Biomedical subjects

M Hirano

Publications and source records attributed to M Hirano.

At least 451 records · Page 25Linked to original sources

PubMed1991

Surgical treatment for aspiration following esophageal reconstruction--a report of two cases and the techniques involved.

Severe aspiration following esophageal reconstruction is often very difficult to treat while preserving the larynx. However, we have successfully adopted a modified surgical procedure previously employed for aspiration caused by neurological diseases or head and neck cancer surgery. We report herein the use of this modified procedure against aspiration in 2 cases following esophagectomy. In the first case, a combination of cricopharyngeal myotomy, infrahyoid myotomy and laryngeal pull-up, with approximation of the thyroid cartilage against the hyoid bone and that of the hyoid bone against the mandible, were performed simultaneously with the primary esophagectomy. In the second case, cricopharyngeal myotomy, infrahyoid myotomy, laryngeal pull-up and infrafold silicone injection were performed three months after the primary operation. Good results were achieved in both cases. Thus, for any case at risk of aspiration after esophagectomy or for any case with severe aspiration following esophagectomy that does not respond to swallow therapy, these operative rehabilitation procedures should be performed before laryngectomy is considered.

Esophagectomy↗

PubMed1991

Quantification of EEG irregularity by use of the entropy of the power spectrum.

A new method for quantifying irregularity of EEGs is proposed in this study. The entropy, an information measure, determines the uniformity of proportion distribution. The peakedness or flatness of the distribution of the EEG power spectrum, representing EEG rhythmicity, can be measured by the entropy, because the power spectrum consists of proportions of power at each frequency. The irregularity of the EEG was measured by the entropy of the power spectrum, called an irregularity index (II). The II was obtained from the power spectrum at F3, F4, C3, C4, P3, P4, O1 and O2 during rest and mental arithmetic in 10 normal subjects. Relative band powers of delta, theta, alpha and beta bands and alpha peak frequency were also obtained. EEGs during rest were significantly more irregular anteriorly than in the occipital areas. Alpha activity was also more irregular in the anterior region. A greater degree of EEG desynchronization during mental arithmetic was found over the left hemisphere and the right occipital area. The II was more sensitive to such desynchronization than alpha band power and alpha peak frequency. The differences in spectral structures between rest and mental arithmetic conditions, mainly over the left hemisphere, were also confirmed by the Kullback-Leibler information.

Adolescent↗

PubMed1991

Cytoprotective activity of pectic polysaccharides from the root of panax ginseng.

An acidic polysaccharide fraction, GRA-4, of the root extract of Panax ginseng, when administered from 50 to 200 mg/kg orally, inhibited gastric lesions induced by HCl-ethanol or absolute ethanol, in a dose-dependent manner. The cytoprotective activity of GRA-4 decreased after its treatment with periodate but not after protein digestion, indicating that the carbohydrate moiety of this acidic polysaccharide contributes to this activity.

Administration, Oral↗

PubMed1991

Osteodystrophy in liver cirrhosis: detection and treatment evaluation using 99Tcm methylene diphosphonate bone scintigraphy.

To investigate osteodystrophy in liver cirrhosis, 99Tcm MDP (methylene diphosphonate) bone scintigraphy was performed on 36 patients with liver cirrhosis. Abnormal lesions were detected in 17 out of 36 scans (47.2%). On the other hand, areas of increased uptake were uncommon in patients with chronic active hepatitis (1/11 cases). Plasma vitamin D3 fractions [25(OH)D3, 24.25(OH)2D3 and 1.25(OH)2D3] were decreased. Statistically significant depletion of 1.25(OH)2D3 was observed in cases with positive bone scintigraphy. 1 alpha(OH)D3 (1-2 micrograms/day) was administered for 6 months to nine patients having abnormal bone scans. Six of them showed improvement without any apparent side-effects. We conclude that hepatic cirrhotic osteodystrophy can be diagnosed positively by 99Tcm MDP bone scintigraphy and can be treated accordingly.

Adult↗

PubMed1991

Carcinoembryonic proteins produced by Wilms' tumor cells in vitro and in vivo.

A Wilms' tumor cell line (HFWT) was established after tissue culture of the Wilms' tumor which had developed in the left kidney of a five-month-old boy. The HFWT line has the following cyto-biological characteristics: 1. The cells have a spindle, round or polygonal shape with neoplastic and pleomorphic features that grew in multilayers without contact inhibition. 2. The cells show a stable proliferation, giving 95 passages within 4 years. 3. The chromosomes show a wide aneuploidy distribution, and the modal number was found in diploid range. The stem cells have a normal karyotyping, 46, XY. 4. Heterotransplantation into nude mice can be easily made, and anaplastic Wilms' tumor resembling the original tumor forms. 5. The principal tumor markers produced by the cells in large amounts in the conditioned culture media were carbohydrate antigen 125 (CA 125) and tissue polypeptide antigen (TPA). 6. A good correlation was found between enlargement of the tumor formed by heterotransplantation into nude mice and the levels of CA 125 and TPA in the serum of the nude mouse. No report on the study of tumor markers widely used in clinical treatment of Wilms' tumor has been available to us, but CA 125 and TPA are considered to be useful in the diagnosis and treatment of Wilms' tumor.

Animals↗

PubMed1991

Carcinoid tumor of the larynx.

Carcinoid tumor of the larynx is a rare neoplasm. Two cases of laryngeal carcinoid tumor are reported and the relevant literature is reviewed. One patient was an 82-year-old male who complained of odynophagia. The tumor was located on the left arytenoid and neck metastasis were present when he died 3 years after surgery. The other patient was an 82-year-old male who complained of hoarseness. His tumor was located in the left ventricle. Bone metastasis was detected one month after surgery and he died of distant metastasis two months following surgery. A review of the literature showed that carcinoid tumors of the larynx are aggressive and malignant, with distant metastasis being the most common cause of death. This tumor is unresponsive to radiotherapy and chemotherapy, so adequate surgical excision remains the only effective treatment.

Aged↗

PubMed1991

Purification of anti-ulcer polysaccharides from the roots of Bupleurum falcatum.

A water-soluble crude polysaccharide fraction (BR-1) prepared from the root of Bupleurum falcatum L. (Japanese name = Saiko) prevented HCl/ethanol induced ulcerogenesis in mice significantly. BR-1 was fractionated into four polysaccharide fractions (BR-2, BR-3, BR-4, and BR-5) by the addition of cetyltrimethylammonium bromide, and the strongly acidic polysaccharide fraction BR-2 showed the most potent inhibition of gastric lesion formation. When BR-2 was further fractionated by anion-exchange chromatography, the most potent anti-ulcer activity was observed in the pectin-like polysaccharide, bupleuran 2IIc. Bupleuran 2IIc was homogeneous as determined by electrophoresis and gel filtration. Bupleuran 2IIc was composed mainly of galacturonic acid with small proportions of arabinose, rhamnose, and galactose, and its average relative molecular mass was estimated to be 63,000 d. BR-2 lost most of its activity after treatment with periodate or digestion with endo-polygalacturonase indicating that the polygalacturonan region and/or the molecular mass may contribute to activity.

Animals↗

PubMed1991

Mixed lymphocyte-autologous tumor cell reaction in hematological malignancies--effect of interferon-beta and correlation with the expression of MHC class I antigen on tumor cells.

The mixed lymphocyte-autologous tumor cell reaction (MLTR) was performed in 15 patients with hematological malignancies. Lymphocyte proliferative response and generation of cytotoxic cells against autologous tumor cells were evaluated and as was the effect of interferon-beta (IFN-beta) (750 IU/ml). Lymphocytes from patients during complete remission had sufficient functions in mixed lymphocyte culture with normal lymphocytes. Tumor cells stimulated allogeneic lymphocytes, although to a generally lesser extent as compared with remission lymphocytes from the same patients. Increased [3H]TdR uptake was observed in 5 patients and was suppressed by the addition of IFN-beta. Autologous tumor cell kill activity was induced by MLTR in 3 patients; IFN-beta-enhanced killing activity was present in these patients as well as in 3 other patients. Tumor cells from the 3 patients with positive autologous tumor cell kill activity had almost the same stimulating capacity as lymphocytes. The expression of MHC class I antigen and IFN-beta-enhanced expression was observed in all tumor cells studied by indirect immunofluorescence. These data suggest that some factors on tumor cells, in addition to MHC class I antigen, participate in the generation of cytotoxic cells against autologous tumor cells and its enhancement by IFN-beta.

Cytotoxicity, Immunologic↗

PubMed1991

Mineralization ability of cultured human osteoblast-like periosteal cells does not decline with aging.

Studies of the mechanisms of osteoporosis have not yet determined whether these conditions result from increased osteoclast activity or decreased osteoblast activity, or perhaps both. Osteoporosis is related to aging and to postmenopausal status. The function and the mitotic capacity of cultured human osteoblast-like cells were investigated in this study. The age at which these cells lose the ability to divide showed a strong negative correlation with donor age (r = .815, p less than .01). There was also significant correlation of maximum cell saturation density with donor age (r = .698, p less than .01). Alkaline phosphatase (ALP) activity and mineralization ability, typical functions of osteoblasts, continue undiminished up to the point at which mitotic capacity ceases. When cells were treated with 1 alpha, 25-dihydroxy vitamin D3 in the presence of 2 mM alpha-glycerophosphate, ALP activity and mineralization ability showed an increase, rather than a decrease, with advancing donor age. However, these functions showed no correlation with in vitro cell aging. We propose that human osteoblast-like cells from elderly subjects do not lose their functions of mineralization and ALP formation, and that loss of these functions with cell aging does not correlate with advancing age.

Adolescent↗

PubMed1991

In vitro and in vivo antifungal activities of BMY-28864, a water-soluble pradimicin derivative.

BMY-28864, a water-soluble pradimicin derivative, had potent in vitro activity against a wide variety of fungi, including those associated with deep-seated mycosis; it inhibited the growth of standard strains and clinical isolates at concentrations of 12.5 micrograms/ml or less. At the MIC or higher concentrations, BMY-28864 was fungicidal for Candida albicans under both growing and nongrowing conditions. BMY-28864 expressed fungicidal activity only in the presence of Ca2+, and its activity was totally diminished when ethylene glycol-bis(2-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA), a Ca2+ chelator, was added to the test medium. The effectiveness of intravenously administered BMY-28864 in vivo was examined and compared with that of amphotericin B in mouse models of fungal infections. Both normal and cyclophosphamide-treated immunosuppressed mice infected with C. albicans, Cryptococcus neoformans, or Aspergillus fumigatus responded to therapy with BMY-28864 (50% protective doses of 17, 18, and 37 mg/kg of body weight in normal mice and of 32, 35, and 51 mg/kg in cyclophosphamide-treated mice, respectively). Lethal lung infections were also established with C. albicans or A. fumigatus in cyclophosphamide-treated mice. The 50% protective doses of BMY-28864 were 15 and 23 mg/kg per dose against C. albicans and A. fumigatus, respectively. The immunosuppression induced by intraperitoneal administration of 200 mg of cyclophosphamide per kg lasted for 5 days, and total recovery was observed by day 7.

Amphotericin B↗

PubMed1991

Hepatocellular carcinomas with excessive copper accumulation: CT and MR findings.

Results of orcein staining and findings obtained with non-contrast-medium-enhanced computed tomography (CT) and magnetic resonance (MR) imaging (T1- and T2-weighted images) were compared for 53 histologically confirmed hepatocellular carcinomas (HCCs). HCCs were 5 cm in the largest diameter. Three lesions with diffuse and strong orcein staining were highly attenuating on nonenhanced CT images. Electron x-ray microanalysis of one of them revealed copper. The high attenuation value at nonenhanced CT may have been due to the abundant copper-binding protein in the cancer cells. The difference between orcein staining results and attenuation patterns at CT was statistically significant (chi 2, P less than .001). It could not be concluded that the paramagnetic effects of copper in HCC had an influence on signal intensity on MR images. The difference between orcein staining results and signal-intensity patterns on T1- and T2-weighted images was not statistically significant.

Adult↗

PubMed1991

Treatment of myelodysplastic syndromes with orally administered 1-beta-D-arabinofuranosylcytosine-5'-stearylphosphate.

1-beta-D-Arabinofuranosylcytosine-5'-stearylphosphate (fosteabine) was administered orally to patients with myelodysplastic syndromes (MDS); refractory anemia with excess of blasts (RAEB), RAEB in transformation, acute leukemia derived from RAEB and chronic myelomonocytic leukemia, in an early phase II study in a multi-institutional study. Among 62 evaluable patients, 2 patients achieved a complete remission, 6 a good response and 8 partial response by daily oral administration of 100-200 mg of fosteabine. The overall response rate was 25.8%. The response rates were almost the same among the four subtypes of MDS. Responses were reached 2-23 weeks (median, 8 weeks) after the start of therapy and continued for 3-50 weeks (median, 10 weeks). Major side effects were myelosuppression and gastrointestinal toxicities. In spite of the disadvantages, such as unpredictable absorption, this newly developed orally administrable cytarabine analogue will be a useful drug in the treatment of MDS.

Adult↗

PubMed1991

Vocal fold fixation in laryngeal carcinomas.

The mechanisms of vocal fold fixation were determined by means of a whole-organ serial section study. A total of 80 laryngectomy specimens, 36 supraglottic and 44 glottic carcinomas, was investigated. In the supraglottic carcinomas, the most frequent cause of fixation of the ipsilateral vocal fold was a deep massive tumor invasion in the arytenoid eminence and the second most frequent cause was an extensive involvement of the thyroarytenoid (TA) muscle. Fixation of the contralateral vocal fold resulted from a deep tumor invasion in the contralateral arytenoid eminence. In the glottic carcinomas, fixation of the ipsilateral vocal fold resulted from an extensive invasion into the TA muscle. Fixation of the contralateral vocal fold was caused chiefly by an invasion into the contralateral TA muscle through the anterior commissure region. It resulted occasionally from an invasion into the interarytenoid muscle and contralateral arytenoid cartilage and cricoarytenoid joint via the posterior part of the larynx.

Arytenoid Cartilage↗

PubMed1991

[Mucosal bridge of the vocal fold].

Mucosal bridge of the vocal fold is a newly recognized laryngeal disease need to be differentiated from the functional voice disorder. A 16-year-old woman with deteriorating hoarseness presented for indirect laryngoscopy and laryngofiberoscopy of just slight swelling of the bilateral vocal folds. Since the laryngeal stroboscopy revealed the decrease of wave formation at the swelling portion, we performed an endolaryngeal microsurgery and discovered a sulcus in a side of the vocal fold and a mucosal bridge in the other side. Resection of the bridge followed by the voice therapy increased the voice range and decreased the hoarseness. This case suggests that the laryngeal stroboscopy and microscopic examination with direct laryngoscopy are the most important for diagnosing the mucosal bridge of the vocal fold.

Adolescent↗

PubMed1991

[Free jejunal autograft for pharyngoesophageal reconstruction].

The complications and swallowing functions were studied in eleven patients who had undergone free jejunal autograft reconstruction after total pharyngolaryngectomy and cervical esophagotomy. All patients have had advanced cancers of the hypopharynx or cervical esophagus. Fistula was complicated in three patients (27%), including one (9%) who died of pneumonia. Death or graft necrosis was not complicated in perioperative period. There was no patient with stenosis. Radiation necrosis of the graft and skin occurred six months after post-operative 60 Gy irradiation in one patient. Ten patients of 11 regained swallowing function. An oral diet was started between 9 and 50 post-operative days, with an average of 19 days. The duration of a diet was from 20 to 60 minutes (mean: 37 to 40 minutes). Five patients could take a normal diet, while the another five ate gluel or liquid food. The free jejunal graft reconstruction of pharyngoesophagus was highly safe reliability and an advantage in an early recovery of swallowing function, but it had some problems with regard to post-operative irradiation and swallowing.

Adult↗

PubMed1991

[Correlation of clinical findings and histologic types in epithelial hyperplasia of the vocal fold].

A series of 60 cases (85 vocal folds) with epithelial hyperplasia of the vocal fold were statistically analysed between the clinical findings and histologic types to identify the significant factors predicting the presence or absence of atypia in the lesion. The factors of age, sex, appearance of the lesion, extent of the lesion and degree of limitation of vocal fold vibration showed significance and therefore were scored respectively for further analysis from -1 to +1 according to the possibility of atypia from low to high. More than half of the group without atypia had total score of 0 or less, while more than half of the group with atypia had total score of +4 or more. The difference between two groups was significantly high (p less than 0.01). This results showed that if total score was 0 or less the possibility of atypia was very low and conservative treatment including discontinuation of smoking and follow-up can be conducted, whereas if total score was +4 or more the possibility of atypia was very high and a proper biopsy followed by laser surgery is indicated.

Adult↗

PubMed1991

[Surgery of the anterior skull base for head and neck tumors].

A total of seven patients with head and neck tumors underwent a surgery of the anterior skull base in combination with an extracranial approach. Two patients had squamous cell carcinoma of the frontal sinus; one, undifferentiated carcinoma of the ethmoid sinus; two, squamous cell carcinoma of the ethmoid sinus; one, olfactory neuroblastoma; and one, recurrent squamous cell carcinoma of the nasopharynx. Two patients, one with frontal sinus carcinoma and one with undifferentiated carcinoma, developed recurrence. The former was treated with a salvage operation and the latter, with radiotherapy and chemotherapy. Six patients are alive disease free (4, 5, 6, 8, 27 and 73 months) whereas the other is alive with disease (8 months). One patient developed partial necrosis of the reconstructed bony skull base and another developed enophthalmus and temporary diplopia postoperatively. No serious complications, however, were noted in any cases.

Adult↗

PubMed1991

[Transcutaneous intrafold injection result and its influencing factors].

The result of transcutaneous intrafold injection and its influencing factors were studied for fifty five procedures in fifty two patients with unilateral recurrent nerve paralysis. Maximum phonation time, mean air flow rate and amplitude perturbation quotient of the voice were normalized or improved after the procedures more than 85%. In general assessment with functional and acoustic examinations, 76% of the procedures showed significant improvement. The paralysis after the thoracic surgery, right vocal fold paralysis and the paralysis complicated with sulcus vocalic tended to have insufficient improvement after injection. The most significant correlation to the result was shown in the degree of vocal fold augmentation immediately after injection. It was depend on the surgeon's technique and the patient's problems such as an anatomical abnormality of the larynx and an insufficient inhibition of the gag reflex.

Adult↗