Biomedical subjects

H Nishijima

Publications and source records attributed to H Nishijima.

At least 19 recordsLinked to original sources

PubMed1995

Oncologic and cosmetic outcome in patients with breast cancer treated with wide excision, transposition of adipose tissue with latissimus dorsi muscle, and axillary dissection followed by radiotherapy.

We evaluated the oncologic and cosmetic outcome in patients with breast cancer treated with wide excision, transposition of adipose tissue with latissimus dorsi muscle (LDM), and axillary dissection followed by radiotherapy. In this study, a wide excision of breast tissue was performed to obtain tumor-free margins. The subsequent breast deformity was not corrected in six patients in the early phase of the study (Group 1), and in 16 patients in the late phase (Group 2) in which the breast deformity was not remarkable at the time of operation. Breast deformity was corrected by transposing adipose tissue with LDM on a vascular pedicle in the remaining 51 patients (Group 3). Five year survival was 100%. Two patients developed distant metastases. None were found to have local recurrence. Fifty percent of the Group 1 patients, 69% of the Group 2 patients, and 67% of the Group 3 patients had an excellent or good cosmetic result. However, when the cosmetic results were evaluated in patients who underwent transposition and had small breasts, the results were excellent or good in 76%, compared to 38% in the patients who had reconstructions who had large breasts. The difference was statistically significant (p = 0.0309). Therefore, it was confirmed that wide excision and axillary dissection followed by breast radiation could provide adequate local control, but frequently resulted in breast deformity. However, transposition of adipose tissue may be useful to correct the breast deformity, especially in women with small breasts.

Adipose Tissue↗

PubMed1994

[An adult of intrathoracic lipoma arising from the chest wall].

A 34-year-old male with intrathoracic lipoma arising from the chest wall is described. Although asymptomatic, the patient was pointed out an abnormal shadow on the chest X-ray film taken at the mass survey. No findings of CT suggested lipoma. The tumor, measuring 2.5 x 2.0 x 1.5 cm in diameter, was surgically removed, and the diagnosis of lipoma was confirmed postoperatively by histopathologic examination.

Adult↗

PubMed1993

The psychological and cosmetic aspects of breast conserving therapy compared with radical mastectomy.

An evaluation of the psychological and cosmetic morbidity of 31 patients who had undergone breast conserving treatment (BCT group) and 71 patients who had undergone radical mastectomy (RM group) revealed that 85% and 73%, respectively, were satisfied with their operative results. BCT appeared superior to RM in relation to body image, with 93% of the BCT group indicating BCT as a future choice of treatment, whereas only 35% of the RM group indicated RM as a future choice of treatment. For 59% of the BCT patients, the results were considered excellent or good by a physician, but fear of recurrence was frequently expressed by both groups even though an early stage of breast cancer had been significantly more common in the BCT group than the RM group. Sexual adjustment was the same in both groups. Body image was thus concluded to have been improved by BCT rather than RM, but psychological morbidity was essentially the same in both groups.

Adaptation, Psychological↗

PubMed1993

Chronic aortic dissection complicated by recurrent obstructive pneumonia.

A 68-year-old man with aortic aneurysm who had repeated episodes of obstructive bronchopneumonia is reported. Serial chest X-rays revealed infiltrative shadows in the left lower lung field. A thoracic computed tomogram demonstrated a dissecting descending aorta compressing the left lower bronchi and abnormal shadows, probably inflammatory, distal to the obstructions. Because of signs of impending rupture of the dissected aorta, surgical repair was performed and there has been no recurrence of respiratory infection since.

Aged↗

PubMed1993

[A case of postoperative chylothorax successfully treated by chemical pleurodesis with OK-432].

Recently, cases of postoperative chylothorax have increased concomitantly with the increase in number of aggressive thoracic surgery. Chylothorax was complicated on the 6 th postoperative day in a 69-year-old male who underwent right lower lobectomy with mediastinal lymph node dissection for adenocarcinoma of the lung. After the leaking point from thoracic duct was confirmed by lymphangiography and chest CT, OK-432 1.5 KE was instilled into the intrapleural space through a intrathoracic tube. By this procedure, the chylous fistulas were completely cured. Application of OK-432, even in such a small dose as 1.5 KE, appeared very useful for the treatment of postoperative chylothorax.

Adenocarcinoma↗

PubMed1993

[A case of chondrosarcoma of the thoracic vertebra].

A case of chondrosarcoma of the thoracic vertebra in a 47-year-old female is described. Chest X-ray, CT and MRI disclosed an abnormal mass lesion in the posterior mediastinum. The lesion was surgically removed through right thoracotomy. The operative findings revealed that the lesion, hard and measuring 6.5 x 4.5 x 4.5 cm in diameter, was originated from the 7th and 8th thoracic vertebra. The lesion was histopathologically diagnosed chondrosarcoma. The chondrosarcoma arising from the thoracic vertebra is very rare, and only 10 cases have hitherto been reported in the Japanese literature.

Chondrosarcoma↗

PubMed1992

Phosphorus-31 magnetic resonance spectroscopy of forearm flexor muscles in student rowers using an exercise protocol adjusted for differences in cross-sectional muscle area.

To assess exercise energy metabolism of forearm flexor muscles in rowers, six male student rowers and six control subjects matched for age and sex were studied using phosphorus-31 magnetic resonance spectroscopy (31P-MRS). Firstly, to adjust for the effect of differences in cross-sectional muscle area, the maximal cross-sectional area (CSAmax) of the forearm flexor muscles was estimated in each individual using magnetic resonance imaging. Multistage exercise was then carried out with an initial energy production of 1 J.cm-2 CSAmax for 1 min and an increment of 1 J.cm-2 CSAmax every minute to the point of muscle exhaustion. A series of measurements of 31P-MRS were performed every minute. The CSAmax was significantly greater in the student rowers than in the control subjects [19.8 (SD 2.2) vs 17.1 (SD 1.2) cm2, P less than 0.05]. The absolute maximal exercise intensity (J.min-1) was greater in the rowers than in the control subjects. However, the maximal exercise intensity per unit of muscle cross sectional area (J.min-1.cm-2) was not significantly different between the two groups. During mild to moderate exercise intensities, a decrease in phosphocreatine and an increase in inorganic phosphate before the onset of acidosis were significantly less in the rowers, indicating a requirement of less adenosine 5'-diphosphate to drive adenosine 5'-triphosphate production. The onset of acidosis was also significantly delayed in the rowers. No difference was observed in forearm blood flow between the two groups at the same exercise intensity (J.min-1.cm-2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

The incidence of cardiac events in Japanese men with atypical or nonanginal chest pain: a prospective study on the significance of exercise testing.

The incidence of cardiac events in Japanese men (mean age 54 +/- 10 years) with atypical or nonanginal chest pain was assessed prospectively. Three groups of patients, those with typical angina (TA; n = 134), those with atypical angina (AA; n = 192), and those with nonanginal chest pain (NA; n = 311) were studied with regard to cardiac events (cardiac death or nonfatal myocardial infarction), risk factors, and results of exercise testing. The total cholesterol and high-density lipoprotein-cholesterol levels were significantly different among the three groups, but no differences were observed for other risk factors. The incidences of cardiac events were 8.5%, 2.2%, and 1.3% in the TA, AA, and NA groups, respectively (p less than 0.05) during 3.2 +/- 1.5 years. Significant ST segment changes were observed in 70.1%, 25.5%, and 18.0% of the patients in the TA, AA, and NA groups, respectively, at the time of enrollment. The risk ratio for cardiac events in a positive exercise test was 1.7 (difference not significant) for the TA group and 6.1 (p less than 0.05) for the others combined (AA and NA groups). The risk ratio adjusted for risk factors (Cox model) was 2.2 (difference not significant) for the TA group and 4.9 (p less than 0.05) for the AA and NA groups combined. In conclusion, the incidence of cardiac events in those with AA or NA chest pain was relatively low in Japan, but the independent prognostic significance of positive exercise testing was demonstrated in this group of patients.

Adult↗

PubMed1992

Beneficial effect of stopping smoking on future cardiac events in male smokers with previous myocardial infarction.

UNLABELLED: We assessed the effect of stopping smoking on future cardiac events (cardiac death and non-fatal myocardial infarction (MI)) in 90 male smokers with previous MI by a prospective follow-up study. At the time of enrollment, the patients were divided into 2 groups according to their current smoking status (Group A: those who had stopped smoking (n = 60), and Group B: those who were still smoking (n = 30)). Follow-up was performed prospectively by annual postal questionnaires. During the mean follow-up period of 3.1 +/- 1.4 years, 13 cardiac events (11 cardiac deaths and 2 cases of non-fatal MI) occurred in the 87 evaluable patients. The cardiac event rates in Groups A and B were 8.5% and 28.6%, respectively, and the relative risk was 3.4 (Group A vs B, p less than 0.05) by univariate analysis. The relative risk using multivariate analysis (Cox) was also statistically significant (3.1, p less than 0.05). HDL-cholesterol was significantly lower in Group B than in Group A, but other coronary risk factors apart from smoking were not significantly different between the two groups. At the end of the follow-up period, 89.8% of the patients in Group A remained nonsmokers and 21% of the patients in Group B had stopped smoking. CONCLUSION: Stopping smoking significantly reduced the risk of future cardiac events in male smokers with previous MI. This prospective follow-up study demonstrated that a significant reduction in the risk of future cardiac events could be achieved by stopping smoking in this group of patients.

Adult↗

PubMed1992

A simple ergometer for 31P NMR spectroscopy during dynamic forearm exercise in a whole body magnetic resonance imaging system.

The purpose of this study was to construct a simple ergometer for the 31P NMR spectroscopic study of dynamic forearm exercise in a whole body magnetic resonance imaging system and to evaluate the total system and the physiological response to this type of exercise using a multistage protocol. The system consisted of a completely nonmagnetic assembly including a rope, pulley and weights. The work of lifting weights was quantitated. The exercise protocol of 1-min increments in work load enabled subjects to reach maximal effort. Phosphocreatine decreased linearly with an increase in work load and was accompanied by a fall in pH and an increase in lactate level in the antecubital vein of the exercising forearm; concomitantly, there was a slight increase in whole body oxygen uptake and heart rate. Spectroscopy gave reproducible results using this exercise protocol. These results demonstrate that this system provides a reliable means for performing 31P magnetic resonance spectroscopy studies during forearm exercise.

Adenosine Triphosphate↗

PubMed1992

[A case of pulmonary blastoma].

A 45-year-old male with pulmonary blastoma was described. The patient suffered from headache and gait disturbance, and was diagnosed metastatic brain tumor. The histopathology of the removed tumor indicated metastasis from pulmonary blastoma. The pulmonary tumor, which had been detected on the chest x-ray film but misdiagnosed tuberculous lesion, was subsequently diagnosed pulmonary blastoma by TBLB. The patient underwent left upper lobectomy with mediastinal lymph node dissection, but died 12 months after the operation. To our knowledge, only 54 cases with pulmonary blastoma have hitherto been reported in the Japanese literature.

Brain Neoplasms↗

PubMed1991

[Experimental evaluation of the reliance of coronary sinus blood flow (CSF) and great cardiac vein blood flow (GCVF) measured by local thermodilution method].

A closed circuit was made to evaluate the reliance of coronary sinus blood flow (CSF) and great cardiac vein blood flow (GCVF) measured by local thermodilution method using multi-thermister catheter. The circuit consists of four parts: a constant-temperature water bath, a reservoir, a rotary pump and a polyethylene tube with a cock. Using this circuit and thermodilution catheters, flow rate was measured under various conditions. Measurements were repeated in changing injection rate of indicator, thermister interval of the catheter, diameter of the polyethylene tube and temperature difference between the room and the water bath. Indicator injection rate and thermister interval were important factors in flow rate measurement. Measured data and real flow were well correlated until 300 ml/min in injection rate of 40-50 ml/min. Other factors did not significantly influence the flow measurement. These results indicate that local thermodilution method is reliable if only injection rate of indicator and thermister interval are suitably settled.

Body Temperature↗

PubMed1989

Multiple primary malignant neoplasms of the head and neck.

This report analyzed the 7,763 cases treated at T.W.M.C., where radiotherapy has been mainly used, between 1968 and 1984. Of these, 258 cases (3.3%) had multiple primary malignant neoplasms, among which 88 cases involved head and neck cancer. The incidence averaged 1.6% during the first 5 years, but increased to an average of 5.7% during the last 5 years. Among head and neck cancer the incidence of multiple primary malignant neoplasms was 8.5% (88/1,033) and the incidence has been gradually increasing annually. Cancers of the head and neck were frequently combined with another primary lesion in the head and neck area or in the digestive tract, especially esophagus and stomach, followed by one in the both cases. The great majority of cancers in the head and neck occurred as the first cancer at age 60-70. The head and neck region is where the respiratory system and digestive system, including lymphatic organs originate and where the external carcinogenic factors enter into the body. These data suggested that multiple primary malignant neoplasms have been increasing in number and becoming an increasing problem. The possibility of multiple primary malignant neoplasms should not be forgotten in routine cancer related clinical work.

Adult↗

PubMed1989

Sustained dilatation of large coronary artery by alpha-human atrial natriuretic peptide in conscious dogs: a comparison with nitroglycerin.

The effects of alpha-human atrial natriuretic peptide (alpha-hANP) on the coronary circulation were compared with those of nitroglycerin in 16 conscious dogs chronically instrumented with a pair of miniature sonomicrometers and an electromagnetic flow probe placed on the left circumflex coronary artery. alpha-hANP (1 and 10 micrograms) and nitroglycerin (0.1, 1 and 10 micrograms) were administered intracoronarily via a cannula implanted in the proximal left circumflex coronary artery. Both alpha-hANP and nitroglycerin dose dependently increased the coronary diameter and coronary blood flow. Although alpha-hANP (10 micrograms) and nitroglycerin (1 microgram) dilated the large coronary artery to almost the same extent (92 +/- 10 vs. 98 +/- 8 microns), the time course of the dilating action differed; the peak dilatation occurred at 5.6 +/- 0.8 and 0.9 +/- 0.07 min (P less than 0.01), and full recovery occurred at 31.5 +/- 3.8 and 5.5 +/- 1.3 min (P less than 0.01) after alpha-hANP and nitroglycerin, respectively. Topical application of alpha-hANP (50 micrograms) to the epicardial coronary artery of three anesthetized open-chest dogs did not affect the coronary diameter and coronary blood flow, while nitroglycerin (50 micrograms) increased both variables. Thus, intracoronary alpha-hANP dilates the large coronary artery more gradually and more sustainedly than nitroglycerin does.

Animals↗

PubMed1989

Effects of ionic and nonionic contrast media on coronary diameter and blood flow in chronically instrumented dogs.

The effects of intracoronary administration of ionic and nonionic contrast media on coronary circulation were studied in 14 chronically instrumented dogs. A pair of 10 MHz piezoelectric crystals and an electromagnetic flow probe were placed on the left circumflex coronary artery, under sterile conditions, to measure the epicardial coronary diameter and coronary blood flow, respectively. A polyethylene tube for drug infusion was inserted into the circumflex coronary artery proximal to the sonomicrometers. In the conscious dogs (n = 8), iopamidol, 2 ml and 5 ml increased the coronary diameter by 64 +/- 19 microns and 66 +/- 19 microns and coronary blood flow by 35 +/- 10% and 61 +/- 18%, respectively (p less than 0.01 vs control level). Meglumine diatrizoate, 2 ml and 5 ml, increased coronary diameter by 102 +/- 20 microns and 114 +/- 18 microns and coronary blood flow by 87 +/- 32% and 107 +/- 26%, respectively (p less than 0.01 vs control level). In the anesthetized dogs (n = 6), a bolus intracoronary injection of 5 ml iopamidol and meglumine diatrizoate within few seconds increased the coronary diameter by 103 +/- 23 microns and 164 +/- 39 microns (p less than 0.05) and increased the coronary blood flow by 126 +/- 33% and 180 +/- 40% (p less than 0.05), respectively. Balloon denudation of the endothelium was performed in six anesthetized dogs. The increases in coronary diameter and coronary blood flow after a bolus injection of contrast medium remained the same after the denudation. Thus application of iopamidol seems to be more suitable than meglumine diatrizoate for quantitative coronary angiography because of the milder and more transient effects on coronary circulation.

Acetylcholine↗

PubMed1989

[Primary lung cancer of the right middle lobe].

During the period from 1973 to 1986, 230 patients with lung cancer were operated on at our Surgical Clinic of Kagoshima University Hospital. There were fourteen patients (6.1%) with lung cancer in the right middle lobe. There were 13 male and 1 female patients. The histological types were adenocarcinoma (10), squamous cell carcinoma (4). Five-year survival rate of 14 patients was 34.9%. Statistically, it was similar to that of the patients with lung cancer in the other lobes. As concerns with the histological type of lung cancer in the right middle lobe, the case of squamous cell carcinoma revealed poorer prognosis than those of adenocarcinoma, because there were many cases of advanced cancer in the former case.

Adenocarcinoma↗

PubMed1989

[Relation between anaerobic threshold and maximal oxygen consumption during graded treadmill exercise].

The ratio of anaerobic threshold (AT) to maximal oxygen consumption (Max VO2), which is referred to as relative AT, was evaluated in six athletic students (S), 12 normal male subjects (N) and 39 patients with chronic heart disease (C). Group C was categorized in three subgroups according to the New York Heart Association functional class (CI: 10, CII: 16 and CIII: 13 patients). The symptomatic-maximal graded treadmill exercise test was performed and respiratory parameters were measured by R1500S Autoaerobics. AT was determined as the oxygen consumption (VO2) at which a linear relationship between pulmonary ventilation and VO2 was lost during progressive exercise. All subjects performed maximal exertion until they were limited by either shortness of breath or leg fatigue. AT (ml/min/kg) was 36.4 +/- 6.0, 25.9 +/- 5.7, 21.4 +/- 4.5, 16.3 +/- 4.0 and 11.1 +/- 2.6, and MaxVO2 (ml/min/kg) was 77.3 +/- 6.5, 47.6 +/- 10.2, 29.5 +/- 6.1, 22.5 +/- 5.8 and 15.5 +/- 3.1, respectively, in group S, N, CI, CII and CIII (p less than 0.01 between each group). Relative AT(%) was 46.8 +/- 4.4, 54.9 +/- 7.2, 72.1 +/- 6.4, 73.0 +/- 8.6 and 72.6 +/- 8.7, respectively, in groups S, N, CI, CII and CIII (p less than 0.01 between S and N, between N and CI-CIII, between S and CI-III). The anaerobic threshold appeared at mid-point in the graded symptomatic maximal exercise test. However, the appearance of AT relative to the maximal oxygen consumption varied from 47 to 73% in the study groups tested. AT appeared relatively early in normal subjects compared to cardiac subjects.

Adult↗

PubMed1988

The prognostic significance of resection of primary tumor in gastric and colorectal cancer patients with synchronous liver metastasis.

The significance of primary tumor resection in gastric and colorectal cancer patients with liver metastasis (H(+)) was evaluated in terms of operative mortality and survival rate by dividing the materials [293 gastric cancer and 80 colorectal cancer patients (53 colon and 27 rectum) with synchronous liver metastasis] into the following groups: Firstly, with or without peritoneal dissemination (P), secondly, with or without resection of the primary tumor and thirdly, with or without postoperative adjuvant chemotherapy. The following results were obtained: (1) The direct operative death rate of primary tumor resection, excluding death from other causes, showed an absence of statistically significant differences between the P0H(+) and P(+)H(+) gastric and colorectal cancer patients. (2) There was no significance in the prognosis between the primary tumor resection + postoperative chemotherapy group and the non-resectable group in the P(+)H(+) gastric and colorectal cancer patients, revealing no prognostic value of the primary tumor. (3) In the P0H(+) gastric and colorectal cancer patients, the primary tumor resection + postoperative chemotherapy group was significantly more favorable in prognosis than was the primary tumor resection alone group or the non-resectable group, showing the value of primary tumor resection.

Adult↗