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Biomedical subjects

H Niwa

Publications and source records attributed to H Niwa.

At least 109 records · Page 6Linked to original sources
PubMed1996

[Clinical considerations from sixteen cases with mediastinal malignant lymphoma].

Sixteen cases with mediastinal malignant lymphoma were treated in our department and a correlation made between the prognosis and other factors: first symptom, maximum diameter of the tumor, type of operation, pathological subtype, clinical stage. First symptom and compressed or invasive symptom with mediastinal mass were not related to prognosis. The cases with bulky tumor over 10 cm in diameter showed a tendency toward poorer prognosis. Complete or incomplete resection did not have significant effect. The cases of Hodgkin's disease had relatively good prognosis. Classification of clinical stage (Ann Arbor classification) did not show significant correlation with prognosis and may be inadequate for staging of mediastinal malignant lymphoma. Surgical treatment may be adapted for mediastinal Hodgkin's disease and early stages of thymic malignant lymphoma.

Adolescent↗
PubMed1996

Clinical analysis of malignant lymphomas of tonsils.

Data of 38 patients with primary tonsil lymphoma, treated during the past 14 years was analysed. All cases were non-Hodgkin lymphomas. There were 11 patients with Stage 1, 14 with Stage II, 8 with Stage III, and 4 with Stage IV tonsillar lymphomas. The applied chemotherapies were CHOP or MACOP-B regimen. The overall 5-year survival rate was 64.4%. Further analysis of the intermediate grade group showed that 5-year survival rates were 72.7%) for patients younger than 60 years old, in contrast to 35.0% for patients aged 60 or older (p 0.0049). Five-year survival rates were 100%) for Stage I, 32.4% for Stage II, 55.6% for Stage III, and 100%) for Stage IV patients (p = 0.0878). In patients with Stage II tonsillar lymphomas, 5-year survival rates were below 100% for CHOP regimen, 100% for MACOP-B regimen, 66.7% for radiation alone, and 0% for radiation followed by chemotherapy (p = 0.1966). In patients with Stage III tonsillar lymphomas, 5-year survival rates were below 100% for MACOP-B regimen, and 0% for initial radiation followed by chemotherapy (p = 0.2568). The factors influencing survival were age, stage, and treatment modality. For Stage I patients without bulky mass, radiation therapy is sufficient. For Stage II patients or Stage I patients with a bulky mass, CHOP regimen (followed by radiation) is the choice of treatment. For Stage III or IV patients,, MACOP-B regimen is promising.

Combined Modality Therapy↗
PubMed1995

Pathogenesis of thymolipoma: report of three cases.

Three case reports of thymolipoma are herein presented. One patient presented with myasthenia gravis, while the other patients were asymptomatic. The tumors in our cases all had histopathologically different features: case 1, lipoma of the thymus; case 2, involuted thymic hyperplasia; and case 3, typical thymolipoma. The histopathological findings of thymolipoma are discussed in the context of the pathogenesis of thymolipoma.

Child, Preschool↗
PubMed1995

Rupture of congenital peripheral pulmonary aneurysm.

A 58-year-old man presenting with solitary aneurysm of a peripheral pulmonary artery was treated by left lower lobectomy. Histologically, the aneurysmal wall showed medial hypertrophy with the loss of smooth muscle fibers, without evidence of a mycotic process or inflammatory exudate. The aneurysm appeared to be congenital in origin.

Aneurysm↗
PubMed1995

Subclavian artery branch ligation reduces hemorrhage during resection of pulmonary aspergilloma.

Treatment of a 71-year-old woman with recurrent massive hemoptysis secondary to an aspergilloma and pleural aspergillosis is reported. Branches of the subclavian artery were ligated using an anterior approach before performing the thoracotomy, and pleuropneumonectomy was accomplished after ligation of the costal arteries. This technique provided a relatively bloodless field and minimized blood loss.

Aged↗
PubMed1995

Differential diagnosis of thymic carcinoma and lung carcinoma with the use of antibodies to cytokeratins.

There are few specific pathologic findings that can be relied on to distinguish primary thymic carcinomas from lung carcinomas with mediastinal extension or showing metastasis to the anterior mediastinum. The immunohistochemical reactivity on frozen sections of thymic carcinomas and lung carcinomas, which are histologically similar to each other, was examined with the use of monoclonal antibodies to cytokeratins 7 and 13. Among keratinizing squamous cell carcinomas, all thymic carcinomas reacted with antibody specific for cytokeratin 7 (9/9, 0%), whereas no staining reaction was seen in lung carcinomas (0/5, 0%) (p < 0.01). This finding can be used as a diagnostic aid in primary thymic keratinizing squamous cell carcinomas to expedite treatment and prognosis. Cytokeratin 7 and cytokeratin 13 monoclonal antibodies reacted with almost all cases of thymic carcinoma. Applications of monoclonal antibodies specific for certain cytokeratins, especially 7 and 13, may be helpful in the diagnosis of other subtypes of thymic carcinomas.

Antibodies, Monoclonal↗
PubMed1995

A case of allergic aspergillus sinusitis with acute onset.

Reports of allergic aspergillus sinusitis have increased in recent years and diagnostic criteria have also come to be established, yet this disease remains a rare disorder. The disorder is generally reported to follow a chronic course. Here we report a case of allergic aspergillus sinusitis with a short morbid term of 3 weeks.

Adult↗
PubMed1995

Esophageal tracheobronchoplasty for membranous laceration caused by insertion of a dumon stent--maintenance of oxygenation by percutaneous cardiopulmonary support.

A 39-year-old man, whose airway was narrowed due to relapsing polychondritis, sustained a tracheobronchial injury during intubation with an internal stent. In the posterior membranous trachea and left main stem bronchus, a 5-cm longitudinal tear extended across the carina. Oxygenation was maintained by percutaneous cardiopulmonary support (PCPS) before and during the operation. An original esophageal tracheobronchoplasty for repair of the membranous laceration is described. Currently, the patient is asymptomatic 16 months after the surgery.

Adult↗
PubMed1995

Mediastinal malignant epithelioid schwannoma.

A case of mediastinal malignant epithelioid schwannoma (MES) is reported. The tumor probably arose in the vagal nerve, and the trachea was involved. A few months after excision of the primary tumor, multiple metastases appeared in lung, cervical spine, and neck lymph nodes. Microscopically, the tumor showed a highly cellular area resembling melanoma or carcinoma. Immunolabeling was done for S-100 protein, keratin, and melanoma-associated antigen. Examination of the entire lesion and in situ characteristics of the tumor involving the vagal nerve were helpful in making the correct diagnosis. Mediastinal MES, to our knowledge, has not been reported to date in the English-language medical literature.

Adult↗
PubMed1995

[Clinical and neuroradiological studies of eclampsia--cerebral vasospasm and relation to the brain edema].

Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T2 high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases.

Adolescent↗
PubMed1995

[Surgical therapy for local recurrence and distant metastasis of lung cancer].

Twenty-two patients underwent surgical therapy for local recurrence and distant metastasis of lung cancer. Twenty patients were resected the tumor and 2 patients received the operation to improve their quality of life. Seven patients were resected lung metastasis, which were 5 adenocarcinomas and 2 squamous cell carcinomas. All metastasis situated in contralateral lung of primary operation. Two lobectomies, 1 segmentectomy, and 4 partial resections were performed. The 5-year survival rate was 28.6%. Four patients were resected brain metastasis, which were 2 adeno-squamous cell carcinomas, 1 squamous cell carcinoma, and 1 large cell carcinoma. The 5-year survival rate was 25%. Three patients were resected the neck and upper mediastinal lymph node metastasis. Since those lymph nodes could not be dissected at the initial operation, different approaches, which was median sternotomy and collar incision of neck, were selected. Two patients were alive 5 months after operation. There were no long-term survivors in 5 patients with bone or soft tissue metastasis. Since the differentiation of lung metastasis from the second primary tumor is impossible, the single lung metastasis should be resected. Resection of single brain metastasis provides better prognosis.

Adenocarcinoma↗
PubMed1995

[Surgical treatment of aortic rupture by blunt chest trauma].

During a ten-year period, seven patients with traumatic rupture of the thoracic aorta were operated upon. Four patients of them were operated within one week. Chest X-rays and chest computed tomography could not always reveal the exact diagnosis of aortic rupture. Intravenous digital subtraction angiography was useful to confirm the diagnosis. The repair of the rupture was accomplished with the adjunct of left heart bypass using Bio-pump, which was useful to reduce the bloodloss with a limited systemic heparinization. Another three patients were diagnosed to have chronic post-traumatic aneurysm of the thoracic aorta and underwent aortic replacement with prosthetic graft. One of seven patients died at seventh postoperative day because of cerebral contusion, the associated lesion of an automobile accident. It is stated that the aortic rupture is immediately fatal in approximately 80% of individuals, and most of remaining 20% die within 2 weeks unless the lesion is repaired. Therefore immediate operative intervention is recommended when the aortic rupture is strongly suspected. Chronic post-traumatic aneurysms should be resected because it has become apparent that the majority of patients with this lesion will develop complication, such as sudden rupture.

Adolescent↗
PubMed1995

[A case report of chronic sternal osteomyelitis after thoracic aortic aneurysmectomy].

A 76-year-old man, who was complicated with chronic sternal osteomyelitis after thoracic aortic aneurysmectomy was reported. He was treated with local wound care and antibiotics for about 3 months, but cutaneous fistula with persistent discharge required sternal bone debridement and omental pedicle grafting. After this treatment the patient was uneventful. 67Ga scintigram and 67Ga-SPECT may be more useful in the diagnosis of this serious complication.

Aged↗
PubMed1995

An echocardiographic study of interactions between pindolol and epinephrine contained in a local anesthetic solution.

An increasing number of dental patients are taking beta-adrenergic blockers for the treatment of hypertension or angina pectoris. If epinephrine-containing local anesthetics are administered to such patients, interactions between epinephrine and the beta-blocking agent may induce cardiovascular complications. We assessed in volunteers the effects of intraoral injection with 2% lidocaine containing 1:80,000 epinephrine (L-E) on cardiac function after pretreatment with the beta-blocking agent pindolol. M-Mode echocardiography was used for the assessment. The injection of L-E after administration of pindolol did not alter cardiac preload, whereas it reduced the stroke volume, due to an increase in afterload and a decrease in myocardial contractility. Reductions in stroke volume and heart rate led to a decrease in cardiac output. Because total peripheral vascular resistance increased markedly, blood pressure was elevated despite the reduced cardiac output. These results suggest that cardiac function of dental patients on beta-blocker therapy can be adversely affected by epinephrine-containing local anesthetics. Therefore, when such an anesthetic solution has to be used in patients on beta-blocker therapy, careful systemic monitoring is needed.

Adrenergic beta-Antagonists↗
PubMed1995

The incidence of arrhythmias during induction of general anesthesia.

In this study, our induction methods of endotracheal anesthesia was evaluated with reference to electrocardiogram, hemodynamic status and arterial blood gas analysis on 153 patients. From the beginning of induction, electrocardiogram was recorded continuously to the completion of intubation. The blood pressure and heart rate were also measured. Arterial blood samples were taken at 40 seconds of apneic period after the mask was removed from the patient's face (CONT group), at 40 seconds of apnea with intratracheal spray (LIDO group), and after intubation following intratracheal spray (INT group). In the electrocardiographic survey, arrhythmias during intubation were rare (1/113, 0.9%). PaCO2 values in INT group showed a significant elevation (+ 14.0 mmHg; p < 0.01) compared to these in CONT group. As a result of careful and gentle induction techniques, the incidence of arrhythmias during intubation was very low. However, an elevation of PaCO2 was not avoidable, even in smooth and successful intubation. In conclusion, the importance of more adequate ventilation coupled with skillful intubation in a shorter period to avoid hypercapnia and arrhythmias is appreciated again in the endotracheal anesthesia for the maxillofacial surgical patients with anatomical airway problems.

Adult↗
PubMed1994

Homologous dinucleotide (GT or TG) deletion in Japanese patients with chronic granulomatous disease with p47-phox deficiency.

The cytosolic 47-kDa protein designated as p47-phox (phagocyte oxidase) is one of the essential components of the superoxide-generating system in phagocytes, and its defect is known to cause chronic granulomatous disease (CGD). Five unrelated CGD patients with p47-phox deficiency were found among 82 CGD patients in Japan. We sequenced the cDNAs and the genomic DNAs corresponding to p47-phox derived from these patients. In all cases examined, the defect was identified to be a GT (or TG) dinucleotide deletion at bases 75/76 (or 74/75, respectively) in the coding sequence for the protein. The same mutation was reported previously for a total of 9 alleles from 5 CGD patients in England and in the United States. It seems, therefore, that the dinucleotide GT deletion is the common mutation in 47-phox deficient CGD due to certain structural issues.

Adolescent↗
PubMed1994

Group II phospholipase A2 in invasive gastric cancer cell line is induced by interleukin 6.

To investigate the role of group II phospholipase A2(PLA2) in cancer, we examined the expression and secretion of group II PLA2 in response to the stimulation of interleukin 6(IL-6) in human gastric cancer cells in vitro. Group II PLA2 determined by a specific radioimmunoassay was constitutively produced in culture supernatant of KATO III (signet ring cell carcinoma) and MKN28 (well differentiated adenocarcinoma). This production in KATO III significantly increased with a treatment of IL-6, whereas that in MKN28 remained at a same level. Moreover, the quantitation by reverse transcription-polymerase chain reaction(RT-PCR) demonstrated the IL-6 inducible overexpression of group II PLA2 mRNA in KATO III. This transcription was mediated by NF-IL6, the same as in hepatocytes. These results suggest two possible mechanisms of group II PLA2 production by cancer cells in vivo, that is, cytokine-induced production and constitutive production.

Adenocarcinoma↗