Superabsorbent cellulosic nonwoven fabric-paraffin embedding technique for small biopsy specimens.
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Biomedical subjects
Publications and source records attributed to K Imai.
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Bone marrow transplantation (BMT) is now increasingly applied not only to hematologic disorders such as leukemias and aplastic anemia but also to some of solid tumors. We experienced ten cases of bone marrow harvest and six cases of autologous or allogeneic BMT during the period from June, 1986 to August, 1987. For autologous BMT cases, bone marrow cells were harvested and cryopreserved at -196 degrees C in liquid nitrogen tank and colony forming assays were examined to ascertain the colony forming ability of harvested bone marrow stem cells. Recovery of colony forming ability after cryopreservation in colony forming unit in culture and burst forming unit in erythrocyte is about 63 to 73% and well preserved. Among 6 cases undergone BMT, five cases are patients with advanced solid tumors including breast cancer, seminoma, lung cancer, malignant lymphoma and brain tumor and these 5 cases have undergone autologous BMT. Conditioning regimen for each cancer in autologous BMT differs based upon conventional chemotherapy regimen and two to four fold dose of conventionally used chemotherapy regimen were administered and after two or three days of high dose chemotherapy, cryopreserved bone marrow cells were thawed and infused. Peripheral white blood cells and platelets were recovered to more than 1000/microliters and 5 x 10(4)/microliters, respectively, within 21 days after bone marrow cell infusion. Disappearance or decrease in tumor size was observed in all cases except brain tumor even though those cases were advanced ones. After autologous BMT, recurrence occurred within three to five months in three cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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Spinal cord monitoring with the spinal cord evoked potentials using direct spinal cord stimulation is a safe and reliable method. The purpose of this study was to determine the degree of the potential change that is permissible to avoid severe neurological complications. Three hundred and fifty-four patients with spinal disorders were monitored with this method. The peak amplitude of the potential used as an indicator of the spinal cord function was evaluated quantitatively. The amplitude changes of those with neurological complication were compared with those without complication. The results in 135 patients with scoliosis were analyzed. False negative results were obtained in two patients who had only slight paresthesia. In the patients with normal spinal cord function, up to 50% reduction of the amplitude was permissible. Spinal monitoring is also useful in the improvement of operative technique because it can immediately disclose injury to the cord resulting from surgical misconduct.
Two cases urachal carcinoma are presented. Both of them had complaints of macrohematuria. One patient received partial cystectomy, and the other patient had radical cystectomy, peritoneo-umbiliectomy, and ureterosigmoidstomy after CDDP and ADM intraarterial injection. The former patient was found to have distant metastasis 7 months after operation. The latter patient has been disease-free for 4 months. The most important point to cure urachal carcinoma is accurate staging and sufficient first treatment, especially pre-operative intraarterial chemotherapy.
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We treated 12 cases of fulminant hepatic failure with plasma exchange, cryofiltration and hemodialysis. Five cases were survived and 7 cases died. The liver volume measured by volus CT on admission was about 1106 ml in survived cases, and was about 457 ml in death cases. In cases which liver volume was under 600 ml, these prognoses were miserable. AT-III, PT and HPT activities were well correlated with liver volume (r = 0.85) and these activities were good indicator to treat the fulminant hepatic failure. The measurement of FBG and APTT were also useful for the estimation of the prognosis. But they were not becoming of indicator to treatment. We have no expectation to prognosis of the cases which PT, HPT and AT-III were under 15%, 10%, and 25%, respectively.
Four patients with mitral valve prolapse and ventricular tachycardia or fibrillation were described. Case 1 was a 46-year-old man with syncope due to ventricular fibrillation. Case 2 was a 36-year-old woman with palpitation and dizziness due to ventricular tachycardia. Case 3 was a 47-year-old man with palpitation and dizziness due to ventricular tachycardia. Case 4 was a 38-year-old man with syncope due to torsade de pointes. Left ventriculograms showed mitral valve prolapse in all cases. Coronary arteriograms were also normal, supporting a noncoronary etiology of the arrhythmia. Patients with unexplained ventricular arrhythmias should be screened for mitral valve prolapse.
Three cases with cerebral ischemic symptoms and an intracranial aneurysm are presented. Using [99mTc]hexamethyl-propyleneamine oxime (HM-PAO) single photon emission computed tomography imaging before and during the Matas test, a quantitative measurement method was developed for evaluating brain collateral circulation. The evaluation correlated well with findings of contrast carotid angiography. This noninvasive method seems to be useful for selection of patients for appropriate surgical treatment.
To investigate the relationship between left ventricular function and electrical changes during myocardial ischemia, ambulatory left ventricular function monitoring and ECG recording were made during the ergometer exercise test in 14 patients with coronary artery disease. An ambulatory ventricular function monitor consists of a small cadmium telluride (CdTe) radionuclide probe (250 g) affixed to the patient's chest wall, a preamplifer (10 g), and a portable data acquisition unit (600 g). Left ventricular time-activity curves were recorded continuously using this monitor, and the end-systolic count (volume), end-diastolic count (volume) and ejection fraction were calculated after background subtraction. Twenty-eight exercise tests were performed in the supine and upright positions. In 15 tests, left ventricular dysfunction, i.e., an increase in the end-systolic count (greater than or equal to 10%) and a decrease in ejection fraction (greater than or equal to 5%), and ST depression (greater than or equal to 0.1 mV) were observed. In these 15 tests, exercise duration was 362 +/- 27 sec. Left ventricular dysfunction occurred earlier than ST depression and the time difference was 97 +/- 19 sec. Left ventricular function recovered 33 +/- 8.5 sec after discontinuation of exercise, while ST depression continued for the additional 85 +/- 18.5 sec after recovery of left ventricular function. In conclusion, 1) left ventricular dysfunction occurs earlier than electrical changes during exercise-induced ischemia; 2) left ventricular dysfunction improves earlier than electrical changes after exercise; and 3) the same temporal sequence exists in the restoration from myocardial ischemia.
Polyclonal and monoclonal anti-idiotypic antibodies were prepared against several monoclonal antibodies which reacted with high molecular-weight melanoma-associated antigens. Idiotype mapping was proposed from the serological data obtained from these anti-idiotypic antibodies. This mapping will be of use for applying the anti-idiotypic monoclonal antibodies for cancer therapy.
Five hundred and sixty-five patients with prostatic cancer, who first visited 9 institutions in Japan between 1981 and 1985, were analyzed. The peak of age distribution was in the seventies. As clinical symptoms, disturbance on micturition was the most frequent and pain caused by metastasis was a complaint in approximately one tenth of the cases. Alkaline phosphatase measurement, prostatic biopsy, intravenous pyelography, bone scintigraphy, cystourethrography, and measurements of serum prostatic acid phosphatase and serum acid phosphatase were performed on more than 80% of the patients. The clinical stage was stage A1 in 6.2%, A2 in 3.7%, B in 14.9%, C in 20.7%, D1 in 7.4%, and D2 in 43.7%. According to the histological grade, well, moderately and poorly differentiated adenocarcinoma were observed in 20.4, 33.3 and 32.7%, respectively. Increased ratio of high grade to low grade was noticed in the lower age group as well as in the advanced stage. In this series, endocrine therapy was still accepted in most of the patients. Almost all were treated with hormonal medication and half of them had undergone bilateral orchiectomy. Surgery, radiation, chemotherapy or multidisciplinary therapy were attempted judging from the clinical stage and histological grade. However, old age restricted the therapeutic modality. Actuarial survival rate at 5 years for stage A1, A2, B, C, D1 and D2 was 89.2, 66.1, 72.7, 51.0, 47.5 and 28.0%, respectively. In the patients with stage D2, the 5-year actuarial rate of poorly differentiated adenocarcinoma was lower than that of well or moderately differentiated adenocarcinoma, even though more intensive therapy was given to the former.
Between 1961 and 1985, 44 cases of penile cancer were experienced at Gunma University Hospital. We statistically analyzed 42 of them. The average age was 56.9 years old, ranging from 28 to 86 years old. Interval from onset of the disease to first visit to our hospital ranged from 0 to 50 months, averaging 9 months. The main chief complaints were mass formation, spontaneous pain, ulceration, and abnormality of urinary stream. More than 75% of them had phimosis. Thirty-one percent had stage 1, 29% stage 2, 38% stage 3, and 2% stage 4 cancer, according to Jackson's classification. All of them were diagnosed with squamous cell carcinoma. Surgical treatment was given to 37 patients (radical or partial penectomy was performed in most cases). Chemotherapy was given to 23 patients (main chemotherapeutic agent was bleomycin or peplomycin) and irradiation to 26 patients. Five-year survival was seen in 77% of the cases, 92% in low stage group (stage 1 and 2) and 63% in high stage group (stage 3 and 4). Ten-year survival was seen in 62% of the cases, 79% in low stage group and 43% in high stage group (Kaplan-Meier method).
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We report 54 patients with urothelial tumors in upper urinary tract admitted to our hospital between July, 1962 and December, 1985. The patients consisted of 38 males and 16 females; side their ages ranged from 47 to 88 years with a mean of 63.4 years. The affected side was the right side in 21 cases, and the left side in 33 cases. Macro-or microhematuria was observed in 87% of the patients. Pathologically, 53 of the patients had transitional cell carcinoma and 1 had papilloma. Six patients had a past history of bladder tumor. Simultaneous bladder tumor was identified in 10 cases. Vesical recurrence was observed in 5 cases. Total nephroureterectomy with bladder cuff resection was employed as the surgical method in 21 cases, and total nephrectomy without bladder cuff resection in 11 patients. The actual five-year survival rate was 53% for all the patients; 52% for patients with renal pelvic tumors, 75% for those with ureteral tumors and 15% for those with renal pelvic and ureteral tumors. The patients who received nephroureterectomy had a postoperative survival rate similar to that of those who received nephroureterectomy with bladder cuff resection. A simultaneous bladder tumor lowered the survival rate.
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