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Biomedical subjects

H Wada

Publications and source records attributed to H Wada.

At least 829 records · Page 46Linked to original sources

[Study on frictional characteristics of KB horizontal brackets. A comparative study of kinetic frictional forces to be caused between various kinds of brackets and wires].

KB horizontal brackets were designed to tip no more than 6 degrees at the maximum. This tipping amount is based on the idea of reducing friction between a wire and brackets to allow the effective tooth movement of the Begg technique even with horizontally long brackets, and does not originate in the concept of carrying out tipping movement. Thereon, experimental measurements by use of Rheometer were conducted to review for comparison of the kinetic frictional forces caused between various wires and the following four types of brackets; KB horizontal brackets, Tip edge brackets, Straight edge brackets and Begg brackets. 1. In case of utilizing ribbon arch wires and rectangular wires, no significant difference was acknowledged among Tip edge, KB horizontal and Straight edge brackets. 2. There proved to be a reduction in the kinetic frictional forces by incorporating tip into the edgewise slots, when using smaller dimensions of the wires which call for the effective tooth movement, however, Begg brackets (in conjunction with Ordinary T-pins and/or Safety T-pins) showed the small value which is far less than that of the three kinds of brackets.

Orthodontic Appliances↗

[A clinical study of six surgically treated patients with malignant tumors arising from chronic pleuritis and pyothorax].

During the clinical course of chronic pleuritis and pyothorax, we frequently have found abnormal clinical signs such as increased abnormal chest shadows, subjective symptoms, such as chest pain and bloody sputum, and the appearance of atypical cells in the pleural effusion. It is very difficult and important to diagnose differentially worsening of chronic inflammation and occurrence of malignant tumors. We have surgically treated six patients with malignant tumors arising from chronic pleuritis and pyothorax, who had the above abnormal signs. All of them were made, and their average age was fifty three years. Two patients exhibited increased abnormal chest shadows, 5 had subjective symptoms (5 with chest pain, 2 with bloody sputum and 2 with fever), and 1 had atypical cells in the pleural effusion. Two patients had suffered from chronic pleuritis, who both had received artificial pneumothorax therapy for pulmonary tuberculosis, and the other 4 patients had suffered from chronic pyothorax, with mean duration of thirty years. The pathological diagnoses were 2 cases each of malignant pleural mesothelioma, squamous cell carcinoma, and malignant fibrous histiocytoma. The two patients with squamous cell carcinoma had pleurocutaneous and bronchopleural fistula. The operative methods were tumor resections with pleuropneumonectomy performed in 2 patients and pneumonectomy in 1. Absolute non-curative operation was performed in 1 patient, and postoperative radiotherapy in 3 patients. All patients died of tumor recurrence, although five of them underwent reoperation, chemotherapy and radiotherapy. Their duration of survival ranged from 3 to 15 months with a mean of 9 months after appearance of malignant tumor signs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Surgical treatment of small cell lung cancer].

Thirty-four small cell lung cancer (SCLC) patients underwent surgery in Kyoto University from 1976 to 1989. The mean age was 62 years males numbered 25 cases, and females 9. All cases were LD except 2 rib-metastasized patients. Seventeen patients were in PS 0, and 17 in PS 1. Twenty-eight patients were treated with chemotherapy. In the remaining 5 patients 2 were treated by only oral 5-FU derivatives, one died upon operation, one was unable to be treated because of advanced age, and the last one refused chemotherapy. Except for the one operational death, 33 cases were able to be evaluated. Out of 28 patients, 16 were treated only by post-operative chemotherapy. As for operational radicality, 21 out of 31 cases were operated radically (68%). The survival rate of these 33 patients reached 78% for 1 year, 37% for and 5 years, with MSI at 26 months. The neoadjuvant (+) group showed a better prognosis than the non-non-neoadjuvant group.

Adult↗

[Intra-arterial and intraportal therapy combined with decollateralization in unresectable cholangiocellular carcinoma--a case report].

A 45-year-old man was referred to our hospital due to obstructive jaundice by intrahepatic cholangiocellular carcinoma. At laparotomy, he was assessed as unresectable because of multiple foci in both lobes. Therefore, two catheters connected to implantable access devices were placed in both the hepatic artery and the portal vein following decollateralization using silicone rubber sheeting, in addition to choledochectomy and choledocho-jejunostomy. After the surgical procedure, he underwent chemoembolization twice using Lipiodol, cisplatin, and Gelfoam, and two intraportal infusions of cisplatin at a dose of 50 mg. Moreover, a total dose of 4 g of 5-FU and 20 mg of MMC was administered through the arterial and portal catheters, respectively. Administration of G-CSF was remarkably effective for severe thrombocytopenia, and leukopenia resulted from this active chemotherapy. He is still alive 7 months after the surgical procedure with the regression of the lesions.

Adenoma, Bile Duct↗

[A long-survival case of hepatocellular carcinoma treated by intra-arterial chemotherapy and immunotherapy].

Hepatic resection is generally considered to be superior to any other therapeutic procedures for hepatocellular carcinoma (H.C.C.). However, the resectability of the patients who have HCC. with liver cirrhosis is still low, and surgery is appropriate in only a minority of patients. Although some successful reports of intra-arterial chemotherapy for HCC. have been documented, most of the therapeutic effects are transient and the survival rate is not satisfactory. This report is of a rare case, that of a long-term survivor with HCC treated by intra-arterial chemotherapy and immunotherapy. A 66-year-old man, with a 10-year history of liver cirrhosis was admitted to The Center for Adult Diseases, Osaka, after detection of a tumor in the right lobe on US. On admission, serum AFP was within normal range, HBs-Ag was negative, and ICG-R 15 was 20.8%. On hepatic angiogram, a hypervascular tumor (6 cm in size) was recognized in the middle of the right lobe. He was assessed as unresectable because of insufficient reserve capacity, and the catheterization of the hepatic artery for intra-arterial chemotherapy and the injection 35 KE of OK-432 into the tumor were carried out under laparotomy. After the procedure, the patient was treated by intra-arterial infusion of doxorubicin (ADR) at a total dose of 150 mg and 5-FU in total dose of 25 g, with a hypodermic injection of OK-432 at a total dose of 161 KE. Hepatic angiography, carried out one year after the procedure, disclosed no foci in the liver. The duration of complete remission continued more than 5 years. The patient eventually died of intrahepatic recurrence, but he lived for 7 years and 3 months after the catheterization.

Aged↗

[Adjuvant surgery to enhance therapeutic effects of chemo-embolization in advanced hepatocellular carcinoma].

Different kinds of adjuvant surgery were carried out in three patients with advanced hepatocellular carcinoma (HCC) to enhance the therapeutic effects of chemo-embolization (TAE). The first patient, who had multiple foci localized in the right lobe, underwent ligation of the right portal vein in order to eliminate the small intrahepatic spreads and to protect against transportal metastasis to the left lobe. Afterward, TAEs were repeated a total of 5 times. The patient is still alive 24 months after the surgery with partial remission of the lesions. The second patient with severe cirrhosis had received TAE twice. Since one of the tumors, which existed in the hepatic hilus, did not respond to TAE, only the non-respondent tumor was removed surgically. This patient remains alive 28 months after the surgery with complete remission of the lesions. In the third patient, repeated TAEs resulted in collateral feeding arteries. Permanent decollateralization using silicone rubber sheeting was carried out following ligation of collaterals. Thus adjuvant surgery to enhance the therapeutic effects of TAE may be a significant palliative treatment for HCC.

Carcinoma, Hepatocellular↗

[Selective anticancer effects of intra-arterial infusion of 3',5'-dioctanoyl-5-fluoro-2'-deoxyuridine (TT82) in hepatocellular carcinoma].

3'-5'-Dioctanoyl-5-fluoro-2'-deoxyuridine (TT 82), one of the lipophilic prodrugs of 5-fluoro-2'-deoxyuridine mixed with Lipiodol (LPD), was injected into the hepatic artery before hepatic resection in 4 patients with hepatocellular carcinoma. Later, the anti-cancer effects of the drug were evaluated mainly by the examination of resected specimens. The serum alpha-fetoprotein levels of three patients in whom the values were over normal range fell to less than 50% of pretreatment values from 7 to 14 days after the injections. In pathological observation of the specimens, the necrosis rates of main tumors were 100%, 70%, 30% and 0%, respectively. In three patients whose main tumors showed complete or partial necrosis, selective depositions of LPD in the tumors were observed on soft X-ray photographs. The concentrations of TT 82 and its metabolites in the tissues of LPD-depositing areas were markedly higher than those in tissue of the regions without LPD deposits. These findings suggested that TT82-Lipiodol mixture remained selectively in the cancerous tissues and exhibited anticancer effects following injection into the hepatic artery.

Aged↗

[Nd-YAG laser therapy in the field of pulmonary surgery].

Since 1980, we have treated 71 patients with malignant tumors and benign lesions by the Nd-YAG laser. The flexible fiberoptic bronchoscope with the local anesthesia was used for the treatments. Fifty-four cases were malignant tumors and 17 were benign lesions involving trachea and/or hilar bronchus. In malignant tumors, 41 cases were lung cancers, 24 of which were squamous cell carcinomas. Of 17 cases of benign lesions, 10 (58.5%) were introgenic stenoses. Palliative treatments were done for 36 cases of lung cancers, of which 23 died within 1 year after treatments. Four of 5 cases, which survived beyond 2 years, were adenoid cystic carcinomas. In 17 benign cases, 13 (76.5%) showed distinct improvements of symptoms and findings after treatments. Three patients died of massive bleedings. In these cases, severe stenoses were observed, which required treatments repeatedly. With the proper knowledge of the indications, limitations and complications, of YAG laser therapy it can be a beneficial mean for the management of benign lesions and malignant tumors in trachea and hilar bronchus.

Female↗

[Hemostatic changes before and after the onset of disseminated intravascular coagulation].

We performed a blood coagulation study during the course of disseminated intravascular coagulation (DIC) in 34 patients with hematological malignancies. Risk factors of DIC such as increasing tumor mass, anti-tumor therapy and severe infections were frequently observed at onset of DIC, and influenced the prognosis of DIC. Before the onset of DIC, the DIC score and FDP value were slightly elevated, and they were significantly increased after the onset of DIC. Before the onset of DIC, the level of fibrinogen was significantly increased but it was decreased after the onset of DIC. These hemostatic abnormalities continued for about 2 weeks. Patients with DIC showing prolonged APTT and PT had a poor prognosis. The abnormalities of PT, FDP, fibrinogen, DIC score, FDP-D-dimer and fibrinopeptide A were significantly greater in DIC than in Pre-DIC defined as the period one week before the onset of DIC. FDP-D-dimer was also higher in Pre-DIC patients than in those without DIC. Although protein S and C 4 b binding protein were not decreased in DIC or Pre-DIC, Protein C activity decreased during the course of DIC, suggesting that FDP-D-dimer and Protein C activity were useful for diagnosis of Pre-DIC and DIC.

Blood Coagulation↗

[Activity of procoagulant and fibrinolysis in homogenate of leukemic cells].

We examined activities of procoagulant and fibrinolysis in homogenate of leukemic cells. Procoagulant activity (PCA) was increased in patients with acute myelocytic leukemia (AML) and acute promyelocytic leukemia (APL), but it was significantly decreased in patients with chronic myelocytic leukemia (CML) and adult T cell leukemia. In CML, PCA was increased in the blastic phase. Plasminogen activator activity (PLGAA) was also increased in patients with AML, APL and acute lymphocytic leukemia (ALL) associated with disseminated intravascular coagulation (DIC). Elastase-like activity, trypsin-like activity and chymotrypsin-like activity (CTLA) were increased in those with myelocytic leukemia, but they were low in those with lymphocytic leukemia. PCA, PLGAA and CTLA were significantly higher in patients with DIC than in those without DIC. Measurement of procoagulant and fibrinolytic activity in leukemic cells homogenate may be useful not only for studying hemostatic abnormalities but also for classification of leukemic cells.

Blood Coagulation Factors↗

[Multivariate analysis of acute leukemia].

The outcome of chemotherapy in patients of 150 cases of acute leukemia was investigated. Patients were divided into two groups, that is group I: 100 cases of acute leukemia treated between 1980-1984, group II: 50 cases of acute leukemia between 1985-1986. Complete remission was achieved in 66% of group I and in 82% of group II. Using multivariate analysis, the initial levels of FDP and WBC count and age were found to be important factors to induce complete remission. Female sex was suggestive of a longer remission duration and survival by discrimination analysis.

Acute Disease↗

[Technical problems on right lung transplantation].

This report describes the technique of the allo-transplantation of the right lung of an adult mongrel dog. Compare to the transplantation of the left lung, we found several pitfalls in the right lung transplantation. 1) The intraatrial groove of the recipient must be divided carefully just at the middle of the right and the left atrium in order to make a generous cuff for the left atrial anastomosis. 2) It is preferable to divide azygos vein to perform easy anastomosis of right pulmonary artery and right bronchus. 3) Care must be taken to make left atrial cuff in donor lung since we did not divide intraatrial groove in the donor animal. It was necessary to make the left atrial cuff with a part of the right atrium attached.

Anastomosis, Surgical↗

Coagulation and fibrinolysis in patients with chronic renal failure on maintenance hemodialysis.

Alteration of the coagulation-fibrinolysis system was examined in patients on maintenance hemodialysis. The mean values of fibrinogen, factor V, factor VII, factor VIII, vWF (activity and antigen), factor IX and factor XI were significantly higher in these patients than in control subjects (p less than 0.01), but factor XII alone was significantly lower. Fibrinolytic parameters (euglobulin lysis time, fibrin plate lysis, fibrin degradation products and alpha 2-plasmin inhibitor-plasmin complex) suggested a hyperfibrinolytic state and plasmin generation in the patients' circulation. These findings suggest that the alteration of the coagulation-fibrinolysis system is aggravated by repeated hemodialysis, either by the influence of the dialyzer itself or heparin.

Adult↗

Brain histamine in Alzheimer's disease.

The concentration of histamine (HA) has been determined by high-performance liquid chromatography (HPLC) with fluorometric detection in 21 different regions of brains from patients with senile dementia of the Alzheimer type (SDAT) and subjects (CB) whose causes of death were not related to neuropsychiatric, neurological and/or neurodegenerative diseases. The highest levels of HA in the central nervous system (CNS) of both control (CB) and SDAT samples were found in the posterior hypothalamus (CB = 3.13 +/- 0.63 pmol/mg; SDAT = 7.75 +/- 1.43 pmol/mg, p less than 0.005), where the HA neurons are located, and in the anterior hypothalamus (CB = 1.77 +/- 0.33 pmol/mg; SDAT = 2.82 +/- 0.45 pmol/mg, p less than 0.005). The lowest HA levels were detected in the cerebellum (CB = 0.12 +/- 0.04 pmol/mg; SDAT = 0.24 +/- 0.09 pmol/mg, p less than 0.01) and medulla oblongata. HA levels were significantly higher in SDAT than in CB in the following areas: motor cortex (Brodmann's area 4) (A4), premotor cortex (A6), postcentral gyrus (A1,2), posterior parietal cortex (A5,7), superior temporal gyrus (A41,42), temporal pole (A38), primary and secondary visual cortices (A17,18), anterior and posterior regions of the hypothalamus, putamen, caudate nucleus, nucleus accumbens, thalamus, hippocampus, pons, medulla oblongata and cerebellum. No changes were seen in globus pallidus and corpus callosum. Since the origin of HA in the brain is dependent upon three main compartments (neuronal, mast cell, vascular smooth muscle), with approximately 60-80% of the total HA belonging to the neuronal pool, on the basis of neurochemical data we postulate that the increase in the levels of HA in SDAT might account for or be associated with alterations in neuroendocrine, cognitive, neurovascular and sleep-wakefulness functions.

Aged↗