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Biomedical subjects

K Tomoda

Publications and source records attributed to K Tomoda.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Evaluation of transcatheter hepatic segmental or subsegmental infusion of SMANCS for treatment of hepatocellular carcinoma].

A total of seventeen patients with hepatocellular carcinoma (HCC), nineteen HCCs, who underwent as an initial treatment transcatheter hepatic segmental or subsegmental arterial administration of SMANCS alone for hepatocellular carcinoma (HCC), were studied to evaluate the efficacy and complication of that treatment. The initial treatments provided CR in eight patients (47%), and repeat administrations of SMANCS achieved CR in an additional four patients (24%). The initial treatment provided a dense deposit of Lipiodol in the twelve tumors (63%), in five of which Lipiodol was thereafter washed out in some portions of the tumor. Complete necrosis was obtained in nine (75%) of fourteen hypervascular tumors, and in two (40%) of five intermediately vascular or hypovascular tumors. Segmental or subsegmental administration of SMANCS was well tolerated with self-controlled abdominal pain or fever well responding to medication. Ascites was seen in three cases, and atrophy of the segment infused occurred in five patients. Cholinesterase significantly reduced at one week and one month, then recovered to baseline two to three months after initial treatment. The cumulative survival rates were 77% at 1 year, 66% at 2 years, and 53% at 5 years in the whole patients. The survival rate was 100% at 5 years in the Child A group. In the patients who obtained CR using SMANCS alone, the survival rates were 89% at 1 year, 74% at 2 years and 56% at 5 years. Although this method may transiently deteriorate hepatic function, segmental or subsegmental administration of SMANCS may be an excellent therapeutic method for treatment of HCC and promising for use in properly selected patients.

Adult↗
PubMed1998

[Three-dimensional gadolinium-enhanced dynamic MRI of whole liver using spectrally selected enhanced fast gradient recall sequence].

Three-dimensional gadolinium-enhanced dynamic MRI of whole liver using the spectrally selected enhanced fast gradient recall sequence (spec IR-efgre3d) was performed in five patients with HCC. Ten HCC nodules were confirmed by CTA, CTAP and Lipiodol CT, and all of them were detected with dynamic MRI. MIP images reconstructed from 3D gadolinium-enhanced dynamic MR studies clearly showed the main portal vein and its branches in all cases. Portal vein thrombosis was also demonstrated with the MIP images.

Carcinoma, Hepatocellular↗
PubMed1998

[Energy expenditure in patients with pulmonary emphysema].

We evaluated resting energy expenditure (REE) using canopy mode indirect calorimetry in 21 ambulatory, clinically stable outpatients with pulmonary emphysema (age: 69.3 +/- 8.4, %IBW: 79.3 +/- 12.5, FEV1: 0.98 +/- 0.36) and compared it with that of a 14 age-matched healthy controls (age: 71.1 +/- 6.0, %IBW: 94.5 +/- 13.4). We also compared REE in malnourished patients (%IBW < 90; 73.0 +/- 7.6, N = 14) and normonourished patients (%IBW > or = 90; 92.0 +/- 5.6, N = 7). We examined the relation ship between %REE (REE/REEpred. x 100) and measurements of lung function tests in 21 emphysema patients using single regression analysis. The REE of the patient group was significantly higher than that of the control group (%REE; 115.9 +/- 12.0 vs 86.5 +/- 8.7, p < 0.01). The REE of the malnourished patient subgroup was significantly higher than that of the normonourished patient subgroup (%REE; 121.9 +/- 7.9 vs 109.9 +/- 9.2, p < 0.01). There were no significant differences in FEV1(L), RV/TLC(%), TLC(pred.%) or DLco/VA (pred.%) between the two patient subgroups. The REE of the normonourished subgroup was significantly higher than that of control group (%REE; 109.1 +/- 9.2 vs 86.5 +/- 8.7, p < 0.01). There were significant relations hips among %REE and FEV1, %FVC, FEV1% G, %DLco/VA and RV/TLC (p < .05). These findings suggest that elevated REE may have a significant relation ship with abnormal lung function, and that elevated REE may be a cause of malnutrition in clinically stable patients with pulmonary emphysema.

Aged↗
PubMed1998

[Gd-DTPA enhanced multi-shot echo-planar MRI: improvement of contrast between metastatic liver cancer and liver parenchyma].

In six patients with metastatic liver cancer, spin-echo multi-shot echo-planar MR imaging 8/2000/80/1 (shot/TR/TE/excitation) of the liver was performed before and 30, 60, 90 and 120 sec after the intravenous injection of Gd-DTPA. Signal-to-noise ratios (SNR) of the liver tumor and liver parenchyma were measured in each phase. The contrast-to-noise ratios (CNR) between the tumor and liver parenchyma were also calculated. While the SNR of the tumor did not change after the injection of Gd-DTPA, the SNR of the liver parenchyma decreased and the CNR between the tumor and liver parenchyma increased.

Adult↗
PubMed1998

[Small cell lung cancer associated with nephrotic syndrome: remission after chemotherapy].

A 66 year-old man was found to have pointed out a 1-cm tumor shadow, on a chest X-ray film when he underwent a gastrectomy because of advanced gastric cancer. Five months after the operation, edema and proteinuria developed, and a chest X-ray film revealed enlargement of the tumor. There was no sign of recurrence of the gastric cancer. Nephrotic syndrome due to IgA-nephropathy and small cell lung cancer was diagnosed. Chemotherapy (carboplatin and etoposide) was effective against both the lung tumor and the nephrotic syndrome. Small cell lung cancer may have been involved in the pathogenesis of the nephrotic syndrome in this patient.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

CT, MR imaging and muscle biopsy in severe crush injury.

PURPOSE: We reviewed CT and MR findings in crush injuries in muscles and compared them with findings at muscle biopsy. MATERIAL AND METHODS: CT and MR examinations were made of the lower extremities in 6 adult patients whose muscles were crushed in the big earthquake in Kobe, Japan, on 17 January 1995. All CT examinations were performed twice and within 60 days of the earthquake. In 5 of the 6 patients, biopsies were taken of the injured muscle after the CT and MR examinations. RESULTS: At CT investigation, the images in 5 patients showed calcification in the muscles, and the crushed muscle appeared atrophic. In 3 of these 5, the degree of calcification decreased with time. At MR investigation, T1-weighted images of the crushed muscle showed isointensity in 4 of the 6 patients and high intensity in the remaining 2. T2-weighted images of the crushed muscle showed inhomogeneous high intensity in all patients. After Gd injection, all the crushed muscles were enhanced, either slightly or markedly. At muscle biopsy, in 5 of the 6 cases, the findings showed calcification in the muscle cells and the total destruction of the normal muscle structure. CONCLUSION: CT and MR findings in crush injury correlated well with the findings at histopathology.

Acute Disease↗
PubMed1997

Superparamagnetic iron oxide enhanced magnetic resonance imaging of rat liver with hepatocellular carcinoma and benign hyperplastic nodule.

RATIONALE AND OBJECTIVES: The authors assess the potential of a new superparamagnetic iron oxide (SPIO) in grading hepatocellular carcinoma (HCC) histologically and in differentiating HCC from benign hyperplastic nodule (HPN). METHODS: Nine Wistar rats (with poorly to moderately differentiated HCC, well-differentiated HCC, and HPN) received drinking water containing N-nitrosomorpholine, and were examined by magnetic resonance imaging (4.7 tesla). Spin-echo images (repetition time/echo time, 600/24.5 mseconds) were obtained before and 15 minutes after intravenous administration of 10 mumol Fe/kg of SH U 555A. RESULTS: Poorly to moderately differentiated and well-differentiated HCC showed no significant change in signal-to-noise ratio (SNR) 15 minutes after contrast, whereas HPN showed a significant decrease in SNR. The contrast-to-noise ratio (CNR) between each kind of tumor and adjacent liver parenchyma showed a significant increase at 15 minutes after contrast. CONCLUSIONS: The SPIO discussed in this article may help to differentiate HCC from HPN, but it remains difficult to grade hepatocellular carcinoma histologically.

Animals↗
PubMed1997

Helical CT during arterial portography and hepatic arteriography for detecting hypervascular hepatocellular carcinoma.

OBJECTIVE: We assessed whether helical CT hepatic arteriography (CTHA) improves detection of hypervascular hepatocellular carcinoma (HCC) when used in conjunction with helical CT obtained during arterial portography (CTAP). SUBJECTS AND METHODS: One hundred two patients with 254 hypervascular HCC nodules underwent both CTHA and CTAP. CTHA and CTAP were separately interpreted for detection of hypervascular HCC nodules by three observers who were unaware of tumor burden in the liver, lodized oil CT performed 1 week and 1 month after transcatheter arterial chemoembolization with iodized oil was the gold standard. Sensitivity and positive predictive value for CTHA alone, CTAP alone, and CTAP and CTHA combined were calculated and compared using the McNemar test. RESULTS: We found no significant difference between the sensitivity of CTAP (85%) and CTHA (87%) for revealing hypervascular HCC nodules. The combination of CTAP and CTHA showed significantly higher sensitivity than either CTAP or CTHA alone for revealing HCC nodules smaller than 20 mm in diameter (p < .01). CONCLUSION: The combination of CTHA and CTAP is recommended to improve the detection sensitivity of small hypervascular HCC nodules.

Adult↗
PubMed1997

[Preliminary evaluation of the apparent diffusion coefficient of the kidney with a spiral IVIM sequence].

We examined the usefulness of the spiral intravoxel incoherent motion (IVIM) sequence in measuring the apparent diffusion coefficient (ADC) of the kidneys. Five volunteers and five patients with chronic renal failure underwent diffusion-sensitive magnetic resonance imaging of the kidneys with the spiral IVIM sequence. The ADC values in patients with chronic renal failure were significantly lower than those in the renal cortex of volunteers. The mean value of ADC in patients with chronic renal failure was lower than that in volunteers, although there was no statistically significant difference. In volunteers, the ADC of the renal cortex was significantly higher than that of the renal medulla. The phantom study indicated that the accuracy of ADC depended on the signal to noise ratio. A spiral IVIM sequence with a high enough signal to noise ratio may be useful in evaluating renal function especially that of the cortex.

Adult↗
PubMed1997

Hepatocellular carcinoma patients showing long-term complete responses to chemoembolization.

The objective was to evaluate hepatocellular carcinoma (HCC) patients showing a long-term complete response (CR) to chemoembolization. We defined the criteria of CR as normalized tumor marker, no enhanced tumor in diagnostic images, and no tumor cells found at autopsy. Five HCC patients showing long-term CR to chemoembolization were evaluated. The CR period ranged from 3.5 to 7 years (mean, 5.7 years). The survival period ranged from 3.5 to 9 years (mean, 6.7 years). Four cases (80%) were stage IV according to the TNM classification due to a portal tumor thrombus. The liver function was rated as Child's A in four cases (80%). Long-term CR to chemoembolization can be achieved even in some advanced HCC cases with a tumor thrombus. We speculate that the good antitumor effect is brought about by the stagnation of both the arterial and portal blood flows to the HCC. Good liver function is also considered to be an important factor for long-term CR and a long survival period. If the liver function is good, advanced HCC with a portal tumor thrombus should be treated aggressively with chemoembolization.

Aged↗
PubMed1997

[Trial of a detachable Y-shaped tube with two valves for serial examinations of CT arterial portography and CT hepatic arteriography].

In five patients with hepatocellular carcinoma, CT arterial portography (CTAP) and CT hepatic arteriography (CTHA) were performed serially by using a newly developed detachable Y-shaped tube with two valves that could be attached to a conventional angiographic sheath. Two catheters could be inserted into the conventional angiographic sheath without blood backflow by using the Y-shaped tube. One catheter could be easily and safety placed on the common or proper hepatic artery, and the other on the superior mesenteric artery. This detachable Y-shaped tube with two valves could make it easy to perform serial CTAP and CTHA examinations.

Angiography↗
PubMed1997

[Cytokine producing ability of peripheral blood mononuclear cells in the clinical course of pulmonary tuberculosis].

Interferon-gamma (IFN-gamma) and interleukin-10 (IL-10)-producing ability of peripheral blood plastic-dish adherent cells and non-adherent cells obtained from patients with active pulmonary tuberculosis (N = 17) and healthy controls (N = 14) upon stimulation with purified protein derivatives (PPD) were assessed. Adherent cells and non-adherent cells were obtained two times from each patient with active pulmonary tuberculosis without any underlying diseases, on admission before the initiation of administering anti-tuberculous drugs and 2 months later from the negative conversion of Mycobacterium tuberculosis in sputum culture. ELISA was performed to measure IFN-gamma and IL-10 levels in culture media of adherent cells and non-adherent cells stimulated with PPD. IFN-gamma levels produced by non-adherent cells on admission were significantly higher than that of healthy controls (p < 0.001). Elevated IFN-gamma levels on admission was reduced after treatment for tuberculosis (p < 0.03), but still remained higher than that in healthy controls. IL-10 levels of non-adherent cells of patients were lower than those of healthy controls, although the difference was not significant. IL-10 levels produced by non-adherent cells on admission correlated with the time needed for negative conversion of bacilli in sputum culture (p < 0.05). IL-10 level produced by adherent cells from nutritionally normal patients were significantly higher than that of healthy controls (p < 0.05), and elevated IL-10 level was significantly reduced after therapy (p < 0.05). In the normonourished patients, the time needed for negative conversion of the bacilli in sputum culture of patients kept higher level of IL-10 of non-adherent cells (N = 5) was significantly longer than that of patients reduced IL-10 level after therapy. These results suggest that IL-10 produced by monocytes may diminish the TH1 responses of patients with pulmonary tuberculosis.

Acute Disease↗
PubMed1997

[A case of Mycobacterium intracellulare infection associated with sinobronchial syndrome].

The patient was 71-year-old male with a history of sinobronchial syndrome since 8 years ago. He has been suffering from cough, sputum and upper abdominal discomfort since January 1994. He was diagnosed as an early gastric cancer by endoscopy, and his chest X-ray film showed an infiltrative shadow in the right upper lung field. A smear of the sputum specimen was positive for acid fast bacilli, which were later identified as Mycobacterium intracellulare. In this case, before the Mycobacterium intracellulare infection, it was confirmed that his mucociliary transport was severely impaired by using aerosol inhalation cine-scintigraphy. This case suggests that an impairment of the local defence mechanisms may play an important role in the pathogenesis of Mycobacterium intracellulare infection.

Aged↗
PubMed1997

Anionic sites of charge barrier in the guinea pig crista ampullaris.

In present studies we obtained anionic sites in the epithelial and capillary basement membranes in the dark cell area of the crista ampullaris in the guinea pig. The immersion method with cationic tracer polyethyleneimine (PEI) was applied. Electronmicroscopically, the arrangement of PEI particles was observed as two strata along the basement membrane. The number of particles could be counted and compared in each portion. The control test with protamine sulfate showed that the number of PEI particles decreased in both the epithelium and capillaries of the dark cell area. In the experiment using furosemide, the stria vascularis and the dark cells had changed, with pathological findings of interstitial edema and PEI particles reduced in number. It is suggested that the PEI particles reflect different conditions of charge in the basement membrane, which influences the production or absorption of the inner ear fluid.

Absorption↗
PubMed1997

Effect of histamine on intracellular Ca2+ concentration in guinea pig isolated vestibular hair cells.

The present study examined the effects of histamine in the guinea pig isolated vestibular hair cells (VHCs) by measuring the dynamic changes of intracellular free calcium ion ([Ca2+]i) concentration using calcium sensitive dye Fura-2. The histamine-induced calcium response in VHCs was markedly increased at the concentration of 10 microM histamine in the presence of extracellular Ca2+, while in the absence of extracellular Ca2+, a slow increase of [Ca2+]i was evident. Receptor specificity of the response to histamine was examined: promethazine (H1 receptor antagonist), cimetidine (H2 receptor antagonist) and thioperamide (H3 receptor antagonist) completely blocked the histamine-induced calcium response at the concentrations of 2.5 microM, 1.0 microM and 1.0 nM, respectively. The responses were mediated by H1, H2 and H3 receptors and resulted in a rise of [Ca2+]i due to an influx of Ca2+ from the extracellular space and a release from intracellular stores. Our preliminary data suggest that under immuno-pathological conditions of the inner ear, histamine released from the mast cells distributed in the endolymphatic sac may act through receptors located on the vestibular hair cell membrane and may regulate the cell function and the signal transduction in the vestibular nerve-hair cell afferent system.

Afferent Pathways↗
PubMed1997

[Cdk inhibiting proteins].

Mammalian cell growth is governed by a number of extracellular signals, among which anti-proliferative stimuli arrest cells in G1 phase of the cell cycle by increasing the activity of a group of polypeptides called cdk inhibitors (cdk inhibiting proteins). So far seven members of cdk inhibiting proteins have been isolated and characterized. They mostly locate in the nucleus and inhibit G1 cyclin/cdk activities by directly binding to them, thereby interfering with phosphorylation of key substrates to exit G1 including retinoblastoma proteins among them. Some of the cdk inhibiting protein genes are frequently deleted or mutated in tumor cells, and certain oncoproteins encoded by transforming viruses target cdk inhibiting proteins, suggesting that cdk inhibiting proteins function as tumor suppressors. It is important to investigate signaling pathways and regulatory mechanisms involving cdk inhibiting proteins not only to better understand cellular proliferation, cell cycle regulation, or cancer development, but also to search for new target molecules for chemotherapy.

Animals↗