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Biomedical subjects

K Kodama

Publications and source records attributed to K Kodama.

773 records · Page 43Linked to original sources
PubMedDate not supplied

Relationship between longitudinal changes in blood pressure and stroke incidence.

The relationship of changes in blood pressure with time to stroke incidence was examined on members of the Adult Health Study sample who have participated in biennial clinical examinations at the Radiation Effects Research Foundation since their inception in 1958. The regression coefficient of blood pressure regressed on time (the increase in blood pressure per cycle) was used as an index of the change in blood pressure with time. Cox's regression analysis, a technique which is suitable for follow-up studies was used. The data suggest that a single blood pressure measurement is not sufficient for predicting risk; the accumulated value or average over a period of time should be considered for this purpose. In addition to the actual blood pressure, the increase in blood pressure with time is a risk factor, particularly for cerebral hemorrhage. Cerebral hemorrhage was more strongly related to diastolic than to systolic blood pressure, while cerebral infarction appeared to be more strongly related to systolic than to diastolic blood pressure.

Adult↗
PubMedDate not supplied

Absence of later auditory brain stem response components, congenital horizontal nystagmus, and hypotonia in male infants.

Five male infants, all of whom showed findings of wave I or waves I and II only of the auditory brain stem response (ABR), congenital horizontal pendular nystagmus, and hypotonia of head and limbs in the early infantile period with later paresis, are discussed. Their ages ranged from 3 to 13 months at the first examination, at which time neither head control, sitting, nor walking had been attained. Follow-up studies of ABRs revealed persistent abnormalities with neither remission nor progression. In spite of these abnormalities, these infants responded well to voices and other sounds. The congenital nystagmus in each case was demonstrated by electronystagmography to have a frequency of 2 to 3 Hz. The correlation between clinical signs and ABR is uncertain as yet. However, our findings are strongly indicative of nonprogressive inborn abnormalities in the lower brain stem.

Brain Stem↗
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Human plasma superoxide dismutase (SOD) activity on reperfusion injury with successful thrombolysis in acute myocardial infarction.

Generation of oxygen free radicals at the time of reperfusion has been implicated as a major causative factor for myocardial reperfusion injury. In order to examine if oxygen free radical scavenger superoxide dismutase (SOD) in human plasma prevent reperfusion injury with successful thrombolysis and limit infarct size, we studied the relationship between infarct size and plasma SOD activity in 25 patients received thrombolytic therapy in antero-septal acute myocardial infarction. Plasma SOD activities were measured by the nitrate method. There was no variance in plasma SOD activity in patients with acute myocardial infarction before and after thrombolysis. Infarct size was evaluated by using % abnormally contracting segments (% ACS) correlation with % ACS (r = -0.58, p less than 0.05) in 17 patients with successful thrombolysis. This significant correlation was still shown in 14 patients without collaterals before recanalization (r = -0.56, p less than 0.05). On the other hand, there was no significant relationship between plasma SOD activities and % ACS in 8 patients with a complete occlusion after thrombolysis (r = -0.081). These results showed that human plasma SOD prevent the reperfusion injury and limit the infarct size in patients with successful thrombolysis and imply that the generation of free radical at the time of reperfusion results in myocardial reperfusion injury.

Adult↗
PubMedDate not supplied

Two cases of Reiter's syndrome.

Two characteristic cases of Reiter's syndrome are reported. One (case T.M) was a 64-year-old female with ulcerative colitis and the other (case O.M) was a 20-year-old male with serum antistreptococcal lysine O (ASLO) and antistreptokinase (ASK) titers of 480x and 2560x, respectively. These cases were both histocompatibility antigen HLA-B27 positive. The ulcerative colitis and iritis were inactive in case T.M. However, case O.M required aggressive treatment for fever and arthralgia. These patients have recently shown no evidence of Reiter's syndrome; however, case T.M has had recurrent bowel hemorrhages due to ulcerative colitis.

Adult↗
PubMedDate not supplied

Familial primary pulmonary hypertension--report of two siblings.

Familial primary pulmonary hypertension was found in two siblings (sister and brother). The woman noted exertional dyspnea at the age of 28 yr. The younger brother noticed exertional dyspnea, cough with bloody sputum and pretibial edema at the age of 38 yr. We diagnosed them as primary pulmonary hypertension as based on hemodynamic and histopathological findings. Regardless of the treatment, both patients died of right-sided heart failure with a short time course. We examined their family members, but there were no other members with primary pulmonary hypertension.

Adult↗
PubMedDate not supplied

Effectiveness of intrathoracic chemothermotherapy for malignant pleurisy due to Ewing's sarcoma: a case report.

This paper describes a case of malignant pleurisy which showed evidence of the effectiveness of a new mode of cancer treatment, intrathoracic chemothermotherapy (ICT). ICT consisted of a bolus intrathoracic injection of 50 mg cis-diamminedichloroplatinum (CDDP) and local heating using 8 MHz radiofrequency waves for 60 min. A patient with multiple lung metastases and malignant pleurisy on both sides due to Ewing's sarcoma was treated on the right side with ICT, along with concomitant systemic administration of 50 mg CDDP. Intrathoracic temperatures were monitored by insertion of thermocouple temperature sensors, and temperatures of 43 degrees C or over were successfully maintained for about 40 min during each of three treatments. Although the patient died 3 months later of advanced metastases in the left lung and malignant pleurisy on the left side, lung metastases in the right lung were stable on radiographs, and autopsy results showed no cancerous lesions in the right thoracic cavity, which had been treated with ICT. Since no effective response had been obtained clinically or histologically before starting ICT, despite frequent administration of anti-cancer drugs, we conclude that heat acted synergistically with CDDP on drug-resistant cells in this case.

Adult↗
PubMedDate not supplied

[Clinical characteristics of postinfarction left ventricular aneurysm with extensive calcification].

The authors experienced 4 cases of calcified postinfarction aneurysm of the left ventricle. They were all male, aged 55 to 71 (mean 64). Risk factor for coronary artery disease was only smoking in 2 patients, but there was none in the others. They had had acute anteroseptal or extensive anterior infarction at age 41-57 years (mean 49.3), and associated major cardiac events 10-22 years (mean 14.5) after acute myocardial infarction. Ventricular tachycardia, congestive heart failure and systemic thromboembolism were seen in 4, 2 and 1 patients respectively. However, none developed angina pectoris. In the 2 patients in whom signal-averaged electrocardiogram was performed, late potential was detected, so it was suspected that ventricular tachycardia could be due to reentry. Left ventricular end-diastolic pressure was elevated in all patients except one and ranged from 11 to 22 mmHg. Left ventricle was dilated in all cases and the end-diastolic volume index ranged from 143 to 503 ml/m2. The left ventricular ejection fraction ranged from 11 to 24%. However, in 2 of the 4 patients, the cardiac index was within normal limits, and evidence of congestive heart failure was absent. In 2 other patients with associated congestive heart failure, cardiac indices were 2.32, 1.56 l/min/m2 respectively. Coronary arteriogram showed a total occlusion in the left anterior descending (LAD) artery in all cases, and only the LAD artery was affected in 2 patients. In the remaining 2 patients, the right coronary arteries also were significantly stenotic or totally occluded, i.e., they had 2-vessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Malignant fibrous histiocytoma of the chest wall in a nonagenarian].

We report a case of malignant fibrous histiocytoma of the chest wall observed in a 94-year-old woman. She noticed appetite loss and general edema a week before admission. The patient was diagnosed as having congestive heart failure due to valvular heart disease on the basis of echocardiographic findings and became symptom-free by treatment with vasodilators and diuretics. However, chest roentgenogram disclosed a extrapleural mass in the left mid-lateral chest. About 2 months after admission, she experienced left lateral chest pain for the first time. The chest CT scan revealed a 5 x 5 x 2 cm mass, adjacent to the lateral-posterior chest wall and projecting into the thoracic cavity and rib osteolysis. Gallium-67 citrate scintigram showed abnormal isotope accumulation in the left middle chest. Biopsy was not done. The therapeutic approach was mainly pain relief, and no tumor resection, chemotherapy, or radiotherapy was performed. The mass increased in size, and increasingly extended into the thoracic cavity on follow-up CT scans. Furthermore, marked invasion of the tumor to subcutis and subscapula was found. She died of cachexia and respiratory failure 34 weeks after admission. Histologic examination revealed malignant fibrous histiocytoma.

Aged↗
PubMedDate not supplied

Cisplatin-based chemotherapy for postoperative recurrence in non-small cell lung cancer patients: relation of the in vitro chemosensitive test to clinical response.

The usefulness of the in vitro chemosensitivity test, the collagen gel droplet embedded culture drug- sensitivity test (CD-DST, Int J Oncol 11: 449, 1997), in cisplatin-based combined chemotherapy for postoperative recurrent tumors in non-small cell lung cancer (NSCLC) patients was retrospectively analyzed. CD-DST data for cisplatin (or carboplatin), etoposide, 5-fluorouracil, mitomycin C, and vindesine were obtained in 311 surgically resected primary lesions. Of them, 25 patients were practically treated with first-line cisplatin- or carboplatin-based chemotherapy for postoperative initial recurrence. Nine (36%) of them responded to the combined chemotherapy for recurrent lesions, including one with complete remission, whereas 16 did not, with no change in 5 and progression in 11. Seven (70%) of 10 patients receiving combined chemotherapy using two or three in vitro sensitive chemoagents showed good responses, whereas there was no responder among the patients receiving chemotherapy including no in vitro sensitive chemoagents. In particular, of 11 patients showing good sensitivity to cisplatin or carboplatin on CD-DST, 8 (73%) responded to chemotherapy, whereas only one (7%) of 14 patients showing cisplatin- or carboplatin-resistance on CD-DST was a responder. Thus, CD-DST results for the chemoagents, especially cisplatin or carboplatin, correlated with chemotherapeutic response, indicating that the CD-DST analysis of surgically resected primary NSCLC tumors is a practically useful indicator of the clinical effect of first-line cisplatin-based combined chemotherapy for postoperative recurrence.

Adult↗
PubMedDate not supplied

Unusual extension of lung cancer into the left atrium via the pulmonary vein.

Four operative cases of lung cancer with intra-atrial extension via the pulmonary vein were reviewed. Three of them had circulatory as well as respiratory symptoms, and their performance status (PS) was extremely poor. In two cases, after assessment of the cardiac involvement using two-dimensional echocardiography and/or CT-scan, we successfully removed the tumor en bloc through combined left atrial resection and radical left pneumonectomy with cardiopulmonary bypass. In both cases, the postoperative course was uneventful, and PS was improved. However, seven months later one patient died of widespread metastases, while the other is alive but has recurrence. The other two patients underwent ordinary lobectomy because there were no abnormal findings in the hilar examinations. However, the lumens of the resected pulmonary veins were filled with tumor tissue. One patient developed a massive embolism, never regained consciousness, and died on the second postoperative day. The last case was discharged without trouble, although the intra-atrial portion of the tumor dislodged intraoperatively into the circulation. As a result, he developed multiple brain metastases four months after the operation. There were no clear patterns in terms of the histological type or tumor location in these cases. On the other hand, all the tumors showed rapid growth and comprised a large mass in the lung parenchyma. Especially the cardiac and intravascular portions of each tumor were less differentiated and more necrotic than the primary focus in the lung. We conclude that radical surgery using a cardiopulmonary bypass for lung cancer patients with such intracardiac involvement is effective for improvement of PS and reduces the risk of sudden death due to cardiac failure or tumor emboli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMedDate not supplied

Reconstruction of the chest wall after full thickness resection: a comparison between myocutaneous flap and acrylic resin plate as reconstructive techniques.

Thirty-three patients with chest wall malignancies underwent full thickness resection of the chest wall and immediate reconstruction of the defects with either synthetic materials (acrylic resin plate, 16 patients) or with myocutaneous flaps (rectus abdominis flaps, 17 patients). Although the acrylic resin plate proved to be excellent for maintaining stability of the chest wall, five patients suffered from local skin necrosis, requiring skin grafting, and four suffered from persistent foreign body reactions, necessitating ultimate removal of the plate. The patients receiving myocutaneous flap repair had excellent wound healing, acceptable rigidity of their chest wall, and no foreign body reactions throughout the follow-up period. The 50% post-operative survival time for the entire series was 29 months, suggesting that the procedure in an effective treatment modality for breast cancer involving the chest wall. Reconstruction with a myocutaneous flap is indicated as long as the chest wall defect is not too extensive.

Acrylic Resins↗
PubMedDate not supplied

Direct communication between the pulmonary artery and the left atrium. A case report and review of the literature.

A case of direct communication between the right pulmonary artery and the left atrium is presented. Twenty-two cases from the literature and our case are analyzed. Complete cure can be obtained by simple ligation, division, or intracardiac repair with cardiopulmonary bypass. This anomaly involves the risk of serious complications such as cerebral abscess and systemic embolization and should be accurately diagnosed and treated by surgery.

Angiography↗
PubMedDate not supplied

Nursing in Japan.

Explore the source record for details and available documents.

Education, Nursing↗
PubMedDate not supplied

Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy.

Although adrenal metastases from lung cancer are frequently detected during the late clinical stage or at autopsy, they are rarely surgically treated following pulmonary resection for lung cancer. We detected adrenal lesions as initial clinical recurrence in 9 (1%) of 904 patients who underwent pulmonary resection for lung cancer at our institute between 1980 and 1992. Adrenalectomy was performed in five who had developed unilateral adrenal metastasis. One underwent simultaneous operation for primary and metastatic lesions, and 4 underwent adrenal surgery following pulmonary resection. The adrenal tumor was removed via laparotomy in three patients, and via posterolateral non laparotomic approach in two. Co-metastatic lesions which were detected incidentally at operation included intestinal metastasis in two patients and regional lymph node metastasis in two; these were simultaneously resected. Following adrenalectomy, all these patients were treated with adjuvant chemotherapy or radiotherapy. Two patients have remained free of relapse for 40 and 26 months, respectively, after adrenal surgery, while three died of other distant metastases more than 9 months after adrenalectomy. In contrast, the four patients who received chemotherapy or radiation therapy died less than 6 months after palliative therapy. Thus, we consider that surgical treatment for adrenal metastases following pulmonary resection for lung cancer is effective in selected cases. The indications for adrenalectomy are presented in comparison with those for palliative therapy, and several difficulties in the surgical management of adrenal metastases are discussed.

Adenocarcinoma↗
PubMedDate not supplied

High prevalence of bcl-2 oncoprotein expression in small cell lung cancer.

Bcl-2 oncoprotein, a member of a new category of oncogenes associated with the regulation of programmed cell death (apoptosis), has been considered to be involved in biological processes such as tumorigenesis and tumor development. To determine the role of bcl-2 oncoprotein in lung cancer, we preliminarily examined the expression of this protein in various histological types. Immunohistochemical staining using monoclonal bcl-2 oncoprotein antibody was performed in surgically resected frozen specimens. Bcl-2 staining was seen in nine of 13 small cell lung cancers (69%), while only 18 out of 69 non-small cell lung cancers (26%) expressed bcl-2 oncoprotein, showing a significantly increased incidence of bcl-2 oncoprotein expression in the former histological type. Considering the greater aggressiveness of small cell lung cancer compared to non-small cell lung cancer, the possibility exists that the high prevalence of bcl-2 oncoprotein expression in small cell lung cancer is closely associated with tumorigenesis and tumor development.

Antibodies, Monoclonal↗
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Estimation of serum level of pS2 protein in patients with lung adenocarcinoma.

We measured pS2 protein in the serum of patients with adenocarcinoma and non-adenocarcinoma types of lung cancer, non-cancerous lung lesions, and the control sera. Although the serum pS2 protein level in patients with lung adenocarcinoma was significantly higher than that in patients with other diseases, as well in control samples, it had little clinical value as a screening tumor marker because the levels in control samples showed a wide range of variation. However, analysis according to the histological subtype of lung adenocarcinoma, ordinary and bronchioloalveolar, revealed a high serum level of pS2 protein in several patients with advanced stage disease in the former, and mucus-producing goblet cell subtypes in the latter, which showed strong pS2 protein expression in tissues, whose serum levels diminished to the control level after resection. Thus, the serum levels of pS2 protein may be a useful marker of tumor burden in selected patients with lung adenocarcinoma.

Adenocarcinoma↗