PAR mRNA level. Thus, pericellular fibrinolytic activity by u-PA/u-PAR and PAI-1 is modulated by bone resorbing factors.
Bone Resorption↗