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Biomedical subjects

J Shikata

Publications and source records attributed to J Shikata.

At least 37 records · Page 2Linked to original sources
PubMed1991

Analysis and prevention of spinal column deformity following cervical laminectomy. I. Pathogenetic analysis of postlaminectomy deformities.

Postlaminectomy deformities were simulated in the cervical or cervicothoracic spine by the use of a displacement incremental method based on finite-element analysis combined with composite material and spanning element theory. The simulation analyses revealed that the primary cause of postlaminectomy deformity was the resection of one or more spinous processes and/or posterior ligaments (ie, ligamenta flava, supraspinous, and interspinous ligaments). After their removal, the tensile stresses that were preoperatively distributed through the posterior ligaments were transferred to the facets. This led to an imbalance of the stresses on the spinal bodies, causing deformity. The gravitational center of the head determined whether the deformity would develop as a kyphosis or increasing lordosis. As the elastic modulus of the soft tissue composites (eg, end plates, ligaments, and facets) increased, a kyphotic deformity changed gradually from swan-neck deformity, to extreme kyphotic deformity with a large curvature, and finally to a straightening deformity. Progressive kyphotic deformity is found only in children.

Adult↗
PubMed1991

[Problems with topical therapies for extensive squamous cell carcinoma of the buttocks].

In patients in whom cancer originating from a bed-sore has advanced to a stage where radical treatment is impossible, topical treatment with ointment, or systemic anti-cancer chemotherapy, is usually applied. We recently attempted treatment of extensive squamous cell carcinoma of the buttocks, for which radical treatment was impossible, by chemotherapy using a reservoir for intraarterial injection. This therapy involved intraarterial injection of bleomycin and 5-FU, together with topical treatment with 5-FU ointment. We describe the problems encountered with this therapy, e.g., measures against fever after intraarterial injection, management of the affected area, evacuation, possibility and limits of radiation therapy, and assessment of its efficacy.

Administration, Topical↗
PubMed1991

[A case report of spontaneous pneumothorax in Marfan's syndrome and an immunohistochemical study of type I collagen in lung tissue].

A 19-year-old male was admitted to Teikyo University Hospital because of dyspnea. The chest film revealed pneumothorax of the right side. The patient was tall and thin, with long tapered extremities. The lens showed ectopia lentis. Echography of the heart showed dilatation of the aorta. A diagnosis of Marfan's syndrome was established on the basis of characteristic skeletal, ocular and cardiovascular findings. At thoracotomy, several bullae were removed by wedge resection. Collagen type distribution in the lung was investigated by an indirect immunohistochemical study using type-special antibody of type I collagen. There were no significant differences in collagen type I in the lung between Marfan's syndrome and control. This suggests that type I collagen in Marfan's syndrome cannot be distinguished from normal collagen I by indirect immunochemical study.

Adult↗
PubMed1991

[A case of adenoma of the nipple with breast cancer].

Adenoma of the nipple is an uncommon lesion which can be mistaken clinically for Paget's disease and pathologically be misinterpreted as an adenocarcinoma. We recently experienced a case of very rare adenoma of the left nipple with left breast cancer. The patient was a 42-year-old, married woman with a firm, partially erosive lump measuring 12 X 12mm in her left nipple and with a left breast lump. Biopsy revealed the breast lump invasive ductal carcinoma and lump of the nipple was adenoma. Modified radical mastectomy was carried out. It is important to bear this rare lesion in mind and perform a thorough examination before making a diagnosis of a lump in the nipple.

Adenoma↗
PubMed1991

Long-term outcome of massive small bowel resection.

The long-term outcome for seven patients 4-17 yr (mean 7.1 yr) after massive small bowel resection, leaving 5-160 cm (mean 86.4) of small bowel, was reviewed. Their mean age at the final enterectomy was 40 yr. Adaptation to foodstuffs and the effects of physiologic alterations and complicating diseases on their return to work were emphasized. More than 3.5 yr after surgery, the patients had adapted to many kinds of foodstuffs, but dietary fat could not be tolerated by three patients. Six patients returned to work an average of 2.7 yr after surgery, but four were obliged to discontinue their work because of rehospitalization for long-term complications. In addition, their working hours were limited, and they could not engage in heavy physical work, owing to physiologic alterations, such as a reduced metabolic state, after massive enterectomy.

Adult↗
PubMed1991

[Dumbbell type tumor of a nerve root treated surgically by vertical curvilinear approach].

A 42-year-old man was admitted for further examination of an abnormal shadow on the posterior mediastinum which was incidentally detected by a routine chest X-ray. Myelography followed by computerized tomographic scanning (CT) revealed that a dumbbell shaped tumor had developed in the paravertebral area adjacent to the vertebral canal through an intervertebral foramen. A vertical curvilinear incision centered at T-6 was made with the patient in a prone position. Total laminectomy or T-5 and T-6 and resection of the left 6th rib provided sufficiently wide exposure for a one-stage resection of the tumor. The dumbbell shaped tumor originated from the root of 6th spinal nerve but did not extend to the spinal cord. The extirpated tumor was diagnosed histologically as schwannoma. Because tumor location had been determined preoperatively by CT scanning after myelography, it was possible to perform complete extirpation of the tumor while avoiding the complications of laminectomy and unnecessary thoracotomy.

Adult↗
PubMed1990

[A clinicopathological study on carcinoembryonic antigen in breast cancer].

The production of carcinoembryonic antigen (CEA) by human breast cancer tissue has been studied in relation to the prognosis of 60 patients with breast cancer who were classified in Clinical Stage of UICC I, II and III, and who were treated by radical mastectomy. Tissue CEA was studied in primary tumors using an immunoperoxidase (PAP) method. The obtained results were as followings: 1) Patients who had CEA-negative tumors had significantly higher 10-year survival rates. 2) The positive staining rate of CEA rises as Clinical Stage and metastatic status of lymph nodes advanced. 3) There were significant correlations between staining rate of CEA and classification of histological type and differentiation. 4) There were significant correlations between staining rate of CEA and lymphoid infiltration around main tumor and Sinus Histiocytosis in regional lymph nodes. 5) These results suggest that immunohistological assessment of CEA in breast cancer tissue may provide more precise prognostic information.

Adult↗
PubMed1990

Calcitonin gene-related peptide in patients with endocrine tumors.

The plasma level of calcitonin gene-related peptide (CGRP) was measured by RIA in 41 patients with endocrine tumors [22 medullary thyroid carcinomas (MTC), seven parathyroid adenomas, four benign insulinomas, five carcinoids, and three pheochromocytomas]. Of the 22 patients with MTC, all five preoperative patients had elevated CGRP levels. The correlation between CGRP and calcitonin levels was significant (P less than .001) in 22 patients with MTC. Six of 19 patients with endocrine tumors other than MTC showed elevated CGRP levels. Immunohistochemical study showed that tumor tissues from all 22 cases of MTC and seven from other endocrine tumors contained immunoreactive CGRP. CGRP reactivity was found in only small numbers of tumor cells. Thus, although CGRP appeared to be a useful additional marker for MTC, the role of CGRP in the pathophysiology of endocrine tumors was not elucidated.

Adenoma↗
PubMed1990

PDN-21: possible tumor marker for medullary thyroid carcinoma.

The plasma level of PDN-21 was measured by RIA in 10 patients with medullary thyroid carcinoma (MTC). All 10 patients with MTC had extremely elevated PDN-21 levels. The correlations between PDN-21, calcitonin gene-related peptide, and calcitonin, (all of which are calcitonin gene products) were significant (P less than .001) in the 10 MTC patients. This study suggests that PDN-21, as well as calcitonin, may be a useful marker for the detection of patients with MTC.

Adult↗
PubMed1990

Nationwide investigations of intestinal obstruction in Japan.

Two nationwide questionnaire surveys of intestinal obstruction in Japan were undertaken, covering two two-year periods, from January, 1975 to December, 1976 and from January, 1985 to December, 1986, respectively. The findings of a comparative review of these two surveys indicated that although the overall mortality of intestinal obstruction had not changed between 1975/76 and 1985/86, being 6.8 per cent and 6.5 per cent, respectively, simple adhesive obstruction had decreased from 3.2 per cent in 1975/76 to 2.0 per cent in 1985/86. The main cause of adhesion was laparotomy and in cases of both simple adhesive obstruction and strangulation adhesive obstruction, the rate of adhesion secondary to laparotomy of the upper gastrointestinal tract and colon and rectum had increased between 1975/76 and 1985/76. Obstructions caused by neoplasms had increased from 8.2 per cent in 1975/76 to 10.0 per cent in 1985/86, while those caused by adhesions had increased further still, from 42.5 per cent in 1975/76 to 60.8 per cent in 1985/86. Among the latter group, non-operatively treated cases had increased, which may be accounted for by the fact that facilities which adopt non-operative treatment using intestinal decompression as the first choice for simple adhesive obstruction cases have increased. In both surveys, the mortality of cases receiving nonoperative treatment was lower than that of operative cases.

Health Surveys↗
PubMed1990

Surgical treatment for paraplegia resulting from vertebral fractures in senile osteoporosis.

Seven extremely rare cases of paraplegia secondary to senile osteoporotic vertebral compression fractures were treated by posterior decompression followed by Harrington rod stabilization. This approach not only ensures more satisfactory decompression, but also facilitates early mobilization and rehabilitation. The follow-up period ranged from 1 year to 3 years, 3 months (average, 24.7 months); in all seven cases a substantial overall improvement was achieved. This report demonstrates that an osteoporotic vertebral body fracture can cause a cord compression, and emphasizes the effectiveness and importance of early surgical treatment.

Aged↗
PubMed1990

Replacement of the lumbar vertebrae of sheep with ceramic prostheses.

We prepared a prosthesis for the replacement of the lumbar vertebrae of sheep, using apatite- and wollastonite-containing glass-ceramic. The material is stronger than human cortical bone and has the special feature of chemical bonding to bone. Ten sheep underwent replacement of L3 and L4 vertebrae, without bone grafting. The animals were killed at intervals from three months to 27 months after operation, and the interface between the prosthesis and bone was examined radiologically, histologically and crystallographically. Bone bonding with the prosthesis had occurred in half the implants. It took at least one year for bonding to be complete, but an apatite layer on the surface of the prosthesis was observed as early as three months after the operation, suggesting the possibility of much earlier bone bonding if more rigid fixation of the prosthesis had been provided.

Animals↗
PubMed1990

Contrast-enhanced intraoperative ultrasonography of small hepatocellular carcinomas.

Nine patients with small hepatocellular carcinomas, ranging up to 2 cm in size (phi: 1.7 +/- 0.2 cm, mean +/- SD), have been encountered, and in two of these patients the cancer was not identifiable by intraoperative ultrasonography. Thus to achieve a better detection of such small hepatic cancers, enhanced intraoperative ultrasonography was tested. Detection by enhanced intraoperative ultrasonography proved successful in all cases. These preliminary results indicate the potential of carbon dioxide as a contrast agent to enhance intraoperative visualization of small liver cancers.

Angiography↗