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Biomedical subjects

K Shimaoka

Publications and source records attributed to K Shimaoka.

At least 37 records · Page 2Linked to original sources

Parathyroid tumors in atomic bomb survivors in Hiroshima: a review.

Parathyroid tumors in A-bomb survivors in Hiroshima have been studied. Thirteen cases of parathyroid tumor were confirmed from 4,136 autopsy cases between 1961 to 1977, and an elevated incidence of tumor with increase of dose (T65D) was demonstrated (P less than 0.01). A high proportion of 42.9%, 6 out of 14 parathyroid tumors extirpated at Hiroshima University Hospital between 1956 and 1988, were atomic bomb survivors exposed within 4.1 km from the hypocenter. From an epidemiological study using 23 parathyroid tumor cases detected in Hiroshima Prefecture between 1974 and 1987, an elevated incidence of parathyroid tumors with increase of dose (proximally exposed, other exposed and control nonexposed) was demonstrated (P less than 0.001).

Humans↗

Squamous cell carcinoma with cyst of the thyroid.

Two cases of primary squamous cell carcinoma associated with a thyroid cyst in the thyroid are described. The majority of squamous cell carcinomas reported so far have had some degree of co-existing adenocarcinoma, while the cases presented in this report had no glandular component at all. The histogenesis of squamous cell carcinoma is not clear, but at present, it is believed that most cases arise from the follicular epithelium. In our cases, in spite of an intensive examination of serially sectioned specimens, no areas of adenocarcinoma, squamous metaplasia from the follicular epithelium, or congenital squamous remnants could be found.

Aged↗

A comparative evaluation of the surgical and radioiodine treatments for Graves' disease.

Radioactive iodine treatment is currently the most popular treatment modality for hyperthyroidism in many patients of the world. In Japan, however, a considerable number of patients with hyperthyroidism have undergone successful surgery. To elucidate the advantages and disadvantages of surgical and 131I treatment, the thyroid function of 66 patients from each group was compared, 5 to 8 years after treatment. None of the surgically treated patients had been reoperated upon on, whereas 12 (18 per cent) of the patients treated with 131I required 2 or more doses. The number of patients with normal ranges of serum T3, T4 and TSH values was almost identical: 33 (50 per cent) of the postoperative patients and 31 (47 per cent) of the post-irradiated patients. In the surgically treated group, there was no tendency for hypothyroidism to develop with the passage of the time. However, although the distribution of T3 and T4 in the normal control and postoperative groups showed a normal bell-shaped distribution, the post-irradiated group did not exhibit this distribution. The normal control group and the postoperative group showed positive correlations of T3 and T4 but the post-irradiated group did not (p less than 0.05). When the titers of antithyroglobulin and antimicrosomal antibodies prior to therapy were compared with those following therapy, they had decreased in 41 per cent and 76.8 per cent, respectively, of the postoperative cases, but in only 24.2 per cent and 45.5 per cent of the post-irradiated cases.

Adolescent↗

Effects of blood pressure changes on development and regression of electrocardiographic left ventricular hypertrophy: a 26 year longitudinal study.

At the Radiation Effects Research Foundation, medical examinations have been conducted biennially since 1958 on a fixed population of approximately 20,000 individuals. Blood pressure measurements and electrocardiographic (ECG) recordings are available for 6,569 individuals who were monitored for at least 11 of the 13 2 year intervals between 1958 and 1984. Data from 601 individuals who had satisfied the Foundation's ECG diagnostic criteria of left ventricular hypertrophy ("Kagan-Yano code") on at least one occasion were reviewed. Both the development and the regression of ECG left ventricular hypertrophy were ascertained in 61 subjects (17 men and 44 women). During the course of development of ECG left ventricular hypertrophy, hypertension (including borderline cases) was noted in 83.3% of the subjects. The most common pattern of ECG left ventricular hypertrophy development was high voltage, followed by ST-T changes. In about half of these cases, the condition of hypertrophy regression was associated with lowering of blood pressure, marked by the disappearance of high voltage ECG readings.

Blood Pressure↗

Histologic typing of non-Hodgkin's lymphomas by in situ hybridization with DNA probes of oncogenes.

Expression of six proto-oncogenes (fos, myc, myb, Ki-ras, Ha-ras, and N-ras) in 43 cases of non-Hodgkin's lymphoma was analyzed by means of in situ hybridization. Biotinylated DNA probes of the six oncogenes and those of immunoglobulin H (IgH) gene and T-cell receptor beta (TCR beta) chain gene were used. The results of in situ hybridization performed under blind conditions by IgH gene and TCR beta chain gene probes were compatible with those of typing by cell surface markers. The nuclear protein-related proto-oncogenes, fos, myc, and myb, were expressed in about 70% to 80% of all cases regardless of phenotype, histology, or histologic grade. On the contrary, genes of ras family were expressed in more limited numbers of cases except for the Ki-ras gene, which was more frequently expressed by cases of the T-cell immunophenotype with a high malignancy grade. The results of dot hybridization with RNA extracted from some cases were compatible with those of in situ hybridization, further demonstrating the specificity of in situ hybridization.

Biotin↗

Suppressive therapy of thyroid nodules in patients with previous radiotherapy to the head and neck.

This is a prospective, randomized study of 431 patients with palpable thyroid nodules who had previous radiotherapy for benign disorders of the head and neck area to determine the response of the thyroid nodules to suppressive therapy and the incidence of thyroid cancer in patients who could not be suppressed and had surgery. A complete response was achieved within 6 months in 18.3 percent of the patients, and in an additional 26 percent of patients between 7 and 12 months postoperatively. Twenty percent of the patients showed complete disappearance of nodules after 1 to 2 years of suppressive therapy. Twenty-two percent who underwent surgery showed carcinoma. If suppressive therapy is to be used, a trial of 1 year rather than 3 or 6 months, as often recommended, may be appropriate.

Adult↗

Deacclimation period in ventricular function after high altitude expedition.

Day-by-day changes in ventricular-ejection time/heart-rate ratio (VET/HR) and in ejection time index (ETI), determined by an impedance method in a decompression chamber, were more labile in the mountaineers who had experienced high altitude (above 6,000 m) within the past 1 year, and the ETI values in the first hypoxic exposure were significantly high in these subjects, though close to those of the non-experienced group in the later exposures, suggesting that the effect of hypoxic acclimation on cardiac function might remain at least 1 year after return to sea level.

Acclimatization↗

Current treatment of Graves' disease.

In this review we have described the rationale for the appropriate treatment of patients with Graves' disease. Because the etiology of this disorder remains obscure, its management remains controversial. Since antithyroid drugs and radioiodine became readily available in the early 1950s, they have been widely used for the treatment of thyrotoxicosis, and the number of cases treated surgically has markedly decreased. However, almost four decades of experience have disclosed an unexpectedly high incidence of delayed hypothyroidism after radioiodine treatment and a low remission rate after antithyroid therapy. As a result, surgery is again being advocated as the treatment of choice. The three modalities of treatment have different advantages and disadvantages, and selection of treatment is of importance. In principle, we believe that for most patients a subtotal thyroidectomy should be performed after the patient has been rendered euthyroid by antithyroid drugs. We attempt to leave a thyroid remnant of 6 to 8 gm.

Antithyroid Agents↗

Multiple endocrine neoplasia IIA found at autopsy.

A case is presented of a 32-year-old black female who died from adult respiratory distress syndrome with disseminated intravascular coagulopathy. At autopsy she was found to have typical multiple endocrine neoplasia IIA, a combination of medullary carcinoma of the thyroid, bilateral adrenal pheochromocytoma and nodular hyperplasia of the parathyroid.

Adrenal Gland Neoplasms↗

Radiation-associated thyrotoxicosis.

We studied 154 consecutive patients with a diagnosis of thyrotoxicosis seen at Roswell Park Memorial Institute from 1963 to 1982. The retrospective review of the clinical materials revealed that 23 (15%) had a previous history of therapeutic radiation for various diseases. The radiation dose ranged from several to 3600 rads to the thyroid with a mean latency of 14.2 +/- 3.0 years. In 11 out of 16 patients who were tested for antithyroglobulin and antimicrosomal showed positive titers of either or both antibodies (69%). In a small number of patients, thyroid stimulating immunoglobulins were studied; long-acting thyroid stimulators (LATS) were positive in one of six tested and thyrotrophin binding inhibitory immunoglobulins (TBII) in five of eight. The radiation-associated thyroidal dysfunction appears to be associated with the organ-specific autoimmune processes and could manifest as either hypo- or hyperfunction of the gland.

Acne Vulgaris↗

A randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma.

A randomized evaluation of the effectiveness and toxicity of the combination of doxorubicin and cisplatin and of doxorubicin alone in patients with advanced thyroid carcinoma was carried out. Ninety-two patients were entered and 84 were evaluable. They were stratified according to histological classification, Eastern Cooperative Oncology Group (ECOG) performance status, and metastatic sites. Forty-one patients received doxorubicin as a single agent and seven had partial response (17%). Forty-three patients received the combination, and there were five complete and six partial responses (combined response rate of 26%). This difference for overall response rate is not significant (P greater than 0.1). However, five complete responses were seen in the combination-treatment group, whereas none were observed in the single-agent treatment group; a significant difference was obtained (P = 0.03). Four of these five complete responders survived for more than 2 years, and two patients remained in a complete response after the discontinuation of therapy and are still alive. None of the partial responses exceeded 2 years in duration. The life-threatening toxicities from chemotherapy occurred in five patients treated with the combination of drugs and two treated with doxorubicin alone. However, none of the toxicities were fatal. The study has shown clearly that the quality of response achieved by the combination of drugs is far superior to that achieved by single-agent chemotherapy.

Adenocarcinoma↗

Radiation associated hyperthyroidism in patients with gynecological malignancies.

To determine the effect of abdominal and/or pelvic irradiation for gynecological malignancies on the later development of hyperthyroidism, 1,884 medical records of the patients diagnoses as carcinomas of cervix and corpus uteri, and of ovary were reviewed. Among 1,269 patients with radiation therapy, 5 patients developed hyperthyroidism after irradiation to the abdomen and/or pelvis. This is a statistically significant increase when compared with an epidemiological study. Radiation dose to the thyroid was estimated to be 30 to 200 rads. Two other patients who were irradiated to the nose or supraclavicular region in addition to the abdomen also developed hyperthyroidism. However, none of 581 patients without radiation therapy became hyperthyroid. The results indicate that radiation therapy for treatment of gynecological malignancy gives a significant radiation exposure with an increase in the incidence of subsequent hyperthyroidism.

Adolescent↗

Absent or delayed preovulatory luteinizing hormone surge in experimental diabetes mellitus.

The proestrus preovulatory luteinizing hormone (LH) surge was absent or delayed in more than 56% of untreated streptozotocin-diabetic rats. Absence of LH surge was associated with anovulation. Insulin treatment for 10-14 days restored the diminished surge and ovulation frequency. Pituitary LH release in response to exogenous gonadotropin-releasing hormone administration in diabetic rats was not different from controls. Impaired hypothalamic function may comprise the basis for the increased incidence of infertility in diabetes mellitus.

Animals↗

Mucin-producing carcinoma of the thyroid gland--a case report and review of the literature.

Mucin-producing carcinoma of the thyroid is rare and its histogenesis has been debated. The first case was reported by Diaz-Perez et al. (1976). We herein report the sixth case of mucin-producing carcinoma of the thyroid which was discovered in a 72-year-old Japanese woman. This patient was admitted with a 10-year history of a lump in the right anterior neck, which started to grow suddenly two months before diagnosis. The pathological diagnosis at biopsy was anaplastic carcinoma. A course of radiation therapy followed by chemotherapy resulted in no response. She died of two months after admission. At autopsy, the main tumor was found in the right lobe of the thyroid with metastasis to the lungs and liver. Histologically, the tumor was composed of mucin-secreting glandular cells and nests of epidermoid cells with keratinization and infrequent formation of intercellular bridges. Mucin was demonstrated both intracellulary and extracellulary.

Adult↗

Second malignant tumors detected by needle aspiration cytology.

Between 1967-1980, 14 second primary cancers were detected by needle aspiration cytology in patients treated for malignant tumors. The interval between the first cancer and the occurrence of the second cancer varied from six months to 21 years. In all 14 cases, the cytologic diagnosis of the second cancer was later confirmed by histopathologic examinations. In 13 patients, the second cancer was dissimilar from the first one, and in one patient the two cancers were subtypes of lymphoproliferative tumors. In three patients the cytologic diagnosis falsely defined the subtype of the second cancer. Malignant lymphoma was the predominant tumor either as the first cancer (50%) or as the second cancer (43%). Thyroid cancer occurred as the second cancer in three patients. Needle aspiration cytology of all newly appearing lesions can be performed routinely during follow-up examinations to discriminate between relapsed disease and new malignant tumors.

Adult↗