[Chemotherapy with high dose CBDCA for advanced non-small cell lung cancer].
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Aged↗
Biomedical subjects
K Arita
Publications and source records attributed to K Arita.
[Pineocytomas; clinicopathological evaluation of 4 cases].
Clinicopathological evaluation of pineocytoma was performed in 4 patients. The subjects, 2 males and 2 females, ranged in age from 17 to 40. All the patients were clinically found to have the symptom of increased intracranial pressure on a monthly basis, but none of them were found to have dorsal midbrain dysfunction symptoms such as Parinaud's sign or Argyll Robertson pupil. Diagnostic imaging produced heterogeneous pictures indicating calcifications and cyst in 2 patients and homogeneous pictures of the tumor parenchyma in the other 2 patients. Histologically, the former cases were found to have many pineal-sand-like calcifications. Median sagittal MR images demonstrated expansive growth of pineocytoma. Quadrigeminal plates which kept their shapes were observed in 2 patients. Craniotomy was performed in all cases, removing the tumor totally in 2 patients. Radiation therapy was given to 3 patients, resulting in complete remission, but radiosensitivity varied according to cases. During the follow-up period of 12 to 42 months, one patient died of peritonitis caused by shunt infection. No recurrence of the tumor was seen in any of the patients. The incidence of pineocytoma was very low. Further evaluation of the tumor involving many cases is advisable.
Adolescent↗
A case of scalp cavernous hemangioma simulating sinus pericranii.
The authors report a case of cavernous hemangioma in the occipital region, which resembled sinus pericranii, protruded in the recumbent posture. A 28-year-old male was admitted with a chief complaint of an occipital fluctuating mass, 5cm in diameter, accompanied by slight pain. The skull X-P was normal. A direct puncture revealed that the lesion was a blood cyst. A cystogram by percutaneous needle puncture revealed paramedian blood pooling with some draining veins but did not show any transcranial communicating vessels. A T2 weighted MR image demonstrated a well demarcated high intensity lesion just beneath the corium. The subtotally removed specimen turned out to be a cavernous hemangioma. We discerned a conceptual confusion of pseudosinus pericranii with scalp cavernous hemangioma, based on the literature review. And we propose that scalp cavernous hemangioma, even if it changes its size according to posture, should not be simply designated as sinus pericranii.
Adult↗
Vasospasm after traumatic subarachnoid haemorrhage: transcranial Doppler evaluation. Case report.
A case of vasospasm after traumatic subarachnoid haemorrhage (SAH) is reported here. Transcranial Doppler Sonography (TCD) was used to evaluate mean flow velocity (MFV) changes of the basal cerebral arteries related to vasospasm. Acceleration of MFV of the right middle cerebral artery (MCA) indicating vasospasm was first noted on TCD evaluation, and then proved by carotid angiography (CAG). Evaluation of all TCD results revealed that the process of relaxation or normalization of the spastic artery started from the proximal side of the basal intracranial artery and gradually moving to the distal side. This interesting phenomenon could be a common process found in vasospasm cases.
Blood Flow Velocity↗
A case of pituitary adenoma producing both growth hormone (GH) and adrenocorticotropic hormone (ACTH).
The authors report a very rare case of pituitary adenoma producing both GH and ACTH. A 29-year-old female was admitted with obesity, amenorrhea, acromegaly, hirsutism, excessive pigmentation, acne, and diabetes mellitus. Computed tomography revealed an intrasellar tumor 16 mm in height, with a destroyed sellar floor. The blood concentrations of GH, ACTH and cortisol were increased (GH: 92 ng/ml, ACTH: 94 pg/ml, cortisol: 18.3 micrograms/dl). No diurnal variation in the amount of cortisol was observed. The urinary 17-OHCS was suppressed by 8 mg but not by 2 mg of dexamethasone. A subtotal adenomectomy was then performed through the transsphenoidal approach, which led to a sufficient reduction of both blood GH and ACTH (cortisol). Histologically the tumor was an acidophilic pituitary adenoma. Immunoperoxidase staining showed diffuse GH and sporadic ACTH producing cells, but failed to show any cells producing both hormones. The electron micrograms of neoplastic cells showed the ultrastructural characteristics of respective GH and ACTH cells. Another increase in both GH and cortisol, which occurred 19 months after the operation, has been controlled by bromocriptine administration. This case may be the first reported case of a pituitary adenoma producing both GH and ACTH, not accompanied by prolactin (PRL) hypersecretion, which has been fully confirmed endocrinologically and histopathologically.
Adenoma↗
Influence of pregnancy on the serum prolactin level following prolactinoma surgery.
We studied the influence of pregnancy on the serum prolactin levels after surgery in 35 patients with prolactinomas. Eighteen out of 22 patients with postoperative normalization of the prolactin level were able to achieve repeated spontaneous pregnancies and endocrine cure by surgery alone, but the other 4 had recurrent hyperprolactinemia. Thirteen patients with persistent hyperprolactinemia after surgery achieved one pregnancy with or without bromocriptine treatment, but did not achieve a second one owing to an increase in the prolactin level after delivery. None of the patients with postoperative hyperprolactinemia showed spontaneous normalization of the prolactin level or restoration of menstruation after delivery. In these 13 patients, the mean increase from the postoperative to the post-delivery prolactin level was less for the patients with bromocriptine-induced pregnancy than for those with spontaneous pregnancy. It is concluded that pregnancy did not adversely affect the serum prolactin level in the patients with a normal postoperative level.
Adult↗
Intraventricular hemangiopericytoma--case report.
A very rare large intraventricular hemangiopericytoma occurred in a 41-year-old male with a 2-month history of headache and paresthesia of the right shoulder and arm. The tumor was partially removed, followed by 50 Gy local Linac irradiation given over 6 weeks. Four months later the residual tumor demonstrated a marked decrease in size and vascularity. The residual tumor was totally removed with less operative bleeding than at the initial operation. This is the first reported case of hemangiopericytoma located in the trigone of the lateral ventricle.
Adult↗
[Plasma cell tumor of the parieto-occipital bone; a case report].
Plasmacytoma originating in the cranial bone is a rare disease. A report is presented of a case of plasmacytoma originating in the parieto-occipital region. The patient was a 62-year-old male with palpation of a parieto-occipital mass as chief complaint. He showed no neurological deficit. Ig-G in the serum was 2240 mg/dl, and M-protein (n-type) was demonstrated in the serum. Bence-Jones protein was negative and bone marrow was normal. Skull X-ray showed osteolytic change in the parieto-occipital region. CT scan and MRI demonstrated a markedly enhanced mass extending from the epidural to the subcutaneous space at the parieto-occipital region. Common carotid angiography showed remarkable tumor stain flowing from the occipital artery, the superficial temporal artery, and the middle meningeal artery. Following embolization of the bilateral occipital artery, parieto-occipital horse shoe scalp incision was done. The tumor was elastic soft and bled easily around the margin of destroyed bone. Subtotal removal of the tumor was accomplished. The removed surgical specimen of the tumor was found to be plasmacytoma. The patient's postoperative course was favorable and no neurological deficit was found. Laboratory studies revealed a remarkable reduction of Ig-G in the serum to 1170 mg/dl. Six months after the operation, no signs of recurrence were seen on CT scan. Plasmacytoma originating in the cranial bone is so rare that only 18 cases have been reported to date. In these cases, laboratory studies have shown no evidence of anemia, Bence-Jones protein in urine, and abnormality of the bone marrow which are characteristic of multiple myeloma.(ABSTRACT TRUNCATED AT 250 WORDS)
Humans↗
[A case of sellar germinoma which was misdiagnosed as pituitary adenoma].
The authors reported a rare case of sellar germinoma which was misdiagnosed as nonfunctioning pituitary adenoma. A 32-year-old woman was admitted to our hospital because of amenorrhea and disturbance of left visual acuity. She had become amenorrhagic after her second delivery two years before. Neurological examination revealed she was normal except for diminished left visual acuity (Rt. = 1.2, Lt. = 0.5). The general condition was good. Urine volume and its specific gravity were within normal range. Endocrinological examination showed hyperprolactinemia (PRL 72 ng/ml) accompanied with impairment of GH, TSH, LH and FSH's reserve. Basal levels and reserve of the blood cortisol were normal. AFP and hCG were within normal range. CT scan revealed a homogenously enhanced intrasellar tumor which had a suprasellar portion (vertical length: 15 mm). T1 weighted MRI revealed low intensity tumor, and T2 weighted image revealed high intensity tumor. Sagittal MR image with gadolinium enhancement showed the pituitary gland anterior to the tumor. Transsphenoidal removal was performed. The histological diagnosis was pure germinoma. After the operation, the intracranial and spinal disseminations were disclosed. Complete neuraxis irradiation resulted in the complete remission of the tumor. Sellar germinoma without diabetes insipidus is considered to be very difficult to diagnose preoperatively. However, the authors proposed that anterior shift of the pituitary gland in sagittal MR image may be a clue to the diagnosis of sellar germinoma.
Adenoma↗
[A clinical study on intrathoracic malignant lymphoma with chronic tuberculous pyothorax].
The authors reported 3 male patients of malignant lymphoma developing from long-standing pyothorax. They had been suffering from tuberculous pyothorax for more than 30 years, after artificial pneumothorax therapy for pulmonary tuberculosis. The most common symptom was chest pain. It was difficult to detect the tumor mass by chest X-ray because of old inflammatory changes. Computed tomography and 67Ga scintigraphy were useful. The lesions tended to grow destroying the surrounding lung, chest wall and ribs. Histologically, 2 cases were diffuse large cell type and one was diffuse intermediate sized cell type. Immunologically, 2 cases were B-cell type lymphoma but one was not clearly classified. They received radiotherapy, but 2 cases died of respiratory failure. These findings suggest that B cell lymphoma might arise following chronic tuberculous pyothorax. Therefore such cases should be followed up carefully.
Empyema, Pleural↗
[A case of pituitary adenoma with simultaneous secretion of TSH and GH detected by double immunostaining method].
A rare case of simultaneous hypersecretion of thyroid stimulating hormone (TSH) and growth hormone (GH) in a pituitary adenoma is reported. A 59-year-old male complaining of general fatigue, dyspnea on exertion and finger tremor was admitted. Examination on admission, he revealed with hyperthyroidism and hypersecretion of TSH and thyroid hormones. Administration of TRH did not further increase serum TSH level, and administration of T3 also had no effect on TSH secretion. CT scan showed a pituitary macroadenoma 13mm in diameter. MRI demonstrated a homogenously hypointense mass with Gd-DTPA enhancement in the left side of the sella turcica. The entire chromophobic adenoma was removed by trans-sphenoidal surgery. Immunostaining of the specimen showed that the cytoplasm of the adenoma cells was positive for both TSH and GH. Double immunostaining using avidin-biotin-peroxidase complex (ABC) method and immunogold silver staining (IGSS) method, showed that the adenoma cells had been secreting both GH and TSH at the same time. After the adenomectomy, the hyperthyroidism disappeared, and all altered indicators of pituitary function returned to normal.
Adenoma, Chromophobe↗
[Long-term surgical results of microprolactinomas].
Sixty three patients with microprolactinoma were studied by long-term follow-up after surgical cure. Postoperative normalization of prolactin (PRL) was seen in 38 (60%) of the total 63 cases, and hyperprolactinemia recurred in 5 (13%) during the follow-up period. Spontaneous restoration of menstruation occurred in 45 (71%), and, in 41 (65%), regular menstrual cycle as continuing at the time of the last follow-up. 34 (72%) of 47 patients who wanted children became pregnant, and 31 of these had a subsequent successful delivery. Clinical cure by surgical treatment alone, followed by spontaneous restoration of menstruation and continuation of regular cycle during the follow-up period after pregnancy and delivery was seen in 41 (65%) of the total cases. From these results, it was concluded that transsphenoidal surgery should be the treatment of first choice for microprolactinoma when complete cure is required.
Adolescent↗
[Dentofacial manifestations in children with vitamin D-dependent Rickets type II].
Calcification of the teeth, size of the teeth and dental arches, facial growth and calcification of the carpal bones were studied in three children with clinically different severities of vitamin D-dependent rickets (DDR), type II, with alopecia, which is 1,25-dihydroxyvitamin D-receptor-defect rickets and is particularly resistant to treatment with calciferol analogues. They were treated in a pediatric clinic with large doses of 1 alpha-hydroxyvitamin D3(1 alpha-(OH)D3) and 2 g/day of calcium lactate. The results were as follows: 1. Hypoplasia of enamel of the deciduous teeth was not found. 2. In the deciduous teeth, large pulp chambers and thin dentin were seen in radiographs before treatment. In patients 1 and 2, these abnormalities were reversed by treatment. In patient 3, who had the severest manifestations, large pulp chambers and thin dentin decreased but still remained. 3. Growth of permanent teeth was retarded before treatment and during resistance to treatment. After effective medication, it caught up and was corrected. 4. Problems concerning maxillary and mandibular growth were not found. However Nasions of three patients were more front and lower and Orbitals were lower than standard. 5. In patients 1 and 2, the calcification of carpal bones was accelerated and in patient 3 retarded. 6. Mesiodistal dimensions of erupted deciduous and permanent teeth were within the standard range, except for patient 3, who had smaller lower deciduous teeth. 7. A ground section of the extracted upper right first deciduous molar from patient 3 showed abundant inter-globular dentin and lack of pre-dentinal layer. From the above findings, it was felt that in all probability dentinogenesis was disturbed by the DDR type II. Abnormally large pulp chambers and thin dentin could be corrected by effective medication. In patients with vitamin D-dependent rickets type II, oral hygiene for caries prevention is the most important procedure, because the pulp will be infected immediately after initiation of dental caries. After effective medication, permanent teeth and jaw bones will probably grow normally.
Carpal Bones↗
Changes of brainstem auditory evoked responses (BAERs) in a brain stem ischemic model using embolization technique in cats, a preliminary study.
In order to evaluate brain stem dysfunction related to ischemic process, the authors monitored the Brainstem Auditory Evoked Responses (BAERs) with time in a brain stem ischemic model. 19 adult mongrel cats were divided into two groups: embolization (n = 14) and sham operated control (n = 5). Embolization was done by injecting cylindrical silicone embolus to the right vertebral artery. Each successful embolization of the basilar artery was then confirmed by vertebral angiography. BAERs were monitored before embolization and then 5-10 min, 15 min, 30 min, 60 min, 3 hr and 6 hr after embolization. The presence of ischemic lesion caused by embolization was confirmed by injecting 2% Evans blue solution 30 min before sacrificing the animals. Leakage of the dye was observed. In embolized animals, significant (Student t test, p less than 0.05) delay of interpeak latencies of waves 1-3, 3-5, and 1-5 was observed 15 min after embolization. This delay became more significant (p less than 0.01) 30 min after embolization. These results provide evidence for the usefulness of BAERs monitoring which can be used to complement other diagnostic methods for patients with vertebrobasilar insufficiency and/or infarction.
Animals↗
[Hypoplasia of tooth in children with inborn errors of metabolism].
For the investigation of the clinical dental manifestations of inborn errors of metabolism, the oral examination of twenty one children aged from 5 months to 15 years 5 months was performed at the pediatric clinic of inborn errors of metabolism. The results were as follows: 1. In six of seven histidinemia patients, white spots, pit or hypoplasia of enamel, fused teeth, peg teeth or abnormal tubercles were observed. 2. In a patient with GM1-gangliosidosis, the upper and lower central incisors had severe white spots. 3. In one patient with osteopetrosis, one of two glycogenosis type IX and one of two homocystinuria patients, white spots or hypoplasia of enamel were observed. 4. One patient with hypophosphatemic vitamin D-resistant ricket, one with vitamin D-dependent ricket type II and one with galactosemia patient had no enamel hypoplasia. It was strongly suggested that there is a specific relationship of histidinemia and GM1-gangliosidosis to dental manifestations.
Adolescent↗
[Studies on the cooperation-enhancing approach in dealing with children in the dental setting. 4. Relationship between adaptability to dental treatment and behavioral and emotional reactions before and during treatment].
The correlation between the behavioral and emotional reactions before dental treatment and the adaptability to dental treatment was evaluated in 84 three-to-six-year old children. Also the physical behavior of the children, the verbal reaction of the children and the speaking of dentists to the children during treatment were investigated among 13 cooperative and 13 uncooperative three-to-six-year old children. Dental treatment was conducted with tooth brushing, surface anesthesia, infiltration anesthesia, rubber dam application, cavity preparation with air turbine, cavity preparation with electric motor and composite resin filling. The results are summarized as follows: 1. There was a significant correlation between twelve of the twenty behavioral and emotional reactions before treatment and the adaptability to dental treatment. 2. The children who showed an uncooperative behavior to dental treatment showed a higher score of physical behavior during each treatment than the children who showed a cooperative behavior to dental treatment. 3. The score of physical behavior increased as the treatment progressed from tooth brushing to infiltration anesthesia. Among the children who showed cooperative behavior, the score showed a peak at the infiltration of anesthesia and then decreased. On the other hand, the children who showed uncooperative behavior continued showing a high score. 4. The uncooperative children showed a higher frequency of verbal reaction and crying than the cooperative children. 5. The frequency of speaking of the dentist to the uncooperative children was one and a half times as much as to the cooperative children. More than sixty percent were "instructions" and "explanations" to both of the cooperative and uncooperative children. "Praise" was used more to the cooperative children, and "count 10" and "encourage" were used more to the uncooperative children.
Child↗
[Effects of mastication on the growth and development of salivary glands in male mice].
Mastication has attracted considerable attention in recent years for its effects on the postnatal growth and development of the mandible, brain, salivary glands and other organs in children. In this study, the relationship between mastication and growth and development of the salivary glands was examined, because the salivary glands are rich in growth factors and many kinds of biological polypeptides, and have endocrine and exocrine actions and effects, on the growth and metabolic rates in developing animals. The experiment utilized two groups of male mice, a control group fed a solid diet, and an experimental group receiving the paste diet ad lib. In the experimental group fed the paste diet, the increase of the tissue weights and the contents of DNA and RNA in the parotid and submandibular glands were lower than those of the control group. Also the rise of amylase activity in the parotid glands was depressed. Next, the polyamine metabolism in the parotid and submandibular glands was examined. The activities of the late limiting enzymes in polyamine syntheses, ornithine decarboxylase and S-adenosylmethionine decarboxylase and the lev- putrescine and spermidine in both parotid and submandibular glands were in the experimental group. These results suggest that mastication plays an important roles in the growth development of the parotid and submandibular glands in mice.
Animals↗
[Studies on factors causing tooth resorption. 1. Role of prostaglandins as a chemical mediator on resorption of deciduous teeth in rabbits].
The aim of this study was to investigate the effects in the administration of indomethacin which is a specific inhibitor of prostaglandins (PGs) in order to understand the role of PGs in physiologic root resorption. For this study, 24 young rabbits aged 7 days which had been in utero for 31-32 days were used. The experimental group (N = 12) was injected with 5.0 mg/kg indomethacin every 12 h, and the control group (N = 12) was injected with normal saline solution every 12 h. 4 animals of each group were sacrificed at the 9th, 11th and 13th day, respectively. Their maxillary deciduous incisors embedded in paraffin were sectioned serially 7 mus in thickness. From each sample was counted the number of odontoclasts appearing on the root surface and measured the volume of the root in the maxillary deciduous incisor. The results were as follows: 1. The appearance of odontoclasts increased in a day-related manner from 9 days to 13 days on the resorption of maxillary deciduous teeth in the control and experimental rabbits. 2. The number of odontoclasts was significantly decreased by the administration of indomethacin (9 days P less than 0.05, 11 and 13 days P less than 0.01). 3. The amount of the root resorption was significantly inhibited by the administration of indomethacin at 9 days which was the initial stage of root resorption in the maxillary deciduous incisors, and then the effect of inhibition rapidly disappeared. These results strongly suggest that PGs can possibly act as a chemical mediator of odontoclastic root resorption occurred during tooth exchange.
Animals↗